Stem-cell transplant works on lupus

In the autoimmune disease known as lupus, immune cells fail to distinguish good guys from bad. They attack cells of their own body as if they were foreign. Vital organs can take a beating.

In an attempt to thwart such self-destruction, scientists have removed stem cells—progenitors of many cell types including immune cells—from the bone marrow of seven lupus patients and reinserted them later. The improvements to the immune system are surprising, the scientists report in the Aug. 26 Lancet. Six of the seven patients appear to be cured.

To start the procedure, the researchers collected some of each patient’s stem cells. Before injecting these cells back into the patients, however, the scientists treated each person with drugs that neutralized existing immune cells.

Once returned to the body of a patient, these nascent immune cells gradually reestablished the immune system’s self-protective priority and gave rise to a new immune system in the lupus sufferers, says study coauthor Ann E. Traynor, a physician at Northwestern University Medical School in Chicago. During the first year after the procedure, the patients took antiviral drugs and other medication to control infections that might strike during this time of vulnerability.

The patients, who ranged in age from 15 to 51 at the start of the treatments 3 years ago, had a severe form of lupus. They suffered from heart and kidney damage, high blood pressure, fatigue, headaches, seizures, and lung disease. All were severely ill before treatment and some were bedridden and near death, Traynor says.

After treatment, all the patients showed better kidney, heart, blood, and lung functions. Only one has relapsed and currently needs to take antilupus medication. The other six are back at work or school and off such medication, says Traynor.

She plans to meet with Food and Drug Administration officials this month to discuss a larger trial of the procedure.

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