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  • Programme Area 4

Autoimmunology

  • Autoantibody
  • Autoimmune diseases
  • Cell therapy
  • Memory Plasma cells

New ways of approaching treatment of autoimmune diseases

Our research group is fundamentally involved in analysing the mechanisms which contribute to and help maintain severe autoimmune diseases in order to develop new therapeutic concepts.

Our main focus is on the role of long-lived autoreactive plasma cells in autoimmune diseases. Long-lived plasma cells reside in niches in the bone marrow and inflamed tissues, where they are resistant to immunosuppressive/cytotoxic drugs or therapies targeting B cells. In collaboration with the research group from Andreas Radbruch, we look for new therapeutic strategies targeting the autoreactive memory. We introduced the proteasome inhibitor bortezomib that depletes plasma cells in the treatment of refractory autoimmune diseases. We also learned that selective plasma cell depletion has to be combined with a therapy targeting the plasma cell precursors to prevent the generation of new plasma cells. Since all these therapies unselectively deplete plasma cells, regardless whether they secrete protective of pathogenic antibodies, we developed an affinity matrix technology for antigen-specific plasma cell depletion.  Recently, we could show for the first time that long-lived memory plasma cells can be depleted in an antigen-specific manner using this technology in a murine model. One current study is aimed to demonstrate an improvement of muscle weakness in a murine model of myasthenia gravis after the specific depletion of plasma cells secreting autoantibodies against the acetylcholine receptor.

About us

Together with the Unit for Bone Marrow Transplantation (Renate Arnold) at the Charité – Universitätsmedizin Berlin, and the research group of Andreas Thiel (BCRT), we demonstrated that the autoreactive memory could be eliminated by immunoablation followed by autologous hematopoietic stem cell transplantation, in patients with severe autoimmune diseases that are refractory to conventional immunosuppression. In most cases this provided the basis for the subsequent regeneration of an intact immune system. In some patients, however, the disease relapsed, or secondary autoimmune disorders occurred. We investigate the reasons for this in a controlled clinical trial in systemic lupus erythematosus (SLE).

In another project, we study the role of dendritic cells in SLE. These cells, in their function as antigen-presenting cells and producers of cytokines, play a significant role in the pathogenesis of SLE. As they are a potential target in the development of new therapies, their characterisation is of major relevance.

Several cytokines are involved in the pathogenesis of SLE and other systemic autoimmune diseases. In past and future clinical trials, we have studied biologics selectively targeting different cytokines or cells (e.g. BAFF/BLys, APRIL, type I interferon, IL-10, B cells, PDC, co-stimulatory molecules). We expect that these different therapeutic approaches will allow us to develop personalised therapies.

Along similar lines, we have developed several novel biomarkers, reflecting specific aspects of the pathogenesis of SLE. We have identified serologic (autoantibodies) and cellular biomarkers (Siglec1 expression on monocytes, B and T cell subpopulations in the peripheral blood and urinary immune cells). We believe these biomarkers will enable us to tailor make our treatment in the future for patients and broaden our understanding of the disease pathogenesis.

Team

Group leader
PD Dr. med. Tobias Alexander

Senior Scientific Advisor
Prof. Dr. med. Falk Hiepe

Scientists
Quingy Cheng, PhD
Laleh Khodadadi, PhD
PD Dr. med. Philipp Enghard
Dr. med. Lennard Ostendorf
Dr. med. Thomas Rose
Spyridon Lipka
Dr. med. Lydia Zorn-Pauly

PhD and MD students
Anne Beenken
Hannah Brandt
Dilara Cirillo
Jonas Martin
Sarnai Naran
Deborah Puppe
Christopher Skopnik
Konrad Speidel
Lena Teichert

Technical Assistence
Diana Metzke

Main cooperation partners

F Mashreghi, HD Chang, A Radbruch, G Krönke, T Dörner, H Mei, J Dong, F Buttgereit, T Kallinich, A Strangfeld, J Klotsche, A Meisel, V Siffrin, F Paul, F Scheibe, H Radbruch, R Arnold, U Keller, J Krönke

Forschungsinstitut für Molekulare Pharmakologie (FMP)

  • Biomedical Center Munich (E. Meinl), LMU München.
  • Max Delbruck Centre (MDC) Berlin (A. Sanders, K. de la Rosa)
  • BIH Center for Regenerative Therapies (BCRT), Berlin (J. Polansky, A. Thiel).
  • Max-Planck Institute for Infection Biology (A. Zychlinski).
  • Max-Planck-Institut für Molecular Physiology (H. Waldmann).
  • Departments of Rheumatology (G. Schett) and Department of Hematology (F. Müller), University Erlangen-Nurnberg, Erlangen.
  • Germany Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg (R. Voll).
  • Department of Rheumatology Lübeck, Universitätsklinikum Schleswig-Holstein (J. Humirch, G. Riemekasten).

Policlinic and Hiller Research Unit for Rheumatology, University Clinic Duesseldorf Heinrich-Heine-University, Duesseldorf (J. Mucke, M. Schneider).

Miltenyi Biotec, Checkimmun, Euroimmun

  • Department of Hematology and Department of Rheumatology, Ospedale San Raffaele, Milano, Italy.
  • Department of Women’s and Children’s Health, Institute of Live Course and Medical Sciences, University of Liverpool, UK. Rheumatology Unit, University of Pisa.
  • Department of Nephrology and Department of Rheumatology, Leiden University Medical Centre, Leiden, Netherlands.
  • Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Institute for Environmental Medicine, Karolinska Institutet, Sweden.
  • Internal Medicine Unit, St-Louis Hospital Paris-Cite University, France.

Amgen, Johnsen&Johnsen, AstraZeneca, Sanofi