Resetting autoimmune disease with CAR cell therapies
Summary
Pathogenic B cell activation underlies many autoimmune diseases (AIDs), and their depletion is an attractive therapeutic approach. Chimeric antigen receptor (CAR)-expressing cells-initially developed and successfully used to treat certain cancers-are increasingly being developed to selectively deplete B cells and 'reset' the immune system in AIDs. In this Review, we survey this fast-developing field, providing insights on the current unmet needs in the treatment of AIDs and how CAR T cells
Content
# Resetting autoimmune disease with CAR cell therapies
*Published: 2026 May 21*
Pathogenic B cell activation underlies many autoimmune diseases (AIDs), and
their depletion is an attractive therapeutic approach. Chimeric antigen receptor
(CAR)-expressing cells-initially developed and successfully used to treat
certain cancers-are increasingly being developed to selectively deplete B cells
and 'reset' the immune system in AIDs. In this Review, we survey this
fast-developing field, providing insights on the current unmet needs in the
treatment of AIDs and how CAR T cells could address these needs. In particular,
we explore the concept of deep B cell depletion, discuss the currently available
technologies and review the key targets (CD19 and B cell maturation antigen)
relevant for the treatment of AIDs. We summarize current evidence on the
efficacy, safety, risks and limitations of autologous and allogeneic CAR T cells
in this setting. Finally, we discuss the future outlook-from a technological and
clinical standpoint-for development of engineered CAR-expressing cell therapies
for AIDs.
DOI: 10.1038/s41591-026-04430-6