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• W4385454322 abstract "Systemic lupus erythematosus (SLE) is a serious autoimmune disease for which there are many possible environmental triggers1-4 but without complete cure. SLE primarily affects young women and can cause multi-organ dysfunction.5 Although non-specific therapeutics such as glucocorticoids and immunosuppressive drugs and specific molecular targeting biologics are currently available, there is still no complete cure and patients often require lifelong treatment.6, 7 The latest technology for cancer therapy, chimeric antigen receptor recombinant (CAR) T-cells, is now also being used to treat autoimmune diseases. A team at the Medical College of Pennsylvania has made significant progress in using CAR T as a treatment strategy for SLE. In this paper, the researchers modified CAR T-cells to remove antibody-producing B cells by targeting the CD19 protein produced on the surface of B cells. They showed that CD19 CAR T effectively eliminated autoimmune antibody-producing B cells in SLE patients, achieving treatment-free remission, and that the therapeutic effect persisted after the B cells were reconstituted in the patients' bodies without serious side effects.8 From the results of this study, CAR T therapy offers a potential new treatment option for SLE patients, but as the researchers suggest, there are still some risks associated with CAR T therapy for autoimmune diseases. For now, clinical data are still insufficient and longer-term follow-up in larger clinical trials is needed to determine the safety and efficacy of CAR T therapy in this setting. In SLE patients, B-cell responses to DNA and nuclear antigens precede the onset of clinical symptoms, making depletion of B-cells a viable therapy strategy for SLE.7-9 Theoretically, T cells can activate and kill B-cells by expressing CARs that encode for binding to specific antigens on target cells. In patients with autoimmune diseases, CAR T-cells are programmed to render B-cells harmless, and B-cells develop antibodies against their own cells. A decade of practical experience with CAR T therapies, which have had great success in oncology, particularly in hematology,10 has encouraged the search for new and broader uses for CAR technology. SLE is an example of a broader category of autoimmune diseases for which cellular therapies hold the promise of providing a powerful novel therapy.11 However, there are still some risks associated with the use of CAR T for SLE. First, there is a defect of humoral immunity after complete removal of B-cells. Current treatment strategies for SLE also increase the risk of infection, and experience from CAR T treatment of hematologic malignancies shows that patients with CD19-CAR-treated tumors can still regenerate B-cells with secreted protective antibodies. Second, the possible toxicity and cytokine storm during CAR T treatment have corresponding therapeutic tools.12-14 In fact, in 2021, the first patient treated for SLE had similar results after treatment with CAR T. The results of this study showed that CAR T therapy may induce rapid remission of refractory SLE. It also indicated that CAR T therapy is feasible, tolerable and efficient in the treatment of SLE.11 Clinical data in the area of CAR T therapy for SLE gives hope for a cure for this autoimmune disease, but the number of patients currently treated is still low. Conditioning therapy-controlled clinical trials need to continue to validate its efficacy, and safety. Currently, most CAR T therapies for autoimmune diseases are still in relatively early clinical or even preclinical development, and it is expected that these therapies will show strong potential in subsequent clinical trials to provide hope for a complete cure for more patients. All authors have no conflict of interest. Dr. Renin Chang and Dr. Su Boon Yong are Editorial Board members of APL and co-authors of this article. To minimize bias, they were excluded from all editorial decision-making related to the acceptance of this article for publication. Original writing: Mei-Chia Chou, Wei-Kai Lee, Wen-Bin Yeh, Su-Boon Yong, Chia-Jung Li, and Renin Chang. Final review and edit: Chia-Jung Li and Renin Chang. The data that support the findings of this study are openly available in [repository name] at [DOI], reference number [reference number]." @default.
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• W4385454322 date "2023-08-01" @default.
• W4385454322 modified "2023-10-17" @default.
• W4385454322 title "<scp>CAR T</scp>‐cells: New therapeutic opportunities in autoimmune diseases?" @default.
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• W4385454322 doi "https://doi.org/10.1111/1756-185x.14696" @default.
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