Dr Oscar Duke has revealed a groundbreaking therapy that could 'reset' the immune system for lupus patients, offering hope to tens of thousands in the UK living with the incurable condition. Speaking on BBC Morning Live, he described the approach as a 'control, alt, delete' for the immune system, but cautioned it may carry drawbacks.
What is Lupus?
Lupus, or systemic lupus erythematosus, is a long-term autoimmune disease where the immune system attacks healthy tissues and organs. Its cause is unknown, and diagnosis is challenging due to highly variable symptoms. Dr Duke noted that during medical training, students learn lupus 'can cause almost any medical symptom that you can think about,' with manifestations 'far too many to list.'
The NHS lists symptoms including joint and muscle pain, extreme tiredness, facial rashes triggered by sunlight, headaches, mouth ulcers, high temperatures, hair loss, weight loss, swollen glands, depression, anxiety, chest or stomach pain, and changes in finger or toe colour in cold or stress. Symptoms can flare up and remit, but some patients experience persistent issues.
Current Treatments and Their Limitations
Existing treatments dampen the immune response to prevent it attacking tissues, but this leaves patients vulnerable to infections. Dr Duke explained that this trade-off is a major drawback.
The Breakthrough: CAR T-Cell Therapy
CAR T-cell therapy offers a new approach. Dr Duke outlined: 'In your blood, you've got the white blood cells that fight infections, but they're also the ones that are attacking you in an autoimmune condition. You've got B and T cells in a soup mixed up together. It tends to be the B cells that are the trigger of these sorts of autoimmune problems.'
The therapy involves extracting T cells, modifying them to target and eliminate B cells when reintroduced to the body. While this removes the harmful B cells, it also destroys 'good B cells.' Dr Duke warned: 'So for a period of time until that all regrows and resets, you're also going to be at a higher risk of other infections that the good B cells might have protected you from.'
Promising Results and Future Potential
Three years after treatment, some lupus patients show no signs of the condition. Dr Duke added that if the therapy proves effective for lupus, it could work for other autoimmune conditions like rheumatoid arthritis. The therapy represents a significant advancement, but the infection risk remains a key concern.
