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ResearchIn-Press PreviewImmunologyInflammation Open Access | 10.1172/jci.insight.196197

CAR19 Tregs treat murine chronic Graft-Versus-Host Disease through immune suppression in absence of measurable B-cell cytolysis

Sujeong Jin,1 Michael C. Zaiken,1 Cameron McDonald-Hyman,2 Christina R. Hartigan,1 Sara Bolivar-Wagers,1 Jemma H. Larson,1 Yiyun Peng,1 Sophia Hani,1 Megan Riddle,1 Asim Saha,1 Angela Panoskaltsis-Mortari,1 Eun Ko,1 Yujie Zhao,1 Rocio Amaro Marquez,1 Pooja Shree Marri Baskar,1 Cindy R. Eide,1 William J. Murphy,3 Keli L. Hippen,1 Geoffrey R. Hill,4 Jakub Tolar,1 Peter T. Sage,5 Christopher A. Pennell,6 Leslie S. Kean,7 and Bruce R. Blazar1

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Jin, S. in: PubMed | Google Scholar |

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Zaiken, M. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by McDonald-Hyman, C. in: PubMed | Google Scholar |

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Hartigan, C. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Bolivar-Wagers, S. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Larson, J. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Peng, Y. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Hani, S. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Riddle, M. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Saha, A. in: PubMed | Google Scholar |

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Panoskaltsis-Mortari, A. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Ko, E. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Zhao, Y. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Amaro Marquez, R. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Marri Baskar, P. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Eide, C. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Murphy, W. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Hippen, K. in: PubMed | Google Scholar |

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Hill, G. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Tolar, J. in: PubMed | Google Scholar

1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

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1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

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1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

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1Department of Pediatrics, Division of Pediatric Blood and Marrow Transplant, University of Minnesota Medical School, Minneapolis, United States of America

2Department of Medicine, Division of Hematology, Oncology and Transplantatio, University of Minnesota Medical School, Minneapolis, United States of America

3Department of Dermatology, UCD, Davis, United States of America

4Translational Science and Therapeutics Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States of America

5Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, United States of America

6Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, United States of America

7Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, United States of America

Find articles by Blazar, B. in: PubMed | Google Scholar |

Published July 14, 2026 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.196197.
Copyright © 2026, Jin et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published July 14, 2026 - Version history
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Abstract

Chronic Graft-Versus-Host disease (cGVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic transplantation. CGVHD pathophysiology involves cooperation between Tfollicular helper cells (TFH) and germinal center B-cells (GCB), allo- and auto-antibody depositions in cGVHD tissues, and fibrosis. We evaluated human CD19-directed chimeric antigen receptor (CAR19) T-cell therapy in a clinically relevant murine cGVHD model with bronchiolitis obliterans syndrome (BOS). Although CD8 CAR19 T-cells effectively reduced peripheral B-cell and GCB frequencies, pulmonary function was unimproved. In contrast, a single CAR19 CD4 regulatory T-cells (Treg) infusion mitigated ongoing pulmonary disease and modulated germinal centers (GC) associated with reduced TFH frequencies compared to control Tregs but without measurable B-cell depletion. Compared to EGFR Treg infusion, mice receiving CAR19 Tregs exhibited enhanced suppression of B-cell activation, preserved splenic architecture, and provided greater opportunities for interaction with CD19+ B-cells at the B-cell follicle boundary zones. Taken together with the absence of detectable B-cell cytolysis, these findings are most consistent with GC suppression rather than B-cell depletion as the dominant mechanism. Overall, our findings suggest that CAR19 Tregs represent a promising and safe cGVHD/BOS therapeutic strategy, offering immunosuppressive benefits and improved disease outcomes that may be more limited with CD8 CAR19 T-cell treatment.

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