Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/JfcycqHvhl
Dr. John Cush @RheumNow( View Tweet )
20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/FphWZwwohx
Dr. John Cush @RheumNow( View Tweet )
Taking a closer look: B-Cell depletion beyond the blood
At #ACR25, we have seen an exciting wave of cellular and immune therapies reshaping the landscape of autoimmune disease treatment. Following the landmark case series by the Erlangen group, multiple cellular therapies have https://t.co/GIrPwlGKE2
Dr. John Cush @RheumNow( View Tweet )
Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/HepyZrYW5L
Dr. John Cush @RheumNow( View Tweet )
Off the Shelf: CAR-T
Dr. Akhil Sood reports on abstract 0663 (iPSC-Derived Off-the-Shelf anti-CD19 CAR T cells Deliver Improved Clinical Outcomes in Lupus with Reduced or No Conditioning Chemotherapy) presented at#ACR25.
https://t.co/mj4b5cCInC https://t.co/s34atFCMlx
Dr. John Cush @RheumNow( View Tweet )
Are we putting the CAR-T before the horse?
CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure. https://t.co/gF9FXjAZ7F
Dr. John Cush @RheumNow( View Tweet )
B Cell Depletion: Check the Lymph Node
Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25.
https://t.co/bvZMGWNzfe https://t.co/dB6iQlgoYx
Links:
Dr. John Cush @RheumNow( View Tweet )
IgG4: Rare, but new treatments on the horizon
IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis.
https://t.co/v07Kp5tQXg https://t.co/rIvOF0mrM1
Links:
Dr. John Cush @RheumNow( View Tweet )
B Cell Depletion: Check the Lymph Node
Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25.
https://t.co/BjgIC3Kng0 https://t.co/flfyLZYW8q
Dr. John Cush @RheumNow( View Tweet )
If you missed this pattern, you missed an autoimmune classic
What’s it? https://t.co/zO48zPCkqP
DocXus @docxusofficial( View Tweet )
The Rapidly Evolving Landscape of Cellular and Immune-based Therapies
When Henry Ford unveiled the Model T in 1908, the automobile industry was forever changed. A similar transformation is now underway in rheumatology, where cellular and immune therapies are redefining how we https://t.co/RQuVETSTG4
Dr. John Cush @RheumNow( View Tweet )
Why are vaccine Abs maintained after CAR-T
-depletion of pathogenic #Abs are dampened/eliminated
Clonal repetoire expansion
Remission=naive B cell pop'n
Reset immune system sparing memory cells
vs ?not all pathogenic cells eliminated in tissue
#ACR25 @RheumNow @ACRheum
#26S21 https://t.co/jb3dD5Ssip
Janet Pope @Janetbirdope( View Tweet )
Needle in a haystack
What T cell to target for #autoimmune diseases
T cell repetoires (TCR) not all are sequenced and many can exist to present antigens
Diff scales of approaches
Implications CAR-T
CD19
CD20
BCMA
Treg
HLAB27
etc!
#ACR25 @ACRheum @RheumNow
Alok Joglekar
#26S08 https://t.co/Qgw8Akz1xk
Links:
Janet Pope @Janetbirdope( View Tweet )
While post-CAR-T CRS might be semi-familiar for rheumatologists, ICANS is a new concept to get our heads around, and one which is far from heterogenous.
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/qX2jKMG2oB
David Liew @drdavidliew( View Tweet )
I've always (very) simplistically considered post-CAR-T CRS and HLH/MAS in the same bucket, and there certainly are substantial similarities.
It raises the obvious question - can we borrow therapies?
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/2HkHxpl89u
David Liew @drdavidliew( View Tweet )
@CarolineDiorio @ChildrensPhila eloquently told the #ACR25 BCRC pre-meeting about the lessons they've learned about CRS and ICANS, the major CAR-T toxicities.
Many questions still to answer, but they've also understood a lot we can learn from.
@RheumNow https://t.co/Jhk1eCLpD4
Links:
David Liew @drdavidliew( View Tweet )
Next Generation T-Cell Engager: The Future
Dr. Alfred Kim reviews abstract 0001 presented at #ACR25.
https://t.co/vmZYfmKCm8 https://t.co/PkLOs9lZ8l
Links:
Dr. John Cush @RheumNow( View Tweet )
#ACR25 Abstr#2695 Inguinal lymph node biopsies pre- and post-OBI, RTX, BLIN & CD19 CAR-T showed complete tissue depletion with CAR-T. B-cells reduced but often incomplete with protein-based depleters; OBI being the best. Still don’t agree with “immune reset” @RheumNow #ACRBest https://t.co/Sq7m9sXlLP
Links:
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Abstract 2696: Phase 1/2 study of rapidly engineered CD19 CAR T showed:
- rapid depletion of CD19 B cells w/ recovery by Day 90
- Days 180 and 360: returning B cells largely naive (CD27-IgD+)
- Interferon expression ↓ after CAR T treatment
@RheumNow #ACR25 https://t.co/FzdFbqWwtE
Links:
Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
Abstract 2695: Deep dive into B-cell depletion (BCD)
Lymph node biopsy pre/post tx:
🔹 CAR T: complete BCD + disrupted follicular architecture
🔹 RTX, OBI, BLIN: reduced BCD + preserved follicular architecture
✅ Complete LN depletion → drug-free remission
@RheumNow #ACR25
Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
Thank you @drdavidliew & @DrLauraCoates ❤️ for highlighting our work. Super-responders (some were IS-Free) do exist with rituximab in #SLE Abstr#1525 @RheumNow https://t.co/S4mMAYInfT
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Fighting fire with butyrate 🔥🚒
♦️probiotics and prebiotics
Dr. Nisha Manek on inflammation and butyrate - it reduces gut inflamm thru the NFKB pathway
#ACR25 @RheumNow https://t.co/19XTrKn1iN
sheila @RHEUMarampa( View Tweet )
Sjögren’s, decoded by Ab -->ESSDAI domains:
• anti-SSA → glandular
• anti-Ro52 / SCL70 → biologic activity
• anti-nucleosome → pulmonary
• anti-histone → pulmonary + cutaneous
Distinct serologic–ESSDAI patterns may guide monitoring and management
@RheumNow #ACR25 A#2295
Jiha Lee @JihaRheum( View Tweet )
#ACR25 Abstr#LB14 Deep blood & tissue depletion are not just confined to CAR-T. Exploratory analysis of REGENCY showed Obinutuzumab induced near-complete depletion & significantly reduced plasma in kidney tissue vs PBO @RheumNow https://t.co/r1danWBM7D
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
#ACR25 Abstr#LB01 After several smaller studies, a Multicentre, Phase 2b RCT of 152 #SLE pts in China. SRI-4 was met in IL-2 as s/c every other day for 12 wks, followed by weekly for another 12 wks vs PBO. Efficacy & T-regs expansion were dose dependent. On to Phase 3 @RheumNow https://t.co/L0rYr5D1R1
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Recent Blogs
