Sustained B cell depletion by CD19-targeted CAR T cells is a highly effective treatment for murine lupus

R Kansal, N Richardson, I Neeli, S Khawaja… - Science translational …, 2019 - science.org
R Kansal, N Richardson, I Neeli, S Khawaja, D Chamberlain, M Ghani, Q Ghani, L Balazs…
Science translational medicine, 2019science.org
The failure of anti-CD20 antibody (Rituximab) as therapy for lupus may be attributed to the
transient and incomplete B cell depletion achieved in clinical trials. Here, using an
alternative approach, we report that complete and sustained CD19+ B cell depletion is a
highly effective therapy in lupus models. CD8+ T cells expressing CD19-targeted chimeric
antigen receptors (CARs) persistently depleted CD19+ B cells, eliminated autoantibody
production, reversed disease manifestations in target organs, and extended life spans well …
The failure of anti-CD20 antibody (Rituximab) as therapy for lupus may be attributed to the transient and incomplete B cell depletion achieved in clinical trials. Here, using an alternative approach, we report that complete and sustained CD19+ B cell depletion is a highly effective therapy in lupus models. CD8+ T cells expressing CD19-targeted chimeric antigen receptors (CARs) persistently depleted CD19+ B cells, eliminated autoantibody production, reversed disease manifestations in target organs, and extended life spans well beyond normal in the (NZB × NZW) F1 and MRLfas/fas mouse models of lupus. CAR T cells were active for 1 year in vivo and were enriched in the CD44+CD62L+ T cell subset. Adoptively transferred splenic T cells from CAR T cell–treated mice depleted CD19+ B cells and reduced disease in naive autoimmune mice, indicating that disease control was cell-mediated. Sustained B cell depletion with CD19-targeted CAR T cell immunotherapy is a stable and effective strategy to treat murine lupus, and its effectiveness should be explored in clinical trials for lupus.
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