From technological iteration to clinical breakthrough: advances of CAR-T cell therapy in autoimmune diseases

BACKGROUND: Chimeric antigen receptor (CAR) -T cell therapy has emerged as a promising approach for treating severe autoimmune diseases (AIDs), offering distinct advantages over conventional immunosuppressive therapies. This review examines recent advancements in both autologous and allogeneic CAR-T platforms for AIDs. METHODS: We analyzed preclinical and clinical evidence regarding CAR-T therapies. These therapies target signaling molecules across various cells in the myeloid and lymphoid lineages, addressing autoimmune pathologies across dermatological, neurological, gastrointestinal, and hematological systems. RESULTS: Diversified CAR-T technological innovations have been developed. CAR-T therapy achieves remarkable efficacy in various AID by precisely eliminating pathogenic cells and facilitating a systemic immune reset, thereby maintaining a favorable balance between therapeutic benefit and safety. CONCLUSION: CAR-T cell therapy represents a revolutionary therapeutic strategy for the management of refractory AIDs. Addressing current challenges will further promote its clinical translation and expand its application in the treatment of AIDs.