Three lupus patients in the UK have received groundbreaking new treatment which could end the need for lifelong drugs.
A new NHS trial is assessing the effectiveness of CAR T-cell therapy previously only used on cancer patients as a one-off treatment against the most serious form of lupus.
The auto-immune disease can cause potentially fatal damage to the heart, lungs, brain and kidneys.
One of the patients, 50-year-old mum-of-three Katie Tinkler, said: If this works, its life changing.
Up till now, theres never been anything for lupus that is a possible cure.
The dream is to be lupus-free that would be phenomenal.
CAR T-cell therapy works by genetically modifying the bodys own immune system to recognise and attack problem cells (Picture: PA)What is lupus?
Lupus is a chronic autoimmune condition which causes the bodys immune system to attack the bodys own tissues instead of things like harmful bacteria.
There are two main types, affecting a total of 70,000 people in the UK: discoid lupus and systemic lupus erythematosus (SLE).
Discoid lupus, the more common type, only affects the skin, causing round lesions typically sun-exposed parts of the head and neck but also sometimes on the arms and trunk.
SLE can affect many different parts of the body including the joints, kidneys, brain and other organs.
People with SLE develop discoid lupus lesions fairly often, although people with discoid lupus rarely get SLE.
The cause of lupus is not clearly known, however research suggests some people may be genetically predisposed to it.
CAR T-cell therapy works by genetically modifying cells to restore the bodys ability to attack problem cells.
Some lupus patients were treated this way in Germany last year and are now in remission, with no need to take lupus-related drugs anymore.
Professor Ben Parker, consultant rheumatologist and study lead at the Manchester Royal Infirmary, said: We are delighted to be the first to deliver this fantastic research in the UK, which we hope will revolutionise treatment for patients with high-risk lupus, that could potentially lead to a cure for the disease.
Lupus is a disease that requires lifelong medication, but this therapy has the potential to change that, which is incredibly exciting.
The trial took place at University College London Hospitals NHS Foundation Trust (Picture: PA)What are the symptoms of lupus?
Discoid lupus typically appears as scaly or crusty coin-shaped rashes on the skin, which can be painful, and are triggered or worsened by sun exposure.
They usually appear on the cheeks, ears and scalp, where they often cause localised hair loss.
The main symptoms of SLE are joint and muscle pain, extreme persistent fatigue and discoid rashes that usually come on after going in the sun.
The NHS also lists the following less common symptoms: headaches, mouth ulcers, a high temperature, hair loss, weight loss, swollen glands, usually in the neck, armpits or groin, depression and anxiety, chest or tummy pain, and changes in the colour of your fingers and toes when youre cold, anxious or stressed.
This groundbreaking new therapy marks a significant milestone in our research into lupus.
Prof Parker said the treatment involved programming the CAR T-cells, adding: Ultimately, it offers a very radical treatment for lupus compared to whats currently available.
What currently is available are treatments that suppress the immune system, that you have to continually take, that are partially effective in most people, very effective in a few people and ineffective in a substantial number of patients with lupus.
The CAR T treatment offers something very different. In those people whove received it, they have been able to stop their immunosuppression after receiving CAR T and remain in whats called drug-free remission.
What are the current treatments for lupus?
There is currently no confirmed cure for lupus, but symptoms can be managed especially if treatment starts early.
Treatment for discoid lupus includes very strong steroids, either applied as topical cream or injected into the lesions.
Patients are also told to stop smoking and use sunscreen that protects against both UVA and UVB light.
If these dont do enough, a range of other oral and topical drugs have been used to varying degrees of success as well as dye lasers.
The treatment for SLE varies depending on the symptoms but often includes anti-inflammatory drugs like ibuprofen.
In the UK, fatigue, skin and joint problems are often treated with hydroxychloroquine while steroid tablets, injections and creams are given for kidney inflammation and rashes.
Ms Tinkler said she was beyond excited at the prospect of long-term relief (Picture: PA)So its potentially very radical, but it still needs to be proven that what weve seen in a small number of people is replicable in a trial setting and then in more routine use.
People undergoing the therapy have to stay in hospital for 10 days and may experience side effects such as their immune system being very susceptible to infection for several weeks, or another condition that causes the immune system to go into overdrive.
Dr Eleni Tholouli, director of the adult stem cell transplant unit at Manchester Royal Infirmary, said: It is an incredibly exciting time to now offer this mode of treatment to lupus patients through this clinical trial, which we hope will provide positive outcomes and revolutionise treatment options for patients with the disease.
Get in touch with our news team by emailing us at webnews@metro.co.uk.
For more stories like this, check our news page.