Chimeric Antigen Receptor T-cell therapy in systemic autoimmune rheumatic diseases: current insights and future prospects.

IF 2.2 Q3 RHEUMATOLOGY
Journal of Rheumatic Diseases Pub Date : 2025-07-01 Epub Date: 2025-01-20 DOI:10.4078/jrd.2024.0122
Bong-Woo Lee, Eui-Jong Kwon, Ji Hyeon Ju
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引用次数: 0

Abstract

Chimeric Antigen Receptor (CAR) T-cell therapy, revolutionary in treating hematological malignancies, is emerging as a promising approach for systemic autoimmune rheumatic diseases (SARDs). This review examines the potential of CAR T-cell therapy in treating conditions such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and idiopathic inflammatory myopathies (IIMs). The evolution of CAR T cells technology, from first to fifth generation, has enhanced its efficacy and persistence. Early clinical studies in SARDs have shown encouraging results, with some patients achieving drug-free remission. CD19-targeted CAR T cells have demonstrated significant B-cell depletion and clinical improvement in patients with SLE, SSc, and IIMs. Despite promising outcomes, challenges remain, including cytokine release syndrome and the need for careful patient selection. Future directions include exploring dual-targeting CARs, chimeric autoantibody receptors (CAARs), and alternative cell sources like γδ T cells, regulatory T cells, natural killer cells. The integration of CAR-based cell therapy into treatment paradigms of patients with SARDs requires further research to optimize efficacy, mitigate side effects, and identify suitable target biomarkers. While hurdles exist CAR-based cell therapy holds the potential to revolutionize management of patients with SARDs, offering hope for long-term, drug-free remission in these complex autoimmune conditions.

嵌合抗原受体t细胞治疗系统性自身免疫性风湿病:目前的见解和未来的前景。
嵌合抗原受体(CAR) t细胞疗法在治疗血液系统恶性肿瘤方面具有革命性意义,正在成为治疗系统性自身免疫性风湿病(SARDs)的一种有前景的方法。这篇综述探讨了CAR - t细胞疗法在治疗系统性红斑狼疮(SLE)、系统性硬化症(SSc)和特发性炎症性肌病(IIMs)等疾病中的潜力。CAR - T细胞技术从第一代到第五代的发展,增强了其疗效和持久性。急性呼吸窘迫综合征的早期临床研究显示出令人鼓舞的结果,一些患者实现了无药物缓解。cd19靶向CAR - T细胞在SLE、SSc和IIMs患者中显示出显著的b细胞耗损和临床改善。尽管有很好的结果,挑战仍然存在,包括细胞因子释放综合征和需要仔细选择患者。未来的方向包括探索双靶向car,嵌合自身抗体受体(CAARs),以及其他细胞来源,如γδ T细胞,调节性T细胞,自然杀伤细胞。将基于car的细胞疗法整合到急性呼吸窘迫综合征患者的治疗模式中,需要进一步研究以优化疗效、减轻副作用并确定合适的靶标生物标志物。尽管存在障碍,但基于car的细胞疗法有可能彻底改变SARDs患者的管理,为这些复杂的自身免疫性疾病的长期无药物缓解提供了希望。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.30
自引率
5.00%
发文量
39
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