For the first time, an off-the-shelf CAR T cell therapy has been used to treat potentially life-threatening autoimmune disorders in three people. Here, immune cells called T cells are genetically engineered to hunt targets inside the body, including rogue immune cells that destroy the body’s own tissues. A patient’s immune cells are extracted and genetically engineered to produce specific protein “Guides” that attach to the surface of each cell. These guides help the cells home in on cancers and alert the body’s immune system to ramp up attacks.
Newer studies have tried directly reprogramming immune cells inside the body.
It’s a tale of two types of immune cells, T and B cells. In autoimmune diseases, they mark healthy tissues as the foe, alerting T cells to destroy them and causing the body to attack itself.
CAR T cells that target these defective B cells could nip autoimmune problems in the bud.
A more efficient way to make CAR T cells is to use immune cells from healthy donors.
Like a plug-and-play Mr. Potato head, the cells can be given genes to increase immune attacks on cancer cells-or to dial down friendly fire from autoimmune flare-ups.
Using the gene editor CRISPR-Cas9, the team wiped out five genes in the donor T cells to prevent them from attacking host cells and protect them from the host’s immune system.
The cells were also engineered to go after dangerous B cells triggering autoimmune responses. The study recruited three people between the ages of 42 and 56, two suffering from systemic sclerosis and one with IMNM. After injection, the CAR T cells multiplied and destroyed targeted B cells.
It’s still debatable whether the cancers were due to the CAR T cells, but the team is aware of the risk.
Eventually, the researchers want to compare off-the-shelf CAR T cells to those engineered from individuals, both in terms of how well they work and how much they cost.