Patients with SLE produce autoantibodies for years before clinical disease appears and progress through normal immunity to benign immunity to pathogenic autoimmunity and, finally, to clinical disease. Even young children with pediatric SLE may produce antinuclear autoantibodies but have a normal B cell profile and no clinical disease, he said. This can progress rapidly to a dysregulated B cell profile and, presumably, epigenetic marking that could allow those patients to be targeted for particular B cell therapies, he said. Chimeric antigen receptor (CAR) T cell-based therapies are another intriguing area of lupus research.5
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Explore This IssueJanuary 2018
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“I don’t think we are yet at the point to use an antigen-specific approach in lupus, but I think the CAR T cells, particularly C-19 CAR T cells, that deplete B cells and a major fraction of positive C-19 plasma cells, could be used for that desired, persistent, profound B cell depletion.”
Susan Bernstein is a freelance journalist based in Atlanta.
- Mohan C, Putterman C. Genetics and pathogenesis of systemic lupus erythematosus and lupus nephritis. Nat Rev Nephrol. 2015 Jun;11(6):329–341.
- Rovin BH, Furie R, Latinis K, et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: The Lupus Nephritis Assessment with Rituximab study. Arthritis Rheum. 2012 Apr;64(4):1215–1226.
- Wei C, Hill A, Smith K, et al. B cell abnormalities in patients with chronic cutaneous lupus erythematosus [abstract]. Arthritis Rheumatol. 2017;69(suppl. 10).
- Scharer CD, Blalock EL, Barwick BG, et al. ATAC-seq on biobanked specimens defines a unique chromatin accessibility structure in naive SLE B cells. Sci Rep. 2016 Jun 1;2016(6):27030.
- Ellebrecht CT, Bhoi VG, Nace A, et al. Re-engineering chimeric antigen receptor T cells for targeted therapy of autoimmune disease. Science. 2016 Jul;353(6295):179–184.