Cure for Lupus? Patients revert disease after experimental treatment

A group of German researchers has revealed that they have used the cells of lupus patients themselves to treat the disease. Although the sample size is small, the results are remarkable: five people went into remission after receiving the experimental treatment.

Lupus is an autoimmune disease that causes defense cells to attack healthy cells in the body, causing inflammation in tissues and organs – joints, skin, eyes, kidneys, brain, heart and lungs.

“This is as close to a cure as we can get”, said Hoang Nguyen, director of the Lupus Research Alliance. The researchers “corrected for cells that produce antibodies against the body’s own tissues,” added the expert, who was not involved in the study.

The approach is known as CAR-T therapy and has been used to treat some aggressive types of cancer. The treatment involves modifying T cells, which are fundamental to the immune system, turning them “into killers” that “effectively fight a specific target in the body”, reported the study. wired. In this case, the target is B cells, which produce antibodies.

Last year, through the same treatment, a lupus patient came into remission. In this new investigation, recently published in Nature Medicinefour more people were followed up, to whom the same thing happened.

The procedure involves removing T cells of patients and their genetic transformation, making them able to recognize a protein called CD19. This appears on the surface of antibody-producing B cells. The modified T cells are then introduced into the patients.

After about 100 days, patients undergoing this therapy began to grow new B cells – but they did not produce harmful antibodies. In fact, these harmful antibodies had completely disappeared.

One of the treated individuals is symptom free for 17 months – the longest period recorded. The others are in remission for five to 12 months. All of them stopped taking medication for the disease, including immunosuppressants.

According to the Lupus Foundation of America, the disease affect about 1.5 million people in the United States and 5 million worldwide, mostly young women.

Most patients are treated with steroids and immunosuppressants, but these make the body more vulnerable to infection and often have side effects. New drugs, designed to protect the body from attacking itself, may help some patients, but not all.

“This impressive study adds to a growing body of evidence” that identifies CAR-T therapy as “a therapeutic option for diseases” beyond cancer, including autoimmune diseases such as lupus, said Jonathan Epstein, scientific director of the School of Medicine. Perelman Medicine at the University of Pennsylvania.

In cancer patients treated with CAR-T therapy, rates of remission complete reach between 68 to 93%, but relapses occur in 40 to 50% of cases. These may also develop an inflammatory reaction called cytokine release syndrome. In the case of lupus, treated patients experienced mild side effects, including fever.

When CAR-T treatment is used in cancer, the modified T cells have to fight a high number of tumor cells at the same time, which can overload the immune system and unleash a cytokine storm. In autoimmune diseases, the number of B cells “is much lower”, explained Georg Schett, vice president of research at the University of Erlangen-Nuremberg in Germany, who was part of the team responsible for the study.

The German team now plans to proceed with a larger study, in which they intend to treat patients with different types of autoimmune diseases, such as rheumatoid arthritis and scleroderma.

While these initial results are promising, the complexity and cost of CAR-T therapy limit its use in the near future, said the wired.

Currently, CAR-T therapies for cancer cost about 400 thousand dollars – value of a single infusion. Hoang Nguyen believes that initially and because of all the constraints, the treatment could be used as a last resort in patients with severe lupus who do not respond to medication.

Taísa Pagno //

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