For the first time, a Dutch person has been successfully treated for an autoimmune disease using cell therapy. The experimental treatment was applied by the Leiden University Medical Center. The treatment has already been successful several times abroad.
The patient was treated in February and had a very severe form of neurological lupus, writes the Leiden University Medical Center (LUMC) on Friday. This is an autoimmune disease in which certain cells – the so-called B cells – produce antibodies against healthy cells. As a result, the patient had, among other things, inflamed organs.
To counter this, the so-called CAR T-cell therapy is used. This treatment is currently only used against cancer. In this therapy, other immune cells – the so-called T cells – are taken from the blood and genetically modified, so that they recognize and destroy the cancer cells. The cells are, as it were, trained to fight the cancer.
Researchers have now discovered that this technique can also be used to attack cells that play a role in the development of autoimmune diseases. “Normally, your immune system should target pathogens such as bacteria, viruses or cancer,” says Margot Jak to NU.nl. She is a hematologist at the UMC Utrecht and not involved in this treatment.
In an autoimmune disease, the B cells turn against healthy cells. Therefore, the T cells in these patients are modified during treatment so that they attack these ‘wrong’ cells. “The idea is that you kill the wrong B cells. This ‘resets’ the immune system, as it were, and ensures that good B cells return.”
Treatment is promising
In this way, German researchers have cured eight patients of lupus. And now a patient in the Netherlands has also been treated in this way with the same autoimmune disease.
The Dutch patient is doing well, the LUMC reports. The hospital also reports that the patient no longer uses medication for lupus. Also, the swelling in the spinal cord has “significantly” decreased and the patient can use muscles that were previously unable to.
Jak calls the news promising. Currently, a lot of research is being done on people with an autoimmune disease in whom all other treatments have not worked. “This is certainly groundbreaking for those patients,” says Jak. “Almost all of them go into remission and seem to stay that way.”
More research needed to apply therapy broadly
There are still some caveats to be placed on the application of the therapy. First of all, it is expensive: a treatment costs around 500,000 euros according to the LUMC. There are also several side effects. CAR T-cell therapy is still experimental and is not (yet) widely used in the Netherlands for the treatment of autoimmune diseases.
Yet the LUMC received approval to administer the therapy to this patient. According to the hospital, research into the treatment is still in an early stage in the Netherlands and large-scale studies still need to be carried out. “The broad application of the treatment will take a long time.”
Jak also expects that research will be done in the near future by several Dutch hospitals into the use of CAR-T-cell therapy in autoimmune diseases. “It must first be proven effective and safe before costs for this will be reimbursed,” she says.
What is an autoimmune disease?
In healthy people, the immune system helps to stop and expel pathogens such as bacteria and viruses. In people with an autoimmune disease, the immune system attacks healthy cells.
There are different forms of autoimmune diseases. Well-known examples are rheumatism, diabetes type 1 and the muscle disease multiple sclerosis (MS). According to the RIVM, approximately one million people in the Netherlands suffer from an autoimmune disease.