Monday, 8 August 2016

Monash discovery points towards more targeted treatments for vasculitis

Dr Joshua Ooi
Vasculitis that involves autoimmune inflammation of the small blood vessels, may sound relatively harmless. But it’s a condition that can lead to serious organ damage—especially to the kidneys.

Researchers in the Centre for Inflammatory Diseases at Monash University have discovered that a particular immune cell (CD8 T cells) plays an important role in the development of vasculitis.

Published recently in the prestigious Journal of the American Society of Nephrology, the study could lead to the development of improved treatments with fewer side effects for these debilitating
Janet Chang

“Vasculitis lacks the profile of other autoimmune diseases, although the incidence in Australia is similar to multiple sclerosis (1/50,000 people) and is most common in people aged 65-74 years,” said co-lead researcher Dr Joshua Ooi. 

One of the problems with the treatment of vasculitis is that there aren’t therapies that are both effective and have a low chance of side effects.

“Without treatment, 80 per cent of patients with vasculitis die within five years. Even with treatment, around 30 per cent of patients die, and half of those die from complications relating to the life-saving treatments given,” said Dr Ooi.

Co-lead researcher and Centre for Inflammatory Diseases’ Director Professor Kitching said that a few years ago, colleagues at the University of Cambridge recognised that a particular genetic signature in CD8 T cells could predict who would get bad disease and who would get less severe disease.

“While the Cambridge discovery had the potential to determine which vasculitis patients would need more intensive and less intensive treatment, no one had determined whether these cells themselves might be important in the disease,” said Professor Kitching.

“Our paper has shown for the first time that CD8 cells, a type of immune cell that usually kill our cells after they are infected by viruses, actually do play a damaging role in vasculitis.”

Currently, vasculitis patients receive a one-size-fits-all type of therapy, with some being over-treated and others under-treated.

First author and School of Clinical Sciences at Monash Health (SCS) PhD student Ms Janet Chang said that as these CD8 cells themselves emerge as targets in immune disease, we may develop better treatments with fewer side effects than the current non-specific immune suppressive drugs.

“We believe our study is a further step along the road to more specific, more targeted, and more effective treatments for this difficult to treat disease,” said Professor Kitching.

This work was funded by an NHMRC Project Grant.   Watch a short video about this research here.

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