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CAR-engineered cytolytic Tregs reverse pulmonary fibrosis and remodel the fibrotic niche with limited CRS
Yun-Han Jiang, … , Sai Chen, Ying-Qiang Guo
Yun-Han Jiang, … , Sai Chen, Ying-Qiang Guo
Published July 8, 2025
Citation Information: JCI Insight. 2025;10(15):e182050. https://doi.org/10.1172/jci.insight.182050.
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Research Article Immunology Pulmonology Therapeutics

CAR-engineered cytolytic Tregs reverse pulmonary fibrosis and remodel the fibrotic niche with limited CRS

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Abstract

Idiopathic pulmonary fibrosis (IPF) is a severe, diffuse, progressive, and fibrosing interstitial disease leading to respiratory failure and death in the absence of organ transplantation. Substantial evidence has confirmed the pivotal role of fibroblasts in the progression of IPF, yet effective therapeutic options are scarce. Single-cell transcriptomics profiling revealed that among the diverse fibroblast subsets, FAP1+ alveolar fibroblasts (AFs) were pivotal for the progression of IPF. On the basis of these findings, we developed FAP1-targeting chimeric antigen receptor cytotoxic effector regulatory T cells (CAR-cTregs), which leveraged the targeted killing advantage of the currently trending CAR-based immunotherapy for tumors and incorporated the immunosuppressive functions of Tregs to mitigate the inflammation caused by both the disease itself and CAR-T cell infusion. Accordingly, CAR-cTregs were constructed to effectively eliminate FAP1+ fibroblasts in vitro. This cytotoxic effect could be abrogated by inhibitors of the granzyme B/perforin pathway. In the bleomycin-induced PF model, CAR-cTregs were found to reverse fibrosis characterized by diminished recruitment of fibrocytes and improved remodeling of epithelial cells. Together, our results demonstrate that CAR-cTregs can serve as a promising therapeutic option for IPF and provide an alternative strategy for treating multiple chronic inflammatory diseases by inducing both cytotoxicity and immunosuppression.

Authors

Yun-Han Jiang, Meng Zhou, Meng-Di Cheng, Sai Chen, Ying-Qiang Guo

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Figure 2

Generation and characterization of FAP1-specific CAR-cTregs.

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Generation and characterization of FAP1-specific CAR-cTregs.
(A) Schemat...
(A) Schematic representation of the retroviral vector expressing the FAP1 CAR. HD,; TM, transmembrane domain; ICD, intracellular domain; HD, hinge domain. (B) Scheme for the generation and expansion of CAR-cTregs and CAR-Tcs. MACS, magnetic-activated cell sorting. (C) The transduction efficiency of the CAR and the expression of FoxP3 in mouse Tregs. (D) The expression of T cell activation marker (CD69) and Treg activation–associated markers (CTLA4 and LAP) was measured by flow cytometry after T cells were cocultured with lung Fibs. (E) Fold expansion on days 6–8, 3 days after CAR gene transfer (n = 21, or 14). (F) Proliferation of UT-Tc, CAR-Tc, cTreg, or CAR-cTregs cocultured with aFibs or Fibs. (G) The secretion of multiple cytokines in the cocultured media was evaluated by a cytometric bead assay. *P < 0.05 by 2-tailed Student’s t test (E) or 2-way ANOVA with Tukey’s post hoc test (F and G). #P < 0.05 for comparisons with Fib+UT-Tc, aFib+UT-Tc, Fib+CAR-Tc, or aFib+CAR-Tc. The data are presented as the mean ± SD (E and F) or the mean (G). n = 14 or 28 (E), n = 8 (F), n = 5 (G). CAR-cTreg, chimeric antigen receptor cytotoxic effector Treg cell; cTreg, cytotoxic effector Treg cell; CAR-Tc, chimeric antigen receptor cytotoxic T cell; UT-Tc, untransduced cytotoxic T cell.

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