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CAR-T cell therapy in nephrology.

Francesco Tondolo1, Elisa Gessaroli2, Federica Maritati1

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Chimeric antigen receptor T-cell (CAR-T) therapy shows promise for immune-mediated kidney diseases by targeting B cells. This advanced immunotherapy offers new hope for patients refractory to standard treatments, potentially improving renal outcomes.

Keywords:
Cell therapyautoimmunitychimeric antigen receptor Timmune-mediated kidney diseases

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Area of Science:

  • Immunology
  • Nephrology
  • Cell Therapy

Background:

  • Immune-mediated kidney diseases involve dysregulated B cell and plasma cell activity.
  • These conditions often resist standard immunosuppressive therapies.
  • Chimeric antigen receptor T-cell (CAR-T) therapy is an emerging immunotherapeutic strategy.

Purpose of the Study:

  • To review the current landscape of CAR-based therapies in nephrology.
  • To explore the immunopathological rationale for CAR-T in kidney diseases.
  • To outline future directions for CAR-T integration into clinical practice.

Main Methods:

  • Review of recent clinical data and studies on CAR-T therapies in autoimmune and kidney disease settings.
  • Evaluation of novel CAR-T platforms like chimeric autoantibody receptor (CAAR)-T cells and bispecific T-cell engagers (BiTEs).
  • Assessment of CAR-T applications in kidney transplantation.

Main Results:

  • CAR-T therapies demonstrate potent and durable depletion of pathogenic lymphocytes.
  • Clinical data suggest CAR-T can induce immunological remission, restore tolerance, and improve renal outcomes.
  • Emerging evidence supports CAR-T use in kidney transplantation, including desensitization and post-transplant disorders.

Conclusions:

  • CAR-T therapy presents a promising new avenue for treating refractory immune-mediated kidney diseases.
  • Novel CAR-T platforms and applications in transplantation are expanding treatment possibilities.
  • Challenges in toxicity, patient selection, cost, and long-term safety require further investigation.