Chimeric antigen receptor technology: an emerging translational immunotherapy in nonneoplastic diseases

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Abstract
Background: One of the most significant recent advancements in cancer immunotherapy is the development of chimeric antigen receptor (CAR) technology. More recently, this approach has been gradually modified for the research associated with various treatment-resistant nonneoplastic diseases by engineering immune cells to provide precise targeting. Results: This narrative review discusses two primary therapeutic approaches the use of CAR technology in the treatment of nonneoplastic diseases. One strategy involves the elimination of specific pathogenic cell populations. Specifically, by engineering T cells, macrophages, or natural killer (NK) cells, pathogenic cells can be eliminated in autoimmune disorders, infectious diseases, and fibrotic lesions. The second approach aims to restore immune homeostasis by using engineered regulatory T cells (Tregs) to control augmented immune effector responses. This strategy has been shown to promote transplant tolerance and has therapeutic potential for inflammatory bowel disease and type 1 diabetes. Furthermore, this review addresses major issues concerning the persistence, safety, and manufacturing accessibility of CAR cells and discusses some emerging technological approaches that could be used for focused refinements of this technology. Conclusions: The precision medicine platform for CAR technology has advanced beyond oncology by integrating targeted cell destruction with the management of immune homeostasis. As future possibilities with frontier cell engineering and interdisciplinary approaches are explored, CAR cell therapy is likely to evolve into a more adaptable, refined, and clinically viable immunotherapy technology, with its therapeutic potential expanded to a broad range of diseases.

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