Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2026, Vol. 40 ›› Issue (6): 76-82.

• Airway Allergic Diseases: From Mechanism to Practice • Previous Articles    

Research progress of CAR-T cell therapy for respiratory allergic diseases

CHEN Ruien1, ZOU Huamei1, LIAO Yun2, YANG Gui1   

  1. 1. Department of Otolaryngology Head and Neck Surgery & Department of Allergy, Shenzhen Longgang Central Hospital/ Guangzhou University of Chinese Medicine Shenzhen Clinical College, Shenzhen 518116, Guangdong, China2. Department of General Practice Medicine, The Third Affiliated Hospital of Shenzhen University, Shenzhen 518002, Guangdong, China
  • Published:2026-11-03

Abstract: Chimeric antigen receptor T-cell therapy(CAR-T)is a novel targeted immunotherapy based on gene editing technology, which has strong targeting capability. Although at the stage of development, it has shown promising prospects and has achieved breakthroughs in the treatment of tumor diseases, autoimmune diseases, and allergies. With high incidence, respiratory allergic diseases could not be cured because of limited treatments. As an emerging technology, CAR-T can specifically target the therapeutic sites of respiratory allergy and effectively alleviate airway inflammation. However, the application of this therapy may lead to adverse reactions and early identification and preventive medication are crucial for addressing this issue. This article systematically summarizes the research progress of CAR-T cell therapy for respiratory allergy in recent years, aiming to provide theoretical basis and research ideas for subsequent in-depth studies and clinical transformation.

Key words: Chimeric antigen receptor T-cell therapy, Respiratory allergic diseases, Targets, Adverse reactions

CLC Number: 

