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Chimeric Autoantibody Receptor T (CAAR-T) cell therapy is an engineered cellular immunotherapy designed to selectively target and eliminate autoreactive B cells. Unlike standard CAR-T cells that typically target a broad lineage marker (such as CD19), CAAR-T cells are engineered to express a specific autoantigen on their surface. This autoantigen acts as the "bait" to bind specifically to the B-cell receptors (BCRs) of pathogenic B cells that produce autoantibodies. Upon binding, the CAAR-T cell is activated through intracellular signaling domains—commonly CD3zeta combined with costimulatory domains like CD28 or 4-1BB—leading to the selective lysis of the autoreactive B cell. This precision approach is intended to treat autoimmune diseases (e.g., Pemphigus Vulgaris, Myasthenia Gravis) and conditions involving neutralizing antibodies (e.g., Hemophilia A with inhibitors) without causing broad B-cell depletion or systemic immunosuppression.
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