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

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.