A study published in the journal Nature Medicine has tested a therapy based on CAR-T cells - T lymphocytes modified in the laboratory - to treat five patients with systemic lupus erythematosus who did not respond to conventional treatments. According to the study, the symptoms subsided in all of them and the improvement was maintained throughout the duration of the study.
Ignacio Melero - Reacción lupus y CAR-T (EN)
Ignacio Melero
Professor of Immunology at the University of Navarra, CIMA researcher and co-director of the Department of Immunology and Immunotherapy at the Clínica Universidad de Navarra.
This is an article of great interest. As is known, adoptive cell therapy with engineered CAR-T cells to destroy B lymphocytes achieves spectacular results against certain types of leukemia and lymphoma. In addition to destroying malignant cells, it is known to destroy all B cells in the body very efficiently. The researchers in this study, who are aware of the role of B lymphocytes in the pathogenic mechanisms underlying systemic lupus erythematosus, have tested the treatment in five patients with very severe lupus, particularly due to kidney damage. The results in these five patients are very encouraging, both from clinical and analytical observations.
These results need to be extended to a larger series of patients, but the treatment seems reasonably safe in terms of risk-benefit and in these five cases it appears to be effective. It could be thought that the B cells that produce autoantibodies in lupus are already plasma cells that are in principle insensitive to the CAR CD19, since as they differentiate (specialize) they lose the expression of this CD19 target. However, the data are solid in the sense that this time of elimination of B lymphocytes is active against severe cases of systemic lupus erythematosus with poor response to conventional therapies. This is pioneering work and paves the way for adoptive cellular immunotherapy in autoimmune diseases.
