Advances in Cell-based Treatments of Autoimmune Diseases: from expanded Tregs until CAR Tregs

Immunotherapy was demonstrated to be a potential strategy to modify or rebalance the immune system, making it a promising tool in the control of autoimmune diseases. Regulatory T cells (Tregs) have shown to play important roles in the induction and maintenance of peripheral tolerance, leading to the prevention of excessive immune responses and graft rejection as well as the management of autoimmunity responses. There are extensive studies investigating Treg roles as a promising tool for the prevention or treatment of autoimmune diseases, solid organ transplantation and graft‐versus‐host disease (GVHD) after in vivo adoptive transfer. On the other hand, chimeric antigen receptor T cells (also known as CAR-T cells), genetically engineered T cells producing an artificial T-cell receptor, are currently mainly used in cancer immunotherapies. Promising results from clinical trials and the success of the CAR-T therapy in oncology, as shown by the FDA-approved CD-19 CAR-T cell, have paved the way for investigating the efficacy of CAR-T therapy in a wide variety of diseases, including autoimmune diseases. In autoimmune diseases, CAR-T cells might be developed to target B cells, as pathological cells responsible for autoimmune reactions. Most importantly, CARs can be transduced into Tregs to develop specific cells for a selected antigen. Of important note, CAR-Tregs, due to their antigen specificity, do not need to migrate into the lymph node but can be specifically directed into the target organ/tissue. However, because of the absence of self-protein expression on the inflamed tissue, the development of CAR-Tregs in autoimmune diseases seems challenging. Nonetheless, CAR-Tregs specific for MHC-I molecules have been developed for transplantations, demonstrating their great potential for the treatment of allograft rejections and autoimmune diseases.

This Research Topic focuses mainly on studies, including Original Research, Hypothesis and Theory, and Review articles, which investigate and discuss the use of Treg, CAR T-cell and CAR-Treg therapies for the treatment of autoimmune diseases. We welcome manuscripts covering, but not limited to, Treg, CAR T-cell and CAR-Treg therapies directed against autoimmune diseases, including RA (rheumatoid arthritis), SLE (systemic lupus erythematosus), MS (multiple sclerosis), T1DM (Type I diabetes mellitus), JIA (Juvenile idiopathic arthritis), AIH (autoimmune hepatitis).