Can we cure lupus?

A general understanding of the mechanisms leading to the development of systemic lupus has emerged over recent years, yet treatment of the illness remains largely empiric and unsatisfactory. Targeted therapy with monoclonal antibodies directed against B cells and against cytokines has met limited success, as has therapy with mesenchymal and hematopoietic stem cells. In the last few years, treatment of refractory disease with chimeric-antigen reactive T cells directed against B cells (CAR-T cells) has shown unexpected promise in small patient series, with apparent long-term and complete remission of disease. Rapid progress in this area is likely to result in improved T cell and natural killer (NK) cell treatment of patients with more readily accessible and practical methods. In parallel, increased understanding of systemic lupus erythematosus disease mechanisms using systems biology and single-cell approaches is likely to uncover additional pathways to intervene in the pathogenesis of disease, raising hopes that additional options will be available for long-term treatment or cure of the disease or even prevention of disease in susceptible individuals.