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10.1172/jci.insight.196197
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
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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
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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
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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
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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
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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
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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
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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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Published July 14, 2026 - More info
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.