new study uses immune cell therapy to put autoimmune disease into remission
the study found that the cancer treatment, car t-cell therapy, shows promise for treating various autoimmune diseases, inducing remission in all participants.
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a new one-time injection treatment for autoimmune disease showing promise in clinical trials.
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a recent study published in the new england journal of medicine has found a new way to treat autoimmune diseases, including systemic lupus erythematosus (sle), idiopathic inflammatory myositis, and systemic sclerosis. the study utilized car t-cell therapy to determine if it could provide drug-free remission for long-term relief of symptoms and damage reduction in people with autoimmune disease.
car t-cell therapy is a type of cancer treatment that uses genetically altered immune cells, known as t-cells, to attack and destroy cancer cells. the therapy has been proven effective in inducing remission in people with autoimmune disease, which is typically only achieved using long-term immunosuppressive drugs, a mainstay therapy for autoimmune disease.
car t-cell therapy versus immunosuppression
immunosuppressive drugs were first introduced in the mid-20th century and, since then, have been used to treat various autoimmune diseases and reduce the risk of organ rejection in transplantation. the drugs work by inhibiting the action of the immune system, which is often needed in autoimmune disease because the immune cells attack their healthy host, causing damage to various bodily systems and organs and the ensuing symptoms.
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while immunosuppressants are successful in the treatment of some autoimmune diseases, they are not without fault. aside from the side effects, such as weight gain, osteoporosis, diabetes, and high blood pressure, to name a few, long-term suppression of the immune system puts a person at an increased risk for developing life-threatening infections and malignancies such as cancer.
immunosuppressants also have to be taken diligently by patients with autoimmune disease, as missing just a single dose can severely impact the course of the disease, causing a flare-up. since autoimmune diseases are progressive and can lead to severe damage, finding something that stops immune cells from killing healthy tissue long-term is vital for patients’ quality of life and life expectancy.
car t-cell therapy, on the other hand, is administered as a single injection designed to provide long-term remission in people living with various immune-related disorders. the treatment has been most notably used for cancer because of its effect on cancer cells.
car t-cell therapy works by combining the body’s own t-cells, specialized white blood cells produced in the bone marrow to fight cancer and other diseases and infections, with chimeric antigen receptor (car) in a lab. the alteration of the cells with car creates new cells that can bind to specific proteins on cancer cells, killing the cell in the process.
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in autoimmune disease, these cells are tweaked to attack autoreactive b-cells, which create autoantibodies, cells designed to produce antibodies to fight infection, cancer, and disease.
while b-cells are an essential part of the immune response in healthy individuals, in those with autoimmune disease, they act as soldiers on the wrong side of the war, killing a person’s healthy cells. because of that, killing them off can lead to fewer immune attacks on healthy tissues within the body.
the study results
the study, “cd19 car t-cell therapy in autoimmune disease—a case series with follow-up,” evaluated 15 patients with various autoimmune diseases. out of the 15 patients, eight had severe sle, 3 had idiopathic inflammatory myositis, and 4 with systemic sclerosis. the therapy was given in one single injection to all 15 patients.
before receiving the injection, the patients were given chemotherapy drugs to help prime the immune system and the body to receive the t-cell therapy. this method, called preconditioning, helps ramp up the body’s immune and metabolic systems to handle the effects of more potent treatments.
after the injection, the study participants were asked to stop all immunosuppressant medication entirely. they were closely monitored over the course of two years to track the effects of the injection on their disease progression and symptoms.
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the results showed that all patients responded positively to the treatment. the people with sle and idiopathic inflammatory myositis experienced full remission, with a complete resolution of symptoms. those with systemic sclerosis also saw a significant improvement in symptoms and reduced disease severity.
while the results seem promising, there were some side effects to note in some of the patients. cytokine release syndrome (crs), a physiological process that occurs when the immune system overreacts to infection or drugs, can occur in these types of therapies, but they vary in severity.
grade 1, mild crs requiring minimal care, happened in 10 patients. one patient experienced a more severe form of crs, grade 2, requiring hospitalization. even with the potential for crs with this type of treatment, the results show car t-cell therapy to be a potentially safe and effective avenue for long-term remission in various autoimmune diseases.
future directions for autoimmune disease treatment
there is currently no cure for autoimmune diseases. globally speaking, these types of diseases are also on the rise, affecting more and more individuals every day. while current therapies do work for some, they come with long-term adverse effects and a decreased quality of life for many who take them.
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due to the success of car t-cell therapy, the treatment could be added to the list of primary autoimmune disease interventions, but only after more clinical studies are conducted to solidify the results of this study further, and confirm that they do more good than harm in terms of sustainable and long-term autoimmune disease remission.
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