CAR-T cell therapy in rheumatic diseases: a review article.

Area of Science:

• Immunology
• Oncology
• Rheumatology

Background:

• CAR-T cell therapy, a revolutionary treatment for hematologic malignancies, is being explored for autoimmune and rheumatic diseases.
• This therapy involves genetically modifying T cells to express chimeric antigen receptors (CARs) for targeted antigen recognition.

Purpose of the Study:

• To review the potential of CAR-T cell therapy in treating autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SSc).
• To discuss emerging applications in Sjögren's syndrome and dermatomyositis.
• To highlight challenges and future directions for CAR-T therapy in rheumatic diseases.

Main Methods:

• Review of existing literature and studies on CAR-T cell therapy applications in autoimmune and rheumatic conditions.
• Analysis of CAR-T cell mechanisms targeting pathogenic immune cells and disease processes.
• Evaluation of potential benefits, risks, and future research needs.

Main Results:

• CAR-T therapy demonstrates potential in maintaining remission in SLE by targeting autoreactive B cells.
• It shows promise in refractory RA by selectively eliminating disease-driving immune cells.
• For SSc, CAR-T therapy may address B cell dysregulation and fibrotic processes.

Conclusions:

• CAR-T cell therapy offers targeted immunomodulation with potential for long-term remission in refractory rheumatic diseases.
• Challenges include cytokine release syndrome, immune toxicity, and cost.
• Advancements like CAR-Tregs and gene editing, alongside clinical trials, are crucial for establishing efficacy, safety, and feasibility.