A T-cell engager platform induces deep plasma cell depletion in autoimmune dry eye

Abstract Bispecific T cell engagers (TCEs) have transformed targeted immunotherapy but remain constrained by ex vivo manufacturing and systemic delivery, limiting their application in autoimmune disorders. Here, we introduce the first in vivo TCE platform, utilizing a T cell-targeted integration-deficient lentiviral vector (T-IDLE) to reprogram endogenous T cells into engineered T cells secreting BCMA×CD3 TCEs (STCEs) directly in vivo . In murine Sjögren’s syndrome-associated dry eye model, a single intravenous administration of T-IDLE STCE achieved deep and sustained depletion of plasmablasts and plasma cells, reversing lacrimal gland inflammation and restoring tear production without detectable off-target transduction. Longitudinal studies in cynomolgus monkeys confirmed translational promise, demonstrating potent plasma cell clearance and favorable safety profiles over 12 weeks post-vector dosing. Mechanistic analyses demonstrated attenuation of Th1/Th17-mediated inflammation and controlled cytokine responses, accompanied by negligible vector integration in non-T cell lineages, thereby substantiating the safety profile of the integration-deficient design. This first-in-class in vivo TCE approach represents a manufacturing-free, scalable immunotherapy strategy for autoantibody-mediated diseases.