Skip to content CAR-T (Chimeric Antigen Receptor T) cell therapy is a groundbreaking immunotherapy that has shown potential in treating SLE by targeting B cells, which play a critical role in the pathogenesis of the disease. In SLE, B cells produce autoantibodies that attack the body’s tissues, leading to chronic inflammation and organ damage. CAR-T therapy works by engineering T cells to express a receptor (CAR) that specifically targets CD19, a marker on B cells, leading to the destruction of these harmful B cells.
CAR-T cells targeting CD19+ B cells provide a more effective and sustained depletion of B cells compared to other therapies, which targets CD20 but fails to eliminate long-lived plasma cells. This profound B-cell depletion can lead to remission of SLE symptoms by eliminating the cells responsible for autoantibody production. Studies also explore CAR-Treg (CAR-T cells designed to regulate immune responses) to restore immune tolerance and reduce autoimmune activity.
Targeted B-Cell Depletion: CAR-T therapy targets CD19+ B cells, providing precise elimination of the pathogenic B cells responsible for producing harmful autoantibodies that drive SLE.
Sustained Remission: Unlike conventional therapies (e.g., anti-CD20 antibodies like rituximab) that may not effectively target long-lived plasma cells, CAR-T cells can lead to prolonged B-cell depletion, potentially resulting in longer-lasting remission.
Reduction in Autoantibody Production: By removing autoreactive B cells, CAR-T therapy directly reduces the source of autoantibodies that damage tissues and organs in SLE.
Potential for Immune System Reset: Profound B-cell depletion can allow the immune system to “reset,” possibly restoring normal immune function and reducing the tendency to develop autoimmunity.
Development of CAR-Treg Approaches: Beyond killing pathogenic B cells, CAR-T regulatory cells (CAR-Tregs) are being explored to actively suppress autoimmune responses, promoting immune tolerance and reducing inflammation without broad immunosuppression.
Patient T-Cell Collection: T cells are collected from the patient’s blood via apheresis, an outpatient procedure that separates white blood cells.
Genetic Engineering: The collected T cells are genetically modified in the laboratory to express a chimeric antigen receptor (CAR) specifically targeting CD19, a marker found on B cells.
Expansion: The engineered CAR-T cells are then expanded in the lab to achieve a sufficient number of therapeutic cells.
Conditioning Chemotherapy: Before infusion, the patient may receive lymphodepleting chemotherapy to reduce existing immune cells and improve CAR-T cell expansion and persistence in the body.
CAR-T Cell Infusion: The engineered CAR-T cells are infused back into the patient, where they seek out and destroy CD19+ B cells responsible for autoimmune activity.
Monitoring and Follow-Up: Patients are monitored for response to therapy, side effects like cytokine release syndrome, and sustained B-cell depletion over time. Long-term follow-up assesses remission status and immune system recovery.
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