Autologous Epstein-Barr virus-specific adoptive T-cell therapy in a patient with lupus nephritis

Clin Transl Immunology. 2024 Nov 19;13(11):e70015. doi: 10.1002/cti2.70015. eCollection 2024.

Abstract

Objectives: Dysregulation of Epstein-Barr virus (EBV)-specific cellular immunity has been hypothesised as one of the contributing factors in the pathogenesis of systemic lupus erythematosus (SLE). Lupus nephritis is a major risk factor for overall morbidity in SLE. Immune-based strategies directed to EBV have been proposed as potential therapeutic strategy for SLE and lupus nephritis.

Methods: Autologous EBV latent antigen-specific CD4+ and CD8+ T cells were expanded in vitro and adoptively transferred to a lupus nephritis patient.

Results: This adoptive immunotherapy had no immediate adverse effects, and the patient was subsequently treated with the anti-CD20 antibody, obinutuzumab. The patient showed a reduction in anti-dsDNA antibodies and improved glomerular filtration rate but remained nephrotic. These observations were coincident with a reduction in anti-viral and global T-cell activation.

Conclusion: To our knowledge, this is the first report of the use of EBV-specific adoptive immunotherapy to treat a patient with lupus nephritis.

Keywords: T cell therapy; autoimmune diseases; lupus nephritis; systemic lupus erythematosus.