In a small trial that uses cancer therapy to harness patients' own cells to treat the autoimmune condition, five seriously ill patients have seen their disease driven into remission after just one injection of modified immune cells.
Scientists are calling the results "spectacular" and "incredibly exciting", saying the findings may herald a new era of managing diseases that are difficult to treat.
It is a lifelong condition that causes organ damage on top of disabling joint pain and affects around one in 1,000 people.
There is an unclear mix of genetic and environmental factors that cause the disease.
Steroids and immunosuppressive drugs can be used to treat inflammation, but they don't remove the elements that cause the disease.
If the promising results of a new study can be replicated safely, then that may change.
The success of cell-based therapies called chimeric antigen receptor (CAR) T-cell therapies that have delivered some stunning results in blood cancers inspired researchers to try the therapy in one patient.
CAR-T therapies work by harvesting a patient's immune cells and engineering them to recognize and destroy rogue cells, be they cancer cells or other immune cells.
In the case of this particular trial, the therapy was designed to hunt down hordes of faulty B cells, specifically those adorned with a cell surfaceprotein called CD19 which in individuals with lupus pumps out autoantibodies that mistakenly latched onto the body's own cells.
The immune system attacks the tissues, causing joint pain, fatigue and skin rash.
The one-time therapy wiped out the patients' misguided B cells without causing significant side effects. The patients' symptoms improved so much that they no longer need to take the medication they used to take.
It's too early to say if the patients are cured or not, but the findings are encouraging.
The five patients have not relapsed despite a resurgence of B cells a few months after they were treated.
The new B cells haven't churned out the autoantibodies their predecessors did, so the researchers think they have succeeded in rebooting the patients' immune systems
Schett said that they were surprised at how effective it was. That blew us away.
The immune system function wasn't completely destroyed. The therapy preserved immunity to diseases the patients had previously been vaccine against.
Mark Leick, a medical oncologist at Massachusetts General Hospital, was not involved in the trial.
It will be necessary to test the therapy in larger groups of patients to see if it works for everyone. There are known side effects of CAR-T therapy that can cause systemic inflammation.
Schett's team is going to conduct another trial to see if CAR-T therapy can be used to treat other autoimmune diseases. Scientists have speculated for a long time that this might be possible.
Should the therapy prove to be safe and effective, it will be difficult to roll it out.
Since CAR-T therapies are tailored to each patient, and making the modified immune cells requires special manufacturing capabilities, it may be possible to use CAR-T therapies as the last resort for patients with severe disease who don't respond to other drugs.
The study was published in a medical journal.
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