2023-09-27 00:19:08
Immune-mediated diseases
Updated Wednesday, September 27, 2023 – 00:19
During the last year, new biomarkers implicated in lupus have been discovered. In addition, new medications are being incorporated, each time less toxic, and promising results are beginning to be seen in clinical trials with CAR-T therapy.
ANDPANIK HAKOBYAN
New biomarkers involved, drugs that have just been approved by regulatory agencies and important clinical trials underway that are beginning to give surprising results… this is the scenario that, in recent times, is fueling the hope of people with lupus, a condition in which the immune system produces antibodies that attack tissues and organs such as the skin, the kidneys, the heart and the lungs, among others, to the point of being able to compromise life. Such was the case, for example, of the Twin Peaks soundtrack singer, Julee Cruise, in June of last year.
A few months later, the media surprised with very exciting news: the first successful case of CAR-T cellular immunotherapy against this disease. It was about an affected young woman from whom cells from her own immune system were extracted to be genetically modified and reintroduced. After this experimental treatment, applied at the University Hospital of Erlangen (Germany), the patient began to notice the remission of symptoms and even the antibodies related to the condition disappeared.
Having repeated the achievement in four other patients, an international study was started at the beginning of this year in which two Spanish hospitals participated: the Vall d’Hebron in Barcelona and the Gregorio Marán in Madrid. The expectation is served, but without forgetting the prudence that must be accompanied by any clinical trial. It is necessary to confirm results in a larger population and verify them with long-term follow-up.
Meanwhile, we must continue investigating the possible origin. Although it is known that genetic and environmental factors influence it, the cause of this autoimmune disease is still unknown and, as stated by Ana Pérez Gómez, head of the Rheumatology Section at the Hospital Príncipe de Asturias HUPA-Alcal de Henares, knowing the trigger helps end the disease. Of course, a lot of progress has been made in recent years.
According to the specialist, apart from improving early diagnosis, new therapeutic agents have been added and the management of the oldest ones has been improved, which results in changes in the prognosis and reduction in the lethality of the disease. For example, we are using corticosteroids less, so cardiovascular risk and infection risk are being reduced, the expert argues. It helps a lot to have several options Biological drugs (less toxicity and fewer side effects): rituxime, belimumab or anifrolumab, the latest to join the lupus therapeutic arsenal.
None works for everything or everyone because the disease is very heterogeneous, warns Prez Gmez. In fact, experts point out that in 20% to 30% of those affected the disease cannot be controlled and this has irreversible implications and damage. In the words of rheumatologists, it increases cardiovascular risk, can affect lung capacity, inflammation of blood vessels, strokekidney damage…. Precisely, the singer and actress Selena Gómez had to undergo a kidney transplant due to the evolution of lupus.
butterfly rash
It is a potentially serious disease that deserves a diagnosis as early as possible and the more and better treatments that are added, the easier it will be to stop the damage it causes.
It should be remembered that lupus affects about 80,000 people in Spain, which It is more common in women (nine out of ten adults) and, usually, in ages between 20 and 40 years. It is characterized by outbreaks with very diverse symptoms: fatigue, joint pain, dry eyes, headache, photosensitivity, sun allergy, erythematous lesions… The most characteristic is a red butterfly-shaped skin rash on the cheeks and nose. after sun exposure.
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