Roads and detours for CAR T cell therapy in autoimmune diseases

Avouac J, Barzel A, Caiati D, Davis RS, Gottschalk S, Grieshaber Bouyer R, Mao X, Luning Prak ET, Radic M, Scherlinger M, Suneja Y, Talleur A, Thacker AL, Unutmaz D (2026)

Publication Type: Journal article, Review article

Publication year: 2026

Journal

Nature Reviews Drug Discovery Nature Publishing Group

DOI: 10.1038/s41573-025-01349-4

Abstract

Chimeric antigen receptor (CAR) T cell therapy has been highly effective in eradicating malignant B cells in cancer, and this success has prompted an extension of the approach to areas beyond oncology. In pioneering studies, CAR T cells targeting the B cell marker CD19 demonstrated robust efficacy as treatment for the autoimmune disease systemic lupus erythematosus. Patients who received anti-CD19 CAR T cells experienced remission of most or all clinical manifestations and discontinued prior medications. These results have spurred intense interest in extending these observations to larger patient cohorts and other autoimmune conditions. More nuanced strategies for use of CARs in autoimmunity have also been developed. Here, we offer insight into the role of B cells in the pathophysiology of autoimmunity and present an overview of preclinical studies and clinical trials that use engineered cell therapy for autoimmune disorders. In discussing the prospects and challenges of this emerging field, a view emerges in which the promise of clinical efficacy invites careful consideration of potential pitfalls.

Authors with CRIS profile

Ricardo Grieshaber Bouyer Professur für Klinische Systemimmunologie

Involved external institutions

The University of Tennessee Health Science Center US United States (USA) (US) Jackson Laboratory US United States (USA) (US) Hôpital Cochin FR France (FR) Tel Aviv University IL Israel (IL) Solomon R. Guggenheim Museum US United States (USA) (US) University of Alabama at Birmingham (UAB) US United States (USA) (US) St. Jude Children’s Research Hospital US United States (USA) (US) University of Pennsylvania (UPenn) US United States (USA) (US) Hôpitaux universitaires de Strasbourg (HUS) / University Hospital Strasbourg FR France (FR)

How to cite

APA:

Avouac, J., Barzel, A., Caiati, D., Davis, R.S., Gottschalk, S., Grieshaber Bouyer, R.,... Unutmaz, D. (2026). Roads and detours for CAR T cell therapy in autoimmune diseases. Nature Reviews Drug Discovery. https://doi.org/10.1038/s41573-025-01349-4

MLA:

Avouac, Jérôme, et al. "Roads and detours for CAR T cell therapy in autoimmune diseases." Nature Reviews Drug Discovery (2026).

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