Advancements and challenges in CAR T cell therapy in autoimmune diseases.


Journal

Nature reviews. Rheumatology
ISSN: 1759-4804
Titre abrégé: Nat Rev Rheumatol
Pays: United States
ID NLM: 101500080

Informations de publication

Date de publication:
06 Aug 2024
Historique:
accepted: 28 06 2024
medline: 7 8 2024
pubmed: 7 8 2024
entrez: 6 8 2024
Statut: aheadofprint

Résumé

Chimeric antigen receptor (CAR) T cells are highly effective at targeting and eliminating cells of the B cell lineage. CAR T cell therapy has become a standard-of-care treatment for patients with relapsed or refractory B cell malignancies. In addition, the administration of genetically modified T cells with the capacity to deplete B cells and/or plasma cells has tremendous therapeutic potential in autoimmune diseases. In the past few years, CD19-based and B cell maturation antigen (BCMA)-based CAR T cell therapies have been applied to various B cell-mediated autoimmune diseases including systemic lupus erythematosus, idiopathic inflammatory myopathy, systemic sclerosis, neuromyelitis optica spectrum disorder, myasthenia gravis and multiple sclerosis. The scientific rationale behind this approach is that deep depletion of B cells, including autoreactive B cell clones, could restore normal immune function, referred to as an immune reset. In this Review, we discuss important aspects of CAR T cell therapy in autoimmune disease, including considerations relating to patient selection, safety, efficacy and medical management. These considerations are based on the early experiences of CAR T cell therapy in autoimmune diseases, and as the field of CAR T cell therapy in autoimmune diseases continues to rapidly evolve, these issues will remain subject to ongoing refinement and adaptation.

Identifiants

pubmed: 39107407
doi: 10.1038/s41584-024-01139-z
pii: 10.1038/s41584-024-01139-z
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. Springer Nature Limited.

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Auteurs

Georg Schett (G)

Department of Internal Medicine 3 - Rheumatology and Immunology, FAU Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany. georg.schett@uk-erlangen.de.
Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany. georg.schett@uk-erlangen.de.

Fabian Müller (F)

Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.
Department of Internal Medicine 5 - Hematology and Oncology, FAU Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.

Jule Taubmann (J)

Department of Internal Medicine 3 - Rheumatology and Immunology, FAU Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.

Andreas Mackensen (A)

Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.
Department of Internal Medicine 5 - Hematology and Oncology, FAU Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.

Wei Wang (W)

Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Rich A Furie (RA)

Department of Rheumatology, Northwell Health, Great Neck, New York, NJ, USA.

Ralf Gold (R)

Department of Neurology, St. Josef-Hospital Bochum, Ruhr-University Bochum, Bochum, Germany.

Aiden Haghikia (A)

Department of Neurology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.

Peter A Merkel (PA)

Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA.

Roberto Caricchio (R)

Division of Rheumatology, UMass Memorial Health, Worcester, MA, USA.

Maria-Antonietta D'Agostino (MA)

Department of Rheumatology, Catholic University of Sacred Heart, Rome, Italy.

Franco Locatelli (F)

Department of Paediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) and Catholic University of the Sacred Heart, Rome, Italy.

Carl H June (CH)

Center for Cellular Immunology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Dimitrios Mougiakakos (D)

Department of Hematology, Oncology, and Cell Therapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
Health Campus Immunology, Infectiology and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg, Germany.

Classifications MeSH