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Several patients with systemic lupus erythematosus appear to be in remission after receiving a promising therapy, containing genetically modified cells (Car-T cells). A real hope in the face of a disease that is very difficult to manage.
In France, nearly 41 people out of 100,000 suffer from systemic lupus erythematosus or systemic lupus. As part of this autoimmune disease, the immune system, which protects against microbes or substances foreign to the body, becomes disrupted and turns against the body’s own cells. It thus produces specific antibodies, called auto-antibodies and a variety of white blood cells called lymphocytes.
Severe forms very difficult to treat
This attack by auto-antibodies and lymphocytes produced in excess is responsible for inflammatory reactions and damage to various tissues: vessels, skin, joints, muscles, blood cells… The manifestations of the disease can thus be rashes. , alterations in the general state of health, joint pain, but also various lesions.
In severe forms, treatment is based on taking various drugs to weaken the immune response. In severe forms, therapies against B lymphocytes can be initiated with a limit, B lymphocytes are also useful to fight against pathogens…
The treatment “resets” the immune system of the patients
In an attempt to alleviate the symptoms and damage of patients already multi-treated, researchers at the University of Nuremberg have recently developed a revolutionary therapy, based on genetically modified CAR-T cells.
As part of this trial, scientists took T cells from 5 patients, four women and one man, aged 22 on average. All were refractory to several immunosuppressive drug treatments.
The immunologists then genetically modified the CAR-T cells of the patients (which are T lymphocytes carrying a chimeric antigen receptor, created in the laboratory) in order to target CD19, a protein of the B lymphocytes, the main cause of the disease. Then, the researchers re-injected the CAR-T cells into the patients’ bodies.
For Professor Georg Schett, lead author of the study: “What’s special about this is that a single infusion of CAR T cells reduced inflammation and the autoimmune response collapsed like a house of cards. Patients were able to stop all therapy, including corticosteroids“.
CAR T cell specialist Prof. Dr. Dimitros Mougiakakos from the University of Magdeburg, who also participated in the study, speaks of a “reset button”: “It is amazing that 100 days after CAR T cell therapy, the B cells have returned, but the disease is still lagging behind. When the immune system of treated patients is examined, it is surprising that newly emerging B cells are “naïve”. So we can be sure to say that a reset button has really been pressed here.”
Promising results to be confirmed
This technique of Car-T cells is already used to treat various cancers. Although this is a study involving a limited number of patients, the results in lupus are very promising with patients in remission who no longer need other treatments. However, the data will have to be confirmed on more patients and with more hindsight.
For all these reasons, the German researchers therefore wish to continue their research. A new study should start soon and include other autoimmune diseases (myositis, systemic sclerosis). In case of confirmation, the technique already used against cancer could be quickly available, apart from any economic consideration (in the context of cancer, these treatments cost several hundreds of thousands of euros).