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[皮肤科中的嵌合抗原受体T细胞:自身免疫性疾病中的作用机制与应用]

[CAR-T cells in Dermatology: Mechanisms of action and applications in autoimmune diseases].

作者信息

Morales-Hernández Osmara, Méndez-Flores Silvia

机构信息

Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Dermatología. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2025 Mar 3;63(2):e6626. doi: 10.5281/zenodo.14617135.

Abstract

BACKGROUND

Chimeric Antigen Receptor T (CAR-T) cells have revolutionized the treatment of hematological malignancies and are expanding into autoimmune rheumatological diseases. In dermatology, they open a new therapeutic field for autoimmune disorders.

OBJECTIVE

To evaluate the mechanisms of action and therapeutic applications of CAR-T cells in autoimmune dermatological diseases, exploring the challenges and future perspectives for their clinical application.

MATERIAL AND METHODS

A thorough review was conducted in PubMed of preclinical and clinical studies on the application of CAR-T in dermatological diseases, selecting articles from the last 5 years with a focus on autoimmune diseases.

RESULTS

The potential of CAR-T cells in autoimmune dermatological diseases is highlighted, such as in pemphigus vulgaris, where CAR-T cells targeting pathogenic anti-Dsg3 B cells have shown efficacy. In cutaneous lupus erythematosus, CAR-T cells directed at CD19 have achieved significant clinical remissions. Additionally, applications in psoriasis and melanoma are explored, although efficacy is limited by adverse factors.

CONCLUSIONS

CAR-T therapy represents a promising option for the management of refractory dermatological diseases, with favorable results in preclinical and clinical models. However, its clinical implementation faces challenges such as optimizing safety and reducing off-target effects. Future research should focus on next-generation CARs and clinical trials that validate their efficacy and safety profile in dermatology.

摘要

背景

嵌合抗原受体T(CAR-T)细胞彻底改变了血液系统恶性肿瘤的治疗方式,并正在扩展到自身免疫性风湿性疾病领域。在皮肤病学中,它们为自身免疫性疾病开辟了一个新的治疗领域。

目的

评估CAR-T细胞在自身免疫性皮肤病中的作用机制和治疗应用,探讨其临床应用面临的挑战和未来前景。

材料与方法

在PubMed上对CAR-T在皮肤病中的临床前和临床研究进行了全面综述,选取过去5年的文章,重点关注自身免疫性疾病。

结果

突出了CAR-T细胞在自身免疫性皮肤病中的潜力,例如在寻常型天疱疮中,靶向致病性抗桥粒芯糖蛋白3(Dsg3)B细胞的CAR-T细胞已显示出疗效。在皮肤红斑狼疮中,针对CD19的CAR-T细胞已实现显著的临床缓解。此外,还探讨了其在银屑病和黑色素瘤中的应用,尽管疗效受到不良因素的限制。

结论

CAR-T疗法是治疗难治性皮肤病的一个有前景的选择,在临床前和临床模型中均取得了良好效果。然而,其临床应用面临着诸如优化安全性和减少脱靶效应等挑战。未来的研究应聚焦于新一代CARs以及验证其在皮肤病学中疗效和安全性的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adac/12054643/035f49556e81/04435117-63-2-e6626-f001.jpg

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