Clinical progress of engineered cellular immunotherapies for autoimmunity

Cellular immunotherapies encompass a broad and rapidly developing group of treatments comprising expanded and/or genetically engineered immune cells, which use the specific properties of human immune cells to counteract human immune-mediated disease. Initially approved for cancers of the B cell lineage, a growing arsenal of cellular immunotherapies are being applied to autoimmune diseases, including chimeric antigen receptor (CAR) T cells, chimeric autoantibody receptor T cells, regulatory T cells and CAR-engineered innate immune cells. These approaches represent a major shift in the way scientists and physicians pursue the treatment of human disease compared to standard immunosuppressive therapies. Here, we review the clinical progress of engineered cellular immunotherapies for autoimmunity. We focus on how antigenic target, engineered cell type, CAR design and treatment regimens affect the therapeutic efficacy and safety of these treatments and how these emerging clinical data can inform future directions in the field.