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CAR-T cell therapy: new hope for systemic lupus erythematosus patients

Cellular & Molecular Immunology volume 18, pages 2581–2582 (2021)Cite this article

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In a recent study from NEJM, Mougiakakos et al. reported a case in which autologous anti-CD19 CAR-T cell therapy was used in the treatment of a refractory SLE patient [1]. Rapid remission of severe SLE was observed in this case, indicating the potential of application of B cell-targeting CAR-T cell therapy in severe autoimmune diseases.

The main pathogenesis of SLE lies in the autoimmune response caused by immune imbalance, and the most critical factor is the dysregulated activation of self-reactive B cells. The continuous production of autoantibodies against self-components by abnormally activated B cells leads to the formation of immune complexes and causes systemic inflammation with damage to various tissues. Therefore, multiple B cell-targeted strategies for SLE have been developed and tested. Among these, the anti-BAFF monoclonal antibody belimumab has been approved for the treatment of SLE, and the anti-CD20 monoclonal antibody rituximab is also widely used in the treatment of SLE. However, due to the heterogeneity of the disease, the treatment effectiveness varies, and disease relapse after treatment remains a problem for these antibody-based therapeutic approaches [2].

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References

  1. Mougiakakos D, Kronke G, Volkl S, Kretschmann S, Aigner M, Kharboutli S, et al. CD19-targeted CAR T cells in refractory systemic lupus erythematosus. N Engl J Med. 2021;385:567–9.

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  4. Jin X, Xu Q, Pu C, Zhu K, Lu C, Jiang Y, et al. Therapeutic efficacy of anti-CD19 CAR-T cells in a mouse model of systemic lupus erythematosus. Cell Mol Immunol. 2021;18:1896–903.

  5. Zhang W, Feng J, Cinquina A, Wang Q, Xu H, Zhang Q, et al. Treatment of systemic lupus erythematosus using BCMA-CD19 compound CAR. Stem Cell Rev Rep. 2021. https://doi.org/10.1007/s12015-021-10251-6.

  6. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT03030976.

  7. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT05030779.

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Funding

Our work was supported by grants from the National Natural Science Foundation of China (31930038, 31770954, and 31530019 to LL).

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Authors and Affiliations

  1. Institute of Immunology and Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, P. R. China

    Xuexiao Jin, Yongmei Han & Linrong Lu

  2. Zhejiang University–University of Edinburgh Institute, Zhejiang University School of Medicine, 314400, Haining, P. R. China

    James Q. Wang & Linrong Lu

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  1. Xuexiao Jin
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  2. Yongmei Han
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Correspondence to Linrong Lu.

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Cite this article

Jin, X., Han, Y., Wang, J.Q. et al. CAR-T cell therapy: new hope for systemic lupus erythematosus patients. Cell Mol Immunol 18, 2581–2582 (2021). https://doi.org/10.1038/s41423-021-00787-5

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