Is There a Place for Chimeric Antigen Receptor–T Cells in the Treatment of Chronic Autoimmune Rheumatic Diseases?

Chimeric antigen receptor–T (CAR‐T) cell therapy is based on specific targeting of tumor antigens, leading to lysis and destruction of tumor cells. The high potency of CAR‐T cells in the management of B cell malignancies has been demonstrated. Following the success of this therapeutic strategy, new CAR‐T cell–derived constructs that have the ability to eradicate pathogenic B cells or restore tolerance have been developed. The present review discusses how the knowledge and technology generated by the use of CAR‐T cells may be translated and integrated into ongoing therapeutic strategies for autoimmune rheumatic diseases. To this end, we describe the details of CAR‐T cell technology, as well as the meaningful achievements attained with the use of CAR‐T cells in onco‐hematology. In addition, we review the preliminary data obtained with CAR‐T cells and their derivative constructs in experimental models of autoimmune diseases. Finally, we focus on how CAR‐T cell engineering interferes with the pathogenesis of 3 chronic autoimmune rheumatic diseases—rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis—and discuss whether these constructs might yield greater efficacy and be associated with fewer adverse events compared to current treatment strategies.