Precision Medicine for Autoimmunity: From CAAR-T Cells to AI-Driven CRISPR-Based Therapies, Challenges and Perspectives

This manuscript examines advancements in antigen-specific immunosuppression, as well as the potential and challenges of applying gene-editing technologies to autoimmune diseases driven by autoantibodies (AAbs). Current approved treatments fail to reach long-lived plasma cells (LLPCs), which may continue secreting pathogenic AAbs after immunobiological courses in some autoimmune illnesses. New approaches, some tested in vitro and some already undergoing clinical trials, such as the chimeric autoantibody receptor (CAAR)-T cells, BiTEs, affinity matrices, and CRISPR-AAb-untargeting, show promise in selectively eliminating autoreactive B lymphocytes. Challenges remain, particularly in adapting CRISPR for in vivo use. The future of precision medicine for autoimmunity will rely in AI-guided personalized approaches, enabling the design of highly specific therapies to target disease-causing autoreactive cells while preserving immune function, marking a transformative step in autoimmune treatment.