CARs: a new approach for the treatment of autoimmune diseases

The development of chimeric antigen receptor (CAR)-based therapeutic interventions represented a breakthrough in cancer treatment. Following the success of the CAR-T-cell strategy, this novel therapeutic approach has been applied to other diseases, including autoimmune diseases. Using CAR-T cells to deplete pathological immune cells (i.e., B cells, autoreactive B or T cells, and accessory antigen-presenting cells (APCs)) has resulted in favorable outcomes in diseases characterized by excessive autoantibody levels or hyperactive lymphocyte cell numbers. The importance of immunosuppressive regulatory T cells (Tregs) in restoring immune tolerance has been well established, and CAR-Tregs have shown promising therapeutic potential in treating autoimmune diseases. Moreover, prior experience from the cancer field has provided sufficient paradigms for understanding how to optimize the structure and function of CARs to improve their function, persistence, stability and safety. In this review, we describe the potential application of CAR-T cells and CAR-Tregs in the treatment of autoimmune diseases, and we summarize the currently available strategies of gene editing and synthetic biological tools that have improved the practical application of CAR-based therapies.

Automated summary

The development of CAR-based therapeutic interventions has revolutionized cancer treatment and has also shown potential in treating autoimmune diseases. CAR-T cells can effectively deplete pathological immune cells, while CAR-Tregs have the ability to restore immune tolerance. The optimization of CAR structure and function has been influenced by previous experience in the field of cancer. This review discusses the potential application of CAR-T cells and CAR-Tregs in treating autoimmune diseases, as well as the strategies of gene editing and synthetic biological tools that have improved CAR-based therapies.