Nearly 800 million people were doomed to have lupus forever. This treatment gives them hope

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 Nearly 800 million people were doomed to have lupus forever.  This treatment gives them hope
nearly 800 million people were doomed to have lupus forever.

“It’s not lupus, it’s never lupus.” With that famous (and insistent) phrase from TV doctor Gregory House, lupus has become a recurring element of popular culture for the last 20 years. However, sometimes it is lupus : specifically 0.1% of the world population (especially young women) suffer from this enigmatic disease today.

And, until yesterday, we thought they would continue to suffer from it for the rest of their lives. Now a new hope has just opened.

What do we talk about when we talk about lupus? Lupus is an autoimmune disease; that is, it is a disease in which the immune system is “confused” and ends up attacking the body itself. The direct consequence is that, since we cannot do without the immune system (and we had no way of curing it), we are facing a chronic disease that accompanies patients throughout their lives.

But that is not the characteristic of lupus, no. It is an elusive disease, rare and difficult to diagnose. The reason is simple: its symptoms are those of many other diseases. It is true that there is a skin rash on the cheeks that is very characteristic of the disease, but even then it does not always occur. Lupus appears and disappears, it is confused with other diseases and we reach its diagnosis, almost by ruling out, by accumulation of symptoms in a differential diagnosis.

And that becomes a huge problem, above all, because it is a complicated disease that can lead to enormous complications: kidney, lung, circulatory problems… A long string of symptoms that, for years, we have only been able to alleviate with immunosuppressants ; that is, to pharmacologically ‘convince’ the immune system to stop attacking the body. A relatively effective treatment, but at the same time full of problems.

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Until now. Yes, because Georg Schett and his team at the University of Erlangen-Nuremberg have managed to use a therapy that until now we used to treat leukemia, lymphoma and myeloma and cure five people of this autoimmune disease. CAR-T, as the treatment is called, involves taking blood from sufferers, genetically engineering the white blood cells, and re-infusing them into the body to do what we want them to do.

In this case, the team used white blood cells designed to eliminate antibody-producing B cells by targeting the CD19 protein on their surface. That, they were convinced, was key in the evolution of the disease. What they did not expect was to come face to face with these results.

17 months without symptoms. Without symptoms and without medication in a disease as enigmatic and treacherous as this is a spectacular result. During the follow-up carried out by the team, all patients had experienced an improvement in symptoms. Furthermore, all had experienced remission of internal organ involvement and disappearance of autoantibodies related to the disease. We are talking about curing the disease with a single application of the treatment: it is an amazingly spectacular result.

And now that? The results are so good (and the technology is so studied) that we are talking about a therapeutic option within reach. However, we must be cautious and continue monitoring these patients. In such a long illness, 17 months is a short time. The good news is that the first large clinical trials are underway to determine safety, and hopefully the next few years will see a cure for this mysterious disease.

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