Abstract
Chimeric antigen receptor (CAR-T) cells have been successfully used in hematologic malignancies and are now being evaluated for systemic autoimmune diseases. CAR-T cells, produced from the patient's T cells, primarily target B cells via CD19 or BCMA, effectively depleting autoreactive clones. In severe systemic lupus erythematosus, clinical trials show durable remission even after B cell recovery, suggesting immune system resetting. Promising results have also been observed in inflammatory myopathies and systemic sclerosis. Allogeneic CAR-T cells from healthy donors, genetically modified to prevent rejection, have shown similar efficacy. While adverse events are reported in hematology, autoimmune diseases trials show good immediate tolerance. Future approaches targeting other autoimmune markers, like CAAR or CATCR cells, and CAR-T regulatory cells, could open new therapeutic avenues for refractory systemic autoimmune diseases.
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