Cellular therapies in systemic Sclerosis: immunopathogenesis-informed precision targeting with CAR-T and CAR-NK approaches

Systemic sclerosis (SSc) is a rare, heterogeneous systemic autoimmune rheumatic disease characterized by immune dysregulation, vasculopathy, and excessive fibrosis. SSc is associated with high morbidity and mortality despite current immunosuppressive and anti-fibrotic therapies. Emerging cellular therapies, particularly chimeric antigen receptor (CAR) T-cell and natural killer (NK) cell approaches offer potential for deep immune reset and long-term remission. This review examines the immunobiological rationale for these therapies in SSc and evaluates their early clinical evidence, including comparisons to other autoimmune diseases.