Multiple sclerosis: Might CAR-T immunotherapy help?
- About 4% of the world’s population suffers from one of more than 100 autoimmune diseases, such as B. Multiple sclerosis.
- Most drugs used to treat autoimmune diseases suppress a person’s entire immune system, leaving them vulnerable to infections.
- Researchers at Washington University School of Medicine in St. Louis discovered a cancer therapy called CAR-T that only targets the immune cells that cause the autoimmune disease, leaving healthy immune cells alone.
About 4% of the world’s total population suffers from an autoimmune disease – a condition in which the body’s immune system mistakenly attacks its own tissues and organs.
Scientists know of more than 100 different autoimmune diseases. This list includes multiple sclerosis (MS), in which the immune system attacks
In general, there is no cure for autoimmune diseases. Doctors usually treat symptoms with medications, lifestyle changes, and other treatments. Some of the
Now researchers at Washington University School of Medicine in St. Louis, MO have discovered that a cancer therapy called CAR-T can be used to target and destroy only the immune cells in a person’s body that cause the autoimmune disease, leaving healthy immune cells at rest be left.
The study was recently published in the journal science immunology.
Chimeric antigen receptor (
“T cells are specialized immune cells that can, for example, kill your own cells if they are infected with a virus,” explains Dr. Chyi-Song Hsieh, the Alan A. and Edith L. Wolff Professor of Rheumatology and Professor of Rheumatology Medicine, Pathology and Immunology at Washington University School of Medicine in St. Louis, MO, co-senior author of this study.
“This ability has been repurposed with CAR-T cells, which have been genetically engineered to target very specific cells that are undesirable in the body, such as B. tumor cells, and kill them,” he said Medical news today.
In CAR-T therapy, a doctor takes a sample of a person’s T cells from a blood sample. The T cells are genetically engineered in a laboratory setting to be CAR T cells, which are designed to attack and clear specific immune cells. The CAR-T cells are infused back into the person’s bloodstream to do their job.
Currently, doctors use CAR-T therapy to treat blood cancers, including leukemia and lymphoma. It is also being studied as a therapy for other types of cancer and to fight solid tumors.
When asked why the research team decided to investigate whether or not CAR-T therapy could be used in autoimmune diseases, Dr. Hsieh that he and the study’s other co-author, Dr. Gregory F. Wu, an associate professor of neurology, pathology, and immunology at Washington University, had previously treated autoimmune diseases like MS and rheumatoid arthritis with immunosuppressive drugs, “but that’s like slowing down the entire immune system, for just one stop a few bad cells.”
“So we have problems with people who catch a cold, but also with serious infections like COVID,” he continued. “Given the success of CAR-T cells in treating cancer, we wanted to see if this technology could be adapted to selectively eliminate only the cells directly responsible for autoimmunity.”
For the study, the researchers designed a molecule that was part of a
Scientists then make their own CAR-T therapy by placing this combo molecule on a type of T cell called a
To test their theory, the researchers applied their CAR-T therapy to mice with an MS-type disease. In analyzing their findings, the scientists found that their engineered CAR-T cells helped reduce signs of the disease in mice, which were already showing neurological effects.
In addition, it helped prevent the development of MS disease in mice that were not yet showing symptoms.
“Our research in animal models suggests that targeting autoimmune cells with CAR-T cells has the potential to treat existing diseases such as MS,” said Dr. Hsee.
“However,” he warned, “it will likely take many years before these findings can be used in patients because, unlike our animal models, we often don’t know exactly what the autoimmune cells are looking for in human autoimmunity.”
“This is an area of active investigation in the scientific community and a solvable problem. We anticipate that this type of CAR-T cell therapy, which targets only the autoimmune cells, can be used to treat and potentially cure autoimmune diseases in a few years.”
“The second important implication of our study is that it appears to be easier to prevent autoimmune diseases than to treat them,” added Dr. Hsee. “We hope that in the future it will be possible to develop therapies to prevent the development of diseases in people with a predisposition to autoimmunity.”
MNT also spoke to dr. Santosh Kesari, a neurologist, neuro-oncologist and director of neuro-oncology at the Providence Saint John Health Center, chair of the Division of Translational Neuroscience and Neurotherapy at Saint John’s Cancer Institute in Santa Monica, CA, and regional medical director of the Research Clinical Institute of Providence Southern California this study.
“This is a completely different approach to getting rid of the actual problem cells, which are usually a minority of all immune cells in the body,” he explains.
“Right now, the current approach is to get rid of most or all of the immune cells in your body. So you get rid of the bad cells, but you also get rid of the good cells. And that’s why we have side effects, risks of infection or other disorders. So this is a specific targeted intervention to just get rid of the bad immune cells and not the good immune cells,” added Dr. Added Kesari.
When asked what he would like to see in the next steps of the research, Dr. Kesari said it would need to be validated in human clinical trials as it evolved.
:The great thing about this is that while it can be more intense and expensive initially if it has a long-term shelf life, it can actually be more cost-effective in the long run. [With] We treat many of these autoimmune diseases such as MS [people] for decades. Therefore, it might actually be better for the patient and more cost-effective for the healthcare system to have a more effective approach that lasts for a long time. It’s going to take us many years to figure all that out, and human studies to figure all that out.”
– dr Santosh-Kesari