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Emerging cellular and immunotherapies for systemic sclerosis: from mesenchymal stromal cells to CAR-T cells and

Alain Lescoat1,2, Hiroshi Kato3, John Varga3

  • 1University of Rennes CHU Rennes, Inserm, EHESP, Irset -Institut de Recherche en Santé, Environnement et Travail-UMRS.

Current Opinion in Rheumatology
|August 31, 2023
PubMed
Abstract

Insights

Emerging cellular therapies offer new hope for treating systemic sclerosis (SSc)-associated interstitial lung disease. These innovative treatments, including engineered T cells, show promise for disease modification and personalized medicine approaches in SSc.

Area of Science:

  • Immunology
  • Cellular Therapy
  • Rheumatology

Background:

  • Systemic sclerosis (SSc)-associated interstitial lung disease (ILD) lacks major disease-modifying therapies despite recent approvals.
  • Novel treatment paradigms are essential for managing SSc-ILD.
  • Cellular therapies present a promising avenue for SSc treatment.

Purpose of the Study:

  • To review emerging cell-based disease-modifying therapies for SSc.
  • To provide an updated overview of the latest advancements in SSc cellular therapy.

Main Methods:

  • Review of current literature on cellular therapies in SSc and related autoimmune diseases.
  • Analysis of engineered T cell approaches, including CAR-T and CAAR-T cells.
  • Exploration of targeting pro-fibrotic and senescence pathways.

Main Results:

  • Engineered regulatory cells show promise in refractory systemic lupus erythematosus (SLE).
  • CAR-T cells demonstrated positive results in a case report of refractory diffuse cutaneous SSc.
  • CAAR-T cells offer potential for eliminating auto-reactive B cells in SSc.
  • Targeting pro-fibrotic or senescence pathways are also promising approaches.

Conclusions:

  • Cellular therapies hold significant potential for disease modification in SSc.
  • Personalized medicine in SSc can be advanced by targeting autoantigens or autoreactive cells.
  • Further research into cellular therapies is warranted for SSc treatment.

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