CAR T cells for systemic autoimmune diseases

Chimeric antigen receptor (CAR) T cells are an advanced cellular therapy produced by genetically modifying T cells to express a synthetic receptor that redirects them to specific cellular targets. Anti-CD19 CAR T cells, approved for use in patients with B cell malignancies, have demonstrated remarkable efficacy in patients with severe refractory autoimmune diseases, such as systemic lupus erythematosus. The purpose of this review is to describe the fundamental aspects of CARs and CAR T cells and the experience of their use in systemic autoimmune diseases. In addition, we discuss the mechanisms through which they achieve clinical effectiveness and present a brief overview of where the field is headed. Even though CAR T cells are a new therapy for autoimmune diseases and their long-term effects are still unknown, they represent a promise for the clinical management of severe autoimmunity and have opened a new window for understanding the pathogenesis of systemic autoimmunity.