Dear Michael

Currently the strategies employed for treating autoimmune diseases include (1) suppression of autoantibody production with steroids or other immunosppressive drugs such as azathioprine, methotrexate or by knocking out B cells that produce antibodies (eg anti CD20 antibody rituximab) (2) immunomodulation with cyclosporine, mycophenylate and others (3) blocking of autoantibody binding to Fc receptors of immune effector cells with high dose intravenous immunoglobulin. I see that you are interested in nanomaterials. You may want to take up this challenge and raise nanoparticles that block autoantibodies? How about aptamers or molecularly imprinted polymers (MIPs) to target them?

Good luck

Siva

Hello Michael, 

please see the attached links for the original data and an accompanying commentary on CAR T cells in autoimmune disease. To my knowledge this was the first report using engineered T cells against an autoreactive BCR/ autoreactive B cells (in a preclinical model of Pemphigus vulgaris). In theory one could specifically target autoreactive B cells and thus deplete circulating autoantibodies, though the approach has not proceeded into clinical trials.

http://science.sciencemag.org/content/353/6295/179.long

http://www.nejm.org/doi/full/10.1056/NEJMcibr1608900

All the best,

Michael

We have been treating a wide range of autoimmune diseases with depletion of autoantibody via B cell depletion with rituximab for some twenty years now. There is a certain degree of specificity in that autoantibodies appear to decline more than the bulk of protective antibodies, probably owing to being produced by short lived plasma cells. However, from the start the desire has been to remove autoantibodies specifically without impact on normal B cell function. This turns out to be a very difficult task for antibodies like rheumatoid factors but may be easier for antibodies to local antigens like AChR. A recent study by Radbruch and colleagues suggests that specific autoantibody deletion strategies may at last be feasible, but it is early days yet.