Persistence of mucosal CAR-T cells and inflammatory remodeling in enterocolitis associated with BCMA CAR-T cell therapy.

Mucosal CAR-T cells persist and cause inflammatory remodeling in enterocolitis, with 10 patients showing severe mucosal dysregulation after BCMA CAR-T therapy.

• Why it matters: Understanding the impact of B-cell-targeted therapies on mucosal immunity is crucial as these treatments expand, yet their effects on intestinal health remain poorly characterized.
• What they did: Researchers analyzed intestinal biopsies from 10 patients with CAR-T cell-induced enterocolitis, comparing them to controls and healthy volunteers using single-cell transcriptomics, flow cytometry, and tissue imaging.
• The result: Findings reveal profound mucosal B-cell depletion, expansion of cytotoxic CAR-T cells, and stromal dysfunction, with JAK inhibition improving symptoms, highlighting a multicompartment inflammatory syndrome.