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Interfering with cardiac fibrosis with CAR-T cells. A new application of in vivo immunological cell targeting

Paper commented by the ESC WG on Cellular Biology of the Heart

The ‘immunorevolution’ caused by targeting cytotoxic T cells carrying chimeric antigen receptor (CAR-T) against malignant cells has been successfully employed to address the growing and potentially pandemic issue of cardiac fibrosis. Using CAR-Ts directed against cells expressing the Fibroblast Activation Protein (FAP), a marker highly expressed in activated cardiac fibroblasts, the Authors successfully removed pro-fibrotic cells from mouse failing hearts, recovering heart function. The treatment had minimal side effects and led to an almost complete reversion of interstitial fibrosis, accompanied by a striking reduction of collagen content. Although the technique will have to be made safer and more specific for selective elimination of pro-fibrotic cells in the human heart, the results are very promising and open the way to immunotherapy treatment of heart failure, giving concrete hopes for reducing its burden.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.