Scientists used a technique normally used to treat cancer to treat five patients with the hard-to-treat disease. Five patients with the disease stopped their standard treatments after one-time therapy.
Before this treatment can be approved for widespread use, it needs to be tested in larger groups of people with the disease. If the results hold up in larger trials, the therapy could one day help people with moderate to severe lupus.
Dr. Schett is the director of rheumatology and immunology at Friedrich Alexander University Erlangen-Nuremberg. The report about the small trial was published in the journal Nature Medicine.
Patients stop all treatments when they get a single shot of CAR T cells. We were surprised by the effect.
Scientists have proof of immune cells in humans.
The immune system mistakenly attacks the body's own cells, causing inflammation, tissue damage, and pain. Patients take multiple drugs to reduce the severity of the symptoms, which range from mild to life threatening.
The body's cells and other cells can be destroyed by the B cells that summon them. There are several medications that target B cells, but they don't work for everyone.
Schett said that there is a group which is very severe and they cycle through many therapies.
CAR T-cell therapy, which has previously been used to treat cancer patients, could be used to treat treatment-resistant lupus patients. During CAR T-cell therapy, doctors extract immune cells, called T cells, from a patient's blood, genetically modify those T cells in the lab and then inject them back into the patient's body. The engineered T cells in approved cancer therapies wipe out both problem and healthy B cells.
CAR T-cell therapy carries a risk of triggering "cytokine release syndrome," in which T cells suddenly unleash a flood of inflammatory molecule into the bloodstream, if the B cells are not present. The treatment is not appropriate for people with only mild disease.
Schett and his colleagues recruited patients who were resistant to treatment for their trial.
The new tool estimates your immune age.
The B cell counts of all five participants plummeted. No patients have relapsed after they stopped taking their prior medication. A patient who was the first to be treated has been drug-free for 17 months.
Schett said that she lived a normal life.
Five months after treatment, the patient's B cell count began to rise but her symptoms didn't come back. The bone marrow began making new B cells that don't pump out the same autoantibodies after the B cells were destroyed.
The other four patients made new B cells without relapsing. Schett said that it seems as though rebooting the B cell system in this way may prevent the disease from returning.
Jean Yean-jin Lin, an instructor of medicine at the Feinberg School of Medicine, was not involved in the trial. Lin told Live Science that it was possible that naive B cells could become autoreactive.
She noted that none of the patients developed cytokine release syndrome or other serious side effects. Ronald van Vollenhoven, a professor of rheumatology at Amsterdam University Medical Centers who was not involved in the trial, told Live Science that more side-effects will come to the surface when more patients are treated.
A bigger trial of CAR T-cell therapy is being planned by Schett and his team. Schett said that the therapy could be tested as a treatment for a number of autoimmune disorders.
If CAR T is approved, it would be an option for patients who have failed other treatments for SLE. The question is if this novel therapy can achieve long- lasting remission or even cure.
The potential for CAR T to change the immune system is exciting.
It was originally published on Live Science
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