Introducing the tolerogenic macrophage therapy as an alternative approach to manage systemic lupus erythematosus: a case series

• Main Authors: Terawan Agus Putranto, Djoko Wibisono, Nyoto Widyo Astoro, Martina Lily Yana, Endra Tri Prabowo, Denny Irwansyah, Nurhadiyanta Nurhadiyanta, Yudo Rantung, Taruna Ikrar, Fred Fandrich
• Format: Article
• Language: English
• Published: DiscoverSys 2019-12-01
• Series: Bali Medical Journal
• Subjects: tolerogenic macrophage, systemic lupus erythematosus, immunotherapy
• Online Access: https://balimedicaljournal.org/index.php/bmj/article/view/1621

<p><strong>Introduction: </strong>Systemic Lupus Erythematosus (SLE) has been quite an enigma in medicine. The possibility of the host own defense mechanism attacking itself is still quite difficult to understand. Patients who suffer from this disease tend to have a problem in their qualities of life, especially as the majority affect female in their productive ages. Conservative therapy to manage this disease is widely developed and implemented. Since the known therapies have several side effects and limitation, a need to develop a new strategy that can re-establish the “tolerance” mechanism of our immune system is increasingly needed. Immunotherapy is already a promising field in the strategy against autoimmune cases. In our facility, we developed immunotherapy called ToM (Tolerogenic Macrophage) which similar to Mreg (Regulatory Macrophage) in order to utilise the “tolerance” ability of this immune apparatus.</p><p><strong>Case: </strong>In this study, we present 2 cases of female patients who suffer from SLE, which underwent ToM Therapy in our Cellcure facility in RSPAD Gatot Soebroto Jakarta-Indonesia. After the procedure the patient was monitored one month and one year. Clinical and control parameter such as ANA (IF) and ANA profile was examined again in both patients to measure the effect of this therapy<strong>. </strong>The ANA titer and the titer of specific antibodies such as dsDNA, Nucleosomes and Histones results show significant reduction, accompanied by the improvement of the symptoms.</p><p><strong>Conclusion: </strong>ToM Therapy seems to have a good efficacy as immunotherapy for SLE. Further study needed to establish this approach.</p>