It’s like turning something off and on again. But that something is the immune system.
In the new study, all five participants went into remission without needing additional drugs beyond the genetically engineered CAR-T cells. The target of those engineered cells — immune cells key for fighting off infections — returned a few months after being wiped out. Some of those cells are primed to attack viruses and bacteria but not the study participants’ healthy cells..
The antibody-producing cells, called B cells, disappeared from blood samples as the CAR-T cells killed them off. But B cells are an important defense against infectious diseases such as measles. Luckily, the immune cells weren’t gone permanently, says Schett, of Friedrich-Alexander-Universität Erlangen-Nürnberg in Germany. A few months later, the patients’ bone marrow had made more. The B cells were back; the lupus was not.
Typically, the immune system has checkpoints that eliminate cells that attack the body instead of a foreign invader. Autoimmune diseases such as lupus occur when these cells that recognize and attack “self” escape scrutiny. For lupus to come back, Schett says, the same mistake may need to happen twice. “So far we think the disease is gone.”
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