Objective: Autoreactive T cells play a critical role in pathogenesis of systemic lupus erythematosus (SLE). Immunization with inactivated autoreactive T cells (T cell vaccination) may activate the idiotype anti-idiotypic network to deplete specific subsets of autoreactive T cells involved in SLE. We conducted a pilot clinical trial of T cell vaccination to investigate the efficiency and safety of T cell vaccination in treatment of SLE.
Methods: Autoreactive T cell clones were derived from peripheral blood mononuclear cells of 6 SLE patients. After irradiated with 80 Gy gamma radiation, 1 x 10(7) T cells were inoculated subcutaneously at 0, 2, 6, 8 week respectively. The patients were followed up for 20-27 months, and monitored for clinical characteristics and side effects from the vaccination.
Results: The clinical manifestations and laboratory abnormalities were improved after inoculation without increasing the dose of corticosteroids and immunosuppressants in most patients. SLEDAI score were decreased remarkably. Proliferative responses against the T cell vaccine were observed in 4/6 patients. No side effect was noticed and CD3+, CD4+ and CD8+ T cell were all in normal ranges after the vaccination and during the follow-up period.
Conclusion: The results of this pilot study indicate that T cell vaccination is a safe and effective treatment in SLE patients.