Systemic lupus erythematosus (SLE) is an autoimmune disease that is characterized by the formation of autoantibodies, organ damage, and inflammation mediated by the immune system. The disease also predominantly affects young women. Although overly reactive B-cells play a large role in the disease, therapies that create antibodies against B cells, reducing their numbers, have had little effect in treating the disease. The limited effectiveness of these therapies are possibly due to the inaccessibility of the auto-reactive B-cells within the lymphatic system and inflamed tissues.
In this study, doctors at the Universitätsklinkium Erlangen in Germany were able to treat SLE in a 20 year old female patient using chimeric antigen receptor T-cell (CAR-T) therapy, a therapy typically used to treat aggressive B-cell cancers. CAR-T therapy was used to deplete her population of circulating B-cells using genetically modified T cells that were able to recognize the CD19 antigen, biomarker, on B-cells and attack them. The reduction in the number of circulating B-cells reduced the amount of autoantibodies produced, resulting in remission of her SLE. The patient's Systemic Lupus Erythematosus Disease Activity Index score decreased from a 16, pre-treatment, to a 0 after completion of the CAR-T therapy. This study proved that the use of CAR-T therapy to attack the antigens on B-cells can be used to treat SLE and possibly other autoimmune disorders.
Mougiakakos, D., Krönke, G., Völkl, S., Kretschmann, S., Aigner, M., Kharboutli, S., Böltz, S., Manger, B., Mackensen, A., & Schett, G. (2021). Cd19-targeted car t cells in refractory systemic lupus erythematosus. New England Journal of Medicine, 385(6), 567–569. https://doi.org/10.1056/nejmc2107725
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