CAR-T cell therapy was originally developed for a few different blood cancers, but has now been found to show promising signs in a number of autoimmune diseases, including myasthenia gravis. CAR-T cell therapy has started to be used in the clinical trials in the UK for MS, and hopefully soon for MG as well.

CAR (Chimeric antigen receptor) T-cell therapy is a type of immunotherapy.  T-cells are part of the blood defence system and along with B cells that make antibodies they are first line defence against a new infection or disease.  B-Cells are the cells that make antibodies that are used to counteract the infection. In myasthenia gravis, and other autoimmune diseases, this defence system has turned against itself, and the B-cells producing antibodies that attack self-targets.

How does CAR T-cell work in autoimmune diseases? 

CAR-T is a personalised therapy, which means it is specially designed for the individual patient. T cells are collected from the blood, and in a laboratory the T-cells are modified to make proteins on their surface called chimeric antigen receptors (CARs) which target the B cells. If these B cells can be removed, the body should stop attacking itself. It is hoped that this may reset the immune system, potentially achieving long-term remission with a single infusion. As this is a new therapy, we are unsure as yet if this is possible.

Several types or CAR-T are in development, targeting different types of B cells. An early study of 12 patients with MG showed promising results, and clinical trials are underway throughout the US and Europe.