The method of CAR-T cell therapy (Chimeric Antigen Receptor T cell therapy) is based on the genetic modification of T lymphocytes aimed at selective elimination of autoreactive cells. This approach is considered as a possible therapeutic strategy in refractory autoimmune diseases (RADs) characterized by the failure of standard immunosuppressive therapy. Objective. To analyze the literature data on the use of CAR-T cell therapy in refractory autoimmune diseases, determine its efficacy and safety as well as consider mechanisms of action and potential risk. Materials and methods. An analysis of literature sources indexable in the international databases (PubMed, Scopus, Web of Science, Cochrane Library) for the period from 2019 to the present was performed. Publications containing information on clinical studies, mechanisms of action of CAR-T cells and complications related to therapy were included. Results. The ability of CAR-T cell therapy to eliminate autoreactive B lymphocytes, restore immunological tolerance and induce long-term remission has been proven. It has been established in a number of clinical studies that this treatment method contributes to significant reduction of RADs activity, but is accompanied by the risk including cytokine release syndrome, immune-mediated neurotoxicity and long-term lymphopenia, due to this close monitoring of patients is required. Conclusion. Researchers consider CAR-T cell therapy as a promising method of refractory autoimmune diseases treatment that provides prolonged remission. However, the issues of immune homeostasis recovery mechanisms, duration of therapeutic effect and possible long-term consequences remain open. Extensive clinical studies with long-term follow-up period are required to finally evaluate the efficacy and safety of this treatment method.
Vasiutin et al. (Mon,) studied this question.