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

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.