  • R593.1
[1] 刘玉, 李帆, 戴蕙芸, 等. 定点突变优化信号肽对嵌合抗原受体T细胞功能的影响[J]. 生物工程学报, 2024, 40(2): 573-584. DOI:10.13345/j.cjb.230506
[2] Maus M V. CD19 CAR T cells for adults with relapsed or refractory acute lymphoblastic leukaemia[J]. Lancet, 2021, 398(10299): 466-467. DOI: 10.1016/S0140-6736(21)01289-7
[3] Kong Y J, Li J Y, Zhao X Y, et al. CAR-T cell therapy: developments, challenges and expanded applications from cancer to autoimmunity[J]. Front Immunol, 2025, 15: 1519671. DOI: 10.3389/fimmu.2024.1519671
[4] Esmaeilzadeh A, Tahmasebi S, Athari S S. Chimeric antigen receptor -T cell therapy: applications and challenges in treatment of allergy and asthma[J]. Biomed Pharmacother. 2020, 123: 109685. DOI: 10.1016/j.biopha.2019.109685
[5] Lyu J, Kou F, Men X, et al. The changes in bacterial microbiome associated with immune disorder in allergic respiratory disease[J]. Microorganisms, 2022, 10(10): 2066. DOI: 10.3390/microorganisms10102066
[6] Mohammad Taheri M, Javan F, Poudineh M, et al. Beyond CAR-T: The rise of CAR-NK cell therapy in asthma immunotherapy.[J] J Transl Med. 2024;22(1):736. DOI:10.1186/s12967-024-05534-8
[7] Huang T, Bei C Q, Hu Z H, et al. CAR-macrophage: breaking new ground in cellular immunotherapy[J]. Front Cell Dev Biol, 2024, 12: 1464218. DOI: 10.3389/fcell.2024.1464218
[8] Khan A N, Chowdhury A, Karulkar A, et al. Immunogenicity of CAR-T cell therapeutics: evidence, mechanism and mitigation[J]. Front Immunol, 2022, 13: 886546. DOI: 10.3389/fimmu.2022.886546
[9] Ma L Y, Dichwalkar T, Chang J Y H, et al. Enhanced CAR-T cell activity against solid tumors by vaccine boosting through the chimeric receptor[J]. Science, 2019, 365(6449): 162-168. DOI: 10.1126/science.aav8692
[10] Abdeladhim M, Zhang A H, Kropp L E, et al. Engineered ovalbumin-expressing regulatory T cells protect against anaphylaxis in ovalbumin-sensitized mice[J]. Clin Immunol, 2019, 207: 49-54. DOI: 10.1016/j.clim.2019.07.009
[11] Ward D E, Fay B L, Adejuwon A, et al. Chimeric antigen receptors based on low affinity mutants of FcεRI re-direct T cell specificity to cells expressing membrane IgE[J]. Front Immunol, 2018, 9: 2231. DOI: 10.3389/fimmu.2018.02231
[12] Chen S S, Chen G Y, Xu F, et al. Treatment of allergic eosinophilic asthma through engineered IL-5-anchored chimeric antigen receptor T cells[J]. Cell Discov, 2022, 8(1): 80. DOI: 10.1038/s41421-022-00433-y
[13] Mavi A K, Gaur S, Gaur G, et al. CAR T-cell therapy: reprogramming patient's immune cell to treat cancer[J]. Cell Signal, 2023, 105: 110638. DOI: 10.1016/j.cellsig.2023.110638
[14] Schubert M L, Schmitt M, Wang L, et al. Side-effect management of chimeric antigen receptor(CAR)T-cell therapy[J]. Ann Oncol, 2021, 32(1): 34-48. DOI: 10.1016/j.annonc.2020.10.478
[15] 吴俣, 李佩璐, 葛军, 等. 嵌合抗原受体调节性T细胞免疫疗法在器官移植中的应用[J]. 器官移植, 2020, 11(5): 547-552. DOI: 10.3969/j.issn.1674-7445.2020.05.003
[16] Beheshti S A, Shamsasenjan K, Ahmadi M, et al. CAR Treg: a new approach in the treatment of autoimmune diseases[J]. Int Immunopharmacol, 2022, 102: 108409. DOI: 10.1016/j.intimp.2021.108409
[17] Golubovskaya V, Wu L J. Different subsets of T cells, memory, effector functions, and CAR-T immunotherapy[J]. Cancers(Basel), 2016, 8(3): 36. DOI: 10.3390/cancers8030036
[18] Riet T, Chmielewski M. Regulatory CAR-T cells in autoimmune diseases: progress and current challenges[J]. Front Immunol, 2022, 13: 934343. DOI: 10.3389/fimmu.2022.934343
[19] Arjomandnejad M, Kopec A L, Keeler A M. CAR-T regulatory(CAR-treg)cells: engineering and applications[J]. Biomedicines, 2022, 10(2): 287. DOI: 10.3390/biomedicines10020287
[20] Chen T, Wang M Z, Chen Y C, et al. Current challenges and therapeutic advances of CAR-T cell therapy for solid tumors[J]. Cancer Cell Int, 2024, 24(1): 133. DOI: 10.1186/s12935-024-03315-3
[21] Vincent R L, Gurbatri C R, Li F D, et al. Probiotic-guided CAR-T cells for solid tumor targeting[J]. Science, 2023, 382(6667): 211-218. DOI: 10.1126/science.add7034
[22] Li Q R, Zhang X Y, Feng Q, et al. Common allergens and immune responses associated with allergic rhinitis in China[J]. J Asthma Allergy, 2023, 16: 851-861. DOI: 10.2147/JAA.S420328
[23] Lambrecht B N, Hammad H. CAR T cells put the brakes on asthma[J]. Nat Immunol, 2024, 25(6): 935-937. DOI: 10.1038/s41590-024-01851-8
[24] Dudek R P, Ma Z Y. CAR T cells for treating severe atopic allergic diseases[J]. Dela J Public Health, 2023, 9(4): 12-15. DOI: 10.32481/djph.2023.11.004
[25] Shamji M H, Valenta R, Jardetzky T, et al. The role of allergen-specific IgE, IgG and IgA in allergic disease[J]. Allergy, 2021, 76(12): 3627-3641. DOI: 10.1111/all.14908
[26] Garman S C, Wurzburg B A, Tarchevskaya S S, et al. Structure of the Fc fragment of human IgE bound to its high-affinity receptor Fc epsilonRI alpha[J]. Nature, 2000, 406(6793): 259-266. DOI: 10.1038/35018500
[27] Dhaliwal B, Yuan D P, Pang M O Y, et al. Crystal structure of IgE bound to its B-cell receptor CD23 reveals a mechanism of reciprocal allosteric inhibition with high affinity receptor FcεRI[J]. Proc Natl Acad Sci USA, 2012, 109(31): 12686-12691. DOI: 10.1073/pnas.1207278109
[28] 唐思艺, 朱新华. CCR3基因在呼吸道过敏性疾病中对相关炎性细胞的作用研究[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(1): 80-84. DOI: 10.13201/j.issn.2096-7993.2021.01.021
[29] Bao Y W, Wu Z K, Zhu X H, et al. The study of the role of purified anti-mouse CD193(CCR3)antibody in allergic rhinitis mouse animal models[J]. Sci Rep, 2024, 14(1): 1059. DOI: 10.1038/s41598-024-51679-3
[30] Zhang Z Q, Bao Y W, Wang H, et al. Artesunate alleviates chronic allergic rhinitis and asthma syndrome via the CCR3/NF-κB pathway: a comprehