Doctors say the apparent success of a treatment for lupus - an autoimmune disease that can cause life-threatening damage to the heart, lungs, brain and kidneys - raises hopes for tackling other autoimmune conditions such a rheumatoid arthritis and multiple sclerosis. The Guardian reports that five people have become the first in the world to receive a therapy that uses genetically altered cells to drive the illness into remission.
The four women and one man, aged between 18 and 24, received transfusions of modified immune cells to treat severe lupus. The treatment forced the disease into remission in all five individuals, who have now been off lupus medication for between three and 17 months.
Lupus, or systemic lupus erythematosus, develops when the immune system erroneously attacks healthy tissues and organs. Researchers think it may be caused by viral infections, particular medicines, and changes in the body around puberty and the menopause.
Doctors in Germany treated five severely ill patients with CAR T-cell therapy after their symptoms did not get better following other treatments. CAR T-cell therapy involves collecting the patient’s T-cells, a vital part of the immune system, and modifying them so that they attack new targets, such as cancer cells, when infused back into the body.
In the most recent work, medics took T-cells from the lupus patients and modified them so that, when they were reinfused, they attacked the patients’ B cells. In lupus, B cells churn out autoantibodies, which instead of defending the body against invading pathogens, attack healthy tissues instead.
According to the study in Nature Medicine, the therapy effectively eliminated the patients’ aberrant B cells and dramatically improved their condition. The disease affected multiple organs in all five patients, but after the therapy severe symptoms including arthritis, fatigue, fibrosis of the heart valves, and lung inflammation all cleared up.
Blood tests on the patients showed that their B cells recovered about four months after the treatment, but they no longer produced aberrant antibodies and the patients remained disease-free. “We are very excited about these results,” said Prof Georg Schett, a rheumatologist who led the work at Friedrich-Alexander University in Erlangen-Nuremberg.
“Several other autoimmune diseases which are dependent on B cells and show autoantibodies may respond to this treatment. These include rheumatoid arthritis, myositis and systemic sclerosis. But also diseases like multiple sclerosis may be very responsive to CAR T-cell treatment.”
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