World's first discovery offers potential cure for lupus

Australian researchers are investigating ways to correct the defect that causes lupus and hope their world-first discovery will provide an effective long-term treatment.

was announced on nature communicationsMonash University-led research has discovered a way to reprogram defective cells in lupus patients with protective molecules from healthy people.

This new treatment uses human cells to restore the immune system's defenses, which prevent autoimmunity (when the immune system attacks one's own cells). This discovery concerns the autoimmune disease lupus, a debilitating disease with no cure and limited treatment options.

But researchers hope that the new method, developed in the test tube and proven in preclinical models, could be developed for other autoimmune diseases such as diabetes, rheumatoid arthritis and multiple sclerosis.

All humans have proteins that the immune system can attack, but healthy people have special cells called “regulatory cells” that prevent this from happening. T cells” or “T-reg” that protects against autoimmune diseases. These are lacking in people who have developed lupus or other autoimmune diseases.

Co-senior author Associate Professor Joshua Oye, head of the Monash University Regulatory T Cell Therapies Group, based at Monash Health, said the treatment's effectiveness was due to the identification of specific protective molecules in healthy people that could be ineffective. This was achieved by reprogramming the T cells of lupus patients and restoring their ability. Turn off unnecessary immune responses.

“We demonstrated the effectiveness of this approach using cells from human lupus patients, both in vitro and in an model of lupus nephritis.

We were able to completely prevent the development of lupus kidney disease without using the usual non-specific and harmful immunosuppressants. It's like resetting an abnormal immune system back to a healthy state, and it's like a major software upgrade. Using the patient's own cells is a very special part of this research. ”

Associate Professor Joshua Oye, co-senior author

Approximately 1 in 1000 Australians are affected by lupus, with rates higher in Indigenous communities. Nine out of ten people with lupus are women, and most develop between the ages of 15 and 45.

Co-senior author Professor Eric Morand, Associate Dean of Clinical and Molecular Medicine at Monash University and founder of the Monash Lupus Clinic, described the effectiveness of the treatment as “profound” and “situational”. “It's a game-changer,” he said.

Study patients are being managed at Monash Health, where Professor Morand is the head of rheumatology. The research team is now planning a clinical trial, scheduled to begin in 2026, to investigate whether the method could be a long-term treatment for lupus patients, he said.

“The ability to specifically target immune defects that cause disease without having to suppress the entire immune system is game-changing,” he said. “Even if the effects are medium-term, we are confident that the treatment can be easily repeated if necessary.”

Associate Professor Oi previously discovered that a lack of certain T-regs, which prevent the immune system from targeting the body, can lead to autoimmune diseases. The new treatment involves taking blood cells from lupus patients, modifying them in the lab to restore this protective effect, and then returning the blood cells.

“This project relies on the generous participation of patients, which allowed us to use human lupus cells at every step,” said Associate Professor Oi. “This allows us to study conditions as close to human diseases as possible in the laboratory.

“This is a unique feature of Monash University: state-of-the-art laboratories are located next to clinicians and patients, in this case at Monash Health.”

Co-lead authors Peter Eggenhuizen, a PhD candidate and research fellow at the Center for Inflammatory Diseases at Monash University, and Dr Rachel Chong, a former PhD candidate at the Center for Inflammatory Diseases at Monash University, said the new method could up to We are confident that we can develop this product for patients of all ages. and 100 other autoimmune diseases, including diabetes, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, scleroderma, and myasthenia gravis.

“This breakthrough offers great hope not only for lupus, but for a variety of autoimmune diseases,” Eggenhuizen said. “There is a very wide range of autoimmune diseases that could be targeted by this approach.”

Dr Chong added: “What's great is that this treatment is so specific that it doesn't negatively impact the rest of the immune system. But this means that treatments need to be carefully developed for each disease. means. is distinct.”

The research was supported by multiple national and international institutions, including the New York-based Lupus Research Alliance, and was part of a series of studies for which Professor Morand and Associate Professor Oi were awarded the 2022 Life Sciences Science Innovation Award. .

Case Study – Vu Nguyen

Vu Nguyen, 39, was diagnosed with lupus in 1995 at the age of nine after developing swelling and pain in her joints. Nearly 30 years later, Vu has experienced a variety of symptoms, kidney biopsies, and hospitalizations. She suffered a stroke when she was 22 years old and currently suffers from epilepsy secondary to lupus.

It took years to stabilize Vu's condition, which led her to found Lupus Victoria. Vu, who has a master's degree in marketing, is pursuing a postgraduate qualification in psychology so she can counsel people with the disease.

“My main symptoms are kidney failure and epilepsy,” Vu said. “With lupus, things change all the time. I'm currently in remission, but I've had a lot of ups and downs because of this disease. I think lupus has made my body more prone to strokes and subsequent epilepsy. I think, I'm fine.'' So far, the epilepsy is the only thing ravaging my body.

“This new treatment really helps people living with lupus. If this treatment had been done about 30 years ago, it would have made a huge difference for me. We can really cut back on different types of drugs. With this treatment, we can do something like, 'Maybe you only need one treatment. ”