Dr. Carmen Scheibenbogen is the director of the Institute for Medical Immunology at Charité Hospital (Berlin, Germany) and a world-leading expert on Long Covid and ME/CFS. She is also a two-time Solve Ramsay Research Grant Program awardee—her Solve-sponsored projects focused on how autoantibodies contribute to ME/CFS pathology.
Over her extensive career, Dr. Scheibenbogen published dozens of research papers that have influenced clinical trials on autoantibody-targeting treatments for people with Long Covid or ME/CFS. Although these treatments are among the most promising for managing symptoms of these diseases, uncertainties about their use remain.
In a recent article in the journal Expert Opinion on Biological Therapy, Dr. Scheibenbogen and her colleagues reviewed some of the new autoantibody-targeting treatments and gave their expert opinion on what we must do to better understand their effectiveness.
Dr. Scheibenbogen’s team reviewed antibody-targeting treatments like daratumumab and rituximab (which lower levels of people’s B cells, the antibody-producing cell type); efgartigimod (which causes people’s antibodies to degrade more quickly); immunoadsorption treatment (by which antibodies or specific subsets of antibodies are filtered from the blood); intravenous immunoglobulin treatment (by which autoantibodies are neutralized and aspects of the immune system inhibited); and Rovunaptabin (also called BC007, which neutralizes autoantibodies that target G-protein-coupled receptors).
Studies of these treatments have mixed results, the team explained. Some studies found these antibody-targeting treatments reduce Long Covid or ME/CFS symptoms significantly. Other studies found mild effects, or none at all. A main reason for these discrepancies is that some studies measured responses of people with ME/CFS or Long Covid in general; not responses of subgroups of people whose diseases are directly related to problems with autoimmunity. For example, several immunoadsorption-treatment studies carefully recruited people with Long Covid or ME/CFS who had elevated levels of autoantibodies (since this treatment is especially appropriate for these people). Indeed, these studies found that immunoadsorption significantly lowered autoantibody levels and improved things like hand-grip strength and neurological function for the selected participants.
Dr. Scheibenbogen’s team recommended more work to find biomarkers to predict which people will respond to each autoantibody-targeting drug. They also recommended launching more randomized clinical trials (instead of observational studies) and measuring responses for substantially more people.
Dr. Scheibenbogen highlighted that CD19-targeting chimeric antigen receptor T-cell therapy may be a particularly exciting treatment for people with autoantibody-related Long Covid or ME/CFS. Even a single dose of this treatment (originally developed for people with cancer) may be enough to substantially and durably reduce symptoms.
Further descriptions of Dr. Scheibenbogen’s Solve-sponsored research can be found on the Solve website.
