The cure for lupus, an autoimmune disease that seriously attacks different organs and tissues of the patient, seems to be getting closer. Now, scientists in Germany have shown that a single therapy, called CAR-T, has made lupus remission possible in 5 patients for 17 months, without any medication involved.
The study describing the cases was published in the journal Nature Medicine and was led by German rheumatologist Georg Schett from the University of Erlangen-Nuremberg. To date, there is no cure for lupus, so there are only treatments that control its symptoms, such as arthritis and inflammation of the heart, kidney, lungs, and brain.
CAR-T: A cellular treatment to remit lupus
CAR-T therapy consists of modifying T lymphocytes to order them to eliminate B lymphocytes because, instead of producing antibodies that defend our body, they produce antibodies that attack it and trigger the disease. Recognition of B lymphocytes is made possible by an antigen known as CD19 on their surface, the same antigen found in malignant leukemia and lymphoma. For that reason, this therapy has initially been used to treat blood cancer.
Although CAR-T is feasible, its procedure is complex because it requires obtaining cells from each patient, cultivating them in the laboratory, and re-inserting them. For the same reason, it is not cheap either: in Spain it costs €320,000, as the Spanish newspaper El País points out.
“Doable, tolerable, and very effective”
The research was carried out on 4 women and 1 man, with an average age of 22 years, who did not respond to common therapies. All had systemic lupus erythematosus (SLE), the most common type of lupus and the one that affects more parts of the body. Lupus affects 0.1% of the world’s population, possibly for genetic reasons, but is prevalent in young women.
After the treatment, all the volunteers experienced a remarkable recovery: the malignant antibodies and their symptoms disappeared and they no longer needed any other type of medication. For that reason, German scientists have described it as “feasible, tolerable and very effective” in their article. “We are very excited about these results”, said Schett. “Several other autoimmune diseases that are dependent on B cells and display autoantibodies may respond to this treatment. These include rheumatoid arthritis, myositis, and systemic sclerosis. But also diseases like multiple sclerosis can be very sensitive to CAR T-cell treatment”, he added. On the other hand, the Spanish immunologist Carola García de Vinuesa said in an interview with El País: “I think it is enough to be moderately optimistic. It can be a very good treatment, especially for patients with severe disease”.