Chimeric antigen receptor T cells for autoimmune diseases, in particular immune thrombocytopenia

Immune thrombocytopenia (ITP) is characterized by immune-mediated platelet destruction and impaired platelet production. Both plasma/B cell-producing anti-platelet autoantibodies and autoreactive T cells lead to thrombocytopenia and treatment refractoriness. Conventional treatments often fail to induce sustained remission off treatment (SROT). Chimeric antigen receptor (CAR) T cell therapy, developed for haematological malignancies, has recently been explored in autoimmunity to target plasma/B cells, reducing autoantibody production. Early studies suggest potential for benefit in refractory autoimmune disease, including ITP. This nutshell review summarizes CAR T cell therapy in autoimmunity, especially refractory ITP.