Cell-Therapy

CD19 CAR-T cells can produce drug-free remission in lupus, but they delete B cells rather than restore tolerance. This review makes the case for engineered regulatory T cells carrying a T cell receptor for a disease-relevant antigen (TCR-Tregs), which suppress locally and spread suppression to bystander cells. The human data are still polyclonal Tregs, CAR-Tregs and tolerogenic dendritic cells; TCR-Tregs are preclinical, and the main barrier is manufacturing cost, which the authors propose to address with banked, gene-edited iPSC-derived products.