The “miraculous” CAR-T cells: The Greek scientist and the new treatment for autoimmune diseases

In 2021, successful the midst of the coronavirus pandemic and portion laboratories had conscionable succeeded successful processing effectual vaccines against COVID-19, a Greek scientist successful Germany continued steadily on his ain probe path, aiming to dainty diseases utilizing CAR-T cells.

At the time, Associate Professor and doc astatine the University Hospital of Erlangen successful Bavaria, Dimitris Mougiakakos had been dedicated since 2017 to processing CAR-T lymphocyte therapies against cancer. However, during that hard play for subject and humanity, helium and his squad gained captious cognition successful the laboratory that led them to a cardinal therapeutic milestone: applying cellular therapy to autoimmune diseases arsenic well.

Since then, his squad has carried retired pioneering objective applications of CAR-T cells worldwide for systemic lupus erythematosus (SLE), myasthenia gravis, and immune thrombocytopenia, leaving a beardown people connected the improvement of cellular therapies for autoimmune diseases. Professor Mougiakakos’ probe is playing a decisive relation successful transferring a therapeutic attack initially developed for hematologic cancers to conditions wherever the immune strategy attacks the assemblage itself, opening caller pathways for treatments that until precocious were considered impossible.

Given that autoimmune diseases — specified arsenic rheumatoid arthritis, aggregate sclerosis, lupus, scleroderma, and myasthenia gravis — impact astir 10% of the population, the value of probe successful this tract is clear. The usage of CAR-T cells for autoimmune diseases is present being studied by large pharmaceutical companies.

“Currently, determination are much than 300 objective trials worldwide for the attraction of autoimmune diseases with cellular therapies. The involvement from the pharmaceutical marketplace is enormous, and this is what drives research. Our publications helped pave the mode for these therapies beyond hematology-oncology. However, our eventual extremity arsenic doctors is to beryllium utile to patients — to cure them. In this field, results are what matter,” says Professor Mougiakakos, present manager astatine the University Clinic of Hematology-Oncology astatine the University of Magdeburg.

“Since 2021, erstwhile we confirmed the reflection that CAR-T compartment therapy destroys not lone cancerous B-cells but besides mean B-cells of the immune strategy — which are liable for producing antibodies and triggering assorted autoimmune diseases — we focused connected this,” helium explains.

His squad fundamentally produced the cellular therapy for autoimmune diseases successful a akin mode arsenic for cancer:
“T-cells are isolated from achromatic humor cells, past genetically modified to people and destruct mean B-cells, and yet reinfused into the patient.”

The archetypal affirmative results

The archetypal diligent to person the cellular therapy was a young German pistillate with terrible lupus. CAR-T cells were past administered to a diligent with myasthenia gravis, and much precocious to a diligent with autoimmune thrombocytopenia.

All are present successful remission from the autoimmune illness they had developed — for which existing treatments had been ineffective — a cardinal request for receiving CAR-T therapy.

“We cognize our travel is inactive long. These 3 cases, though precise successful, are isolated. Clinical trials are needed, arsenic required by the ineligible framework, to beryllium the effectiveness of CAR-T compartment therapy. Fortunately, galore studies are present underway — our halfway collaborates with centers successful the U.S., Italy, France, and countries successful Asia. We are besides successful discussions with centers successful Greece, which makes maine peculiarly happy, some due to the fact that of the responsiveness of Greek colleagues and the anticipation of diligent information successful experimental therapies,” helium notes.

Systemic lupus erythematosus and scleroderma are among the main autoimmune diseases presently nether objective investigation, with encouraging preliminary results, portion the planetary technological assemblage awaits last Phase 3 outcomes.

The €300,000 cost

Another contented that concerns the prof is the broader probe framework.

“Beyond strict adherence to ineligible requirements successful research, it is precise important to stock cognition and acquisition with different hospitals, some successful Germany and internationally. As the pandemic showed, this tin importantly accelerate aesculapian advancement erstwhile scientists rapidly stock information and expertise,” helium says.

He besides stresses the value of establishing a beardown ethical model astir these innovative and precise costly cellular therapies. Notably, a CAR-T attraction for crab patients costs astatine slightest €300,000.

“The evident question is whether healthcare systems volition beryllium capable to carnivore the cost. This is not lone an economical issue, but a profoundly ethical one, concerning adjacent entree of patients to caller therapies,” helium says.

Despite his concerns, his optimism remains beardown erstwhile discussing rapidly advancing technological information that is opening caller paths.

“We are present exploring allogeneic CAR-T therapies. Instead of utilizing the patient’s ain cells, which we genetically modify and reinfuse, we purpose to execute the aforesaid effect utilizing cells from steadfast donors. The probe tract is highly dynamic, and successful 2026 we expect results from objective trials connected allogeneic CAR-T therapies,” helium says.

This attack aims to make “off-the-shelf” cellular therapies, overcoming the costly and time-consuming process of producing personalized treatments, arsenic good arsenic addressing ethical concerns related to precocious costs and constricted access.

A passionate researcher

He describes himself arsenic “lucky to beryllium portion of specified a development, which is the imagination and extremity of each idiosyncratic successful the laboratory.” His interaction is significant: helium has published much than 170 technological papers successful journals specified arsenic Lancet, Lancet Neurology, New England Journal of Medicine, Nature, and Nature Medicine, and has secured probe backing exceeding €25 million.

He is intelligibly a passionate researcher who sees subject not conscionable arsenic a profession, but arsenic a idiosyncratic mission.

“When you emotion something, erstwhile it fascinates you, you don’t spot it arsenic work. For me, probe is simply a tract afloat of challenges and idiosyncratic bets. I americium ne'er satisfied and ever purpose higher,” says the 47-year-old professor.

He tries to instill this aforesaid passionateness successful his team, which includes 4 trainee doctors from Greece. He is besides encouraged by the beardown involvement from Greek colleagues successful probe and cellular therapies.

“I americium successful interaction with colleagues successful Greece, and we are trying to make the model for this innovation truthful that objective trials tin besides instrumentality spot successful Greek hospitals, benefiting Greek patients,” helium says.

He wanted to go a doc from his aboriginal teenage years, adjacent though nary 1 successful his household worked successful medicine. The kid of immigrants — his parents moved from Skoutari successful Laconian Mani and Nea Peramos successful Attica to Hanover, Germany, successful the precocious 1960s — helium devoted himself to schoolhouse and excelled academically.

Academic career

He began his world travel successful 1998, studying medicine astatine Hannover Medical School. He aboriginal specialized successful hematology and oncology astatine assemblage centers successful Freiburg, Regensburg, and Erlangen.

His involvement successful probe was besides inspired by his older sister, who pursued doctoral studies aft graduating from the National Technical University of Athens. From 2008 to 2011, helium worked astatine the Karolinska Institute successful Stockholm with a assistance from the German Research Foundation (DFG).

After returning to Germany, helium led the Max Eder probe radical funded by German Cancer Aid and completed his habilitation astatine Friedrich-Alexander University of Erlangen.

In Magdeburg, alongside his world career, helium has built his household beingness with his wife, besides a doctor, and their 3 sons. Despite his beardown absorption connected research, helium has not forgotten his roots. He visits Greece arsenic often arsenic imaginable with his family, particularly Skoutari successful Mani, wherever his parents settled aft years of moving successful Germany.