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B cells and the autoantibodies they produce are central to the pathophysiology of lupus. Monoclonal antibodies directed at B cells, such as rituximab, sometimes are effective. However, such treatments don't reach and eliminate pathogenic B cells that reside deep within lymphoid organs and inflamed tissues, allowing the disease to resurge.
A multi-institutional team from Germany reasoned that chimeric antigen receptor (CAR) T-cell therapy, used to treat patients with B-cell malignancies, might eliminate pathogenic B cells in lupus more effectively than monoclonal antibodies do. The T cells of five patients (median age, 22) with severe refractory lupus were engineered to attack B cells and were reinfused into the patients. This led to deep dep…