Pioneer for Innovative Cell Therapies
For the first time, a cancer immunotherapy was successfully used to treat the previously incurable autoimmune disease lupus with the participation of a Magdeburg scientist.
A team of scientists in Germany has successfully treated five patients suffering from severe lupus with a so-called CAR-T cell therapy. CAR-T cell therapy has so far been used mainly in the treatment of blood cancer. Prof. Dr. Dimitrios Mougiakakos, Director of the University Clinic for Hematology and Oncology Magdeburg, is part of this expert group. The latest treatment results were published in the journal Nature Medicine. Already at the end of 2021, Prof. Mougiakakos published as first author in the New England Journal of Medicine, a paper on a young patient with lupus who was successfully treated with CAR-T cells for the first time worldwide.
Photo: Prof. Dr. Dimitrios Mougiakakos, Director of the University Hospital for Hematology and Oncology Magdeburg.
Photographer: Sarah Kossmann/UMMD
Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system turns against its own body. Autoantibodies are produced by B cells that, instead of protecting the body against invading pathogens, attack healthy tissue. SLE sometimes manifests as a severe inflammatory disease and in some cases can cause life-threatening damage to the heart, lungs, brain and kidneys. Approximately one in 1,000 people is affected, far more of them women than men.
Prof. Mougiakakos explains the approach of the scientists and the treatment method of CAR T-cell therapy: "In the two studies presented here, the patients' own T cells - a key component of the immune system - were removed and genetically reprogrammed into so-called chimeric antigen receptor (CAR) T cells, which recognize certain characteristics in B cells and then destroy them. Subsequently, this 'living drug' was administered to the patients as an infusion. The goal was to eliminate the harmful B cells as well. The clinical symptoms and laboratory results of the patient in our 2021 case report improved rapidly, and further treatment for her SLE was no longer necessary." And the most recent results from the five patients in the Nature Medicine paper also confirmed these positive results. The clinical picture improved dramatically and organ damage, some of it severe, was resolved.
Prof. Mougiakakos speaks of a possible immunological "restart" triggered by CAR-T cell therapy, since after a certain time the B cells return, but these do not produce any autoantibodies and the patients thus remain disease-free.
The oncologist underlines the importance of the results: "This work could be the prelude to a completely new approach to treating autoimmune diseases. Several other autoimmune diseases that are co-caused by B cells could respond to such a treatment. It is therefore of particular importance to me that we, together with colleagues from Halle (Saale), make Saxony-Anhalt a pioneer for innovative cell therapies.
- Mougiakakos D et al., CD19-targeted CAR T cells in refractory systemic lupus erythematosus. New England Journal of Medicine 2021. 385(6):567-569. doi: 10.1056/NEJMc2107725.
- Mackensen D et al., Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus. Nature Medicine 2022. Online ahead of print. doi: 10.1038/s41591-022-02017-5.