Five lupus patients enter long-lasting remission after immunotherapy
Scientists in Germany have reported that five patients undergoing an experimental treatment for lupus have all entered remission for up to 17 months. The promising breakthrough came from the use of CAR T cell immunotherapy, an emerging treatment for diseases like cancer.
Systemic lupus erythematosus (SLE, or just lupus) is an autoimmune disease that affects most of the body. Immune cells mistakenly attack healthy tissues, resulting in a range of symptoms from fever, fatigue, joint pain and skin rashes up to severe damage to vital organs including the heart and kidneys. Symptoms can be persistent, or come and go in flares followed by periods of remission.
While there’s currently no cure, treatment options include glucocorticoids that reduce inflammation, therapies that quiet immune cells, or drugs that help with pain flares. But now, scientists at the University of Erlangen–Nuremberg in Germany have demonstrated promising results with a new experimental treatment – chimeric antigen receptor (CAR) T cell therapy.
This treatment is a form of immunotherapy that’s currently under investigation as a treatment for cancer, with exciting signs of success. It involves removing immune cells from a patient’s body, engineering them to hunt down a specific target, then returning them to the body to get to work.
In this case the target was CD19, a protein expressed on the surface of B cells, the immune cells that go rogue during lupus. The team administered the CAR T cells to five patients with active lupus, including four women and one man all in their late teens and early 20s.
And sure enough, the results were impressive. The CAR T cells expanded rapidly through the patients’ bodies over the first 10 days before dropping off, which reduced their B cells below detectable levels. When the scientists followed up between three and 17 months after the treatment, all five patients had entered and remained in remission, with their symptoms fading to the point where they no longer needed their usual drug routines.
Intriguingly, patients’ B cell populations bounced back in the months after treatment, but the new ones were “naive,” meaning they no longer had the antibodies that caused them to attack the body’s own cells. The team says that this suggests that effectively, “rebooting of the immune system may occur after CAR T cell treatment.”
Importantly, side effects seemed mild, like fever for a few days, and the team reported no infections.
These results may point to a potential new therapy for lupus, and perhaps even other autoimmune diseases. However, future clinical trials will be needed, with larger cohorts and longer follow-up periods, to fully assess the safety and efficacy of CAR T cell therapy for these kinds of illness.
The research was published in the journal Nature Medicine.
Source: Springer Nature via Scimex