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Related Concept Videos

T Cell Types and Functions01:24

T Cell Types and Functions

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When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
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T Cell Activation and Clonal Selection01:22

T Cell Activation and Clonal Selection

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T cells are integral to our adaptive immune system, recognizing and effectively responding to foreign antigens. T cell activation and clonal selection are pivotal in orchestrating this immune response. This article elucidates these mechanisms, detailing the roles of cluster of differentiation (CD) markers, major histocompatibility complex (MHC) molecules, costimulatory signals, and the process of clonal selection.
Naive T cells that have not yet encountered an antigen express two primary CD...
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B Cell Activation and Differentiation01:24

B Cell Activation and Differentiation

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The adaptive immune response, a sophisticated defense mechanism, relies on the activation and differentiation of B lymphocytes, or B cells. These processes enable our bodies to mount a tailored response against specific pathogens such as bacteria, free virus particles, toxins, and parasites.
When naive B cells encounter a specific antigen that can bind to the B cell receptor (BCR) on their surface, they undergo sensitization to respond to the antigen's presence. Sensitization begins with...
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The JAK-STAT Signaling Pathway01:20

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Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as  SH2...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Connective Tissue Cell Types01:22

Connective Tissue Cell Types

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Connective tissue develops from the mesoderm of a developing embryo and consists of cells, fibers, and ground substance: a gel-like material containing large complexes of carbohydrates and proteins. Connective tissue was first identified as a separate tissue family in the 18th century, and Johannes Peter Muller coined the term connective tissue.
Fat cells (adipocytes), smooth muscle cells (myoblasts), and bone cells (osteoblasts) are some connective tissue cell types. Some immune system cells...
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An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
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An Adoptive Transfer Model of Rheumatoid Arthritis in Mice

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T-cell engagers in rheumatology.

Alberto Nordmann-Gomes1, Leila Khalili1, Stephen Wax2

  • 1Columbia University Irving Medical Center, Department of Medicine, Division of Rheumatology, New York, NY, USA.

Best Practice & Research. Clinical Rheumatology
|April 8, 2026
PubMed
Summary

T-cell engagers (TCEs) show promise for autoimmune diseases by targeting B-cells. While early efficacy is encouraging, further studies are needed to optimize dosing and confirm long-term safety and response durability.

Keywords:
Autoimmune diseasesBispecific antibodiesBispecific t-cell engagersRheumatologyT-cell engagers

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Area of Science:

  • Immunology
  • Rheumatology
  • Oncology

Background:

  • T-cell engagers (TCEs) are revolutionizing hematologic malignancy treatment.
  • B-cells play a key role in autoimmune diseases, driving interest in TCEs for rheumatology.
  • TCEs offer a potential alternative to CAR-T therapy for autoimmune conditions.

Purpose of the Study:

  • To review the biological basis, structural variations, and dosing of TCEs in rheumatology.
  • To summarize emerging clinical efficacy and safety data of TCEs in autoimmune diseases.
  • To assess the potential of TCEs as a novel therapeutic strategy for refractory autoimmune conditions.

Main Methods:

  • Narrative review of 12 studies involving 80 patients with various autoimmune diseases (SLE, RA, SSc, IIM, PSS).
  • Analysis of TCE types used, including blinatumomab, teclistamab, and mosunetuzumab.
  • Evaluation of clinical outcomes, adverse events (Cytokine Release Syndrome - CRS), and dosing strategies.

Main Results:

  • Early clinical improvements observed, including reduced disease activity and normalized biomarkers.
  • Persistent or recurrent disease activity noted post-treatment in some patients.
  • Cytokine Release Syndrome (CRS) occurred in 46% of patients (mostly grade 1/2); no neurotoxicity or deaths reported.

Conclusions:

  • TCEs demonstrate promising early efficacy and acceptable safety in refractory autoimmune diseases.
  • Potential role of TCEs as a novel therapeutic strategy is supported.
  • Further prospective studies are essential to establish optimal dosing, long-term safety, and response durability.