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CD19 CAR-T 细胞治疗滤泡性淋巴瘤后重度银屑病长期缓解

英文原题:Long-term Remission of Severe Psoriasis Following CD19 CAR-T Cell Therapy for Follicular Lymphoma.

PubMed 2026/07/16(内容时间) Clin Exp Dermatol Q2 · IF 2.8(JCR 2025)

研究概要

银屑病在CD19 CAR-T细胞治疗四周内消退,并且在没有接受任何银屑病针对性治疗的情况下,已保持缓解超过4.5年。

中文摘要

银屑病是一种慢性、免疫介导的炎症性疾病,尽管有高效的生物制剂治疗,但很少能实现持久的、无需治疗的缓解。我们报告一例60岁女性,有49年重度、治疗难治性斑块状银屑病病史,在接受自体CD19靶向嵌合抗原受体(CAR)T细胞治疗滤泡性淋巴瘤后,实现了完全且持续的疾病清除。银屑病在CD19 CAR-T细胞治疗后四周内消退,并已保持缓解超过4.5年,未接受任何针对银屑病的治疗。这一观察结果与新兴报道一起提示,在银屑病中深度清除组织中的B淋巴谱系细胞可能诱导长期的疾病修饰。在机制上,CD19 CAR-T治疗比抗CD20方法靶向更广泛的B细胞群体,可能破坏致病性B-T细胞相互作用和自身反应性免疫环路。这些发现挑战了当前以T细胞为中心的银屑病范式,并支持探索以B细胞为靶点的免疫重置策略,作为实现持久缓解或治愈的途径。

展开英文摘要原文

Psoriasis is a chronic, immune-mediated inflammatory disease in which durable, treatment-free remission is rarely achieved despite highly effective biologic therapies. We report a 60-year-old woman with a 49-year history of severe, treatment-refractory plaque psoriasis who developed complete and sustained disease clearance following autologous CD19-directed chimeric antigen receptor (CAR) T-cell therapy for follicular lymphoma. Psoriasis resolved within four weeks of CD19 CAR-T-cell therapy and has remained in remission for over 4.5 years without any psoriasis-directed treatment. This observation, together with emerging reports, suggests that deep tissue depletion of B-lymphoid lineage cells in psoriasis may induce long-term disease modification. Mechanistically, CD19 CAR-T therapy targets a broader spectrum of B-cell populations than anti-CD20 approaches, potentially disrupting pathogenic B-T cell interactions and autoreactive immune circuits. These findings challenge the prevailing T cell-centric paradigm of psoriasis and support exploration of B-cell-directed, immune reset strategies as a route towards durable remission or cure.

论文信息

作者
Gulliver WP、Perlmutter JW、Gulliver SR、Tiplica GS、Lynde CW、Gniadecki R、Atkins H、Griffiths CEM
第一作者单位
Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.Canada
通讯作者单位
St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK.United Kingdom
期刊
Clinical and experimental dermatology2026 Jul 16
原文标识
PubMed 42462170 · DOI 10.1093/ced/llag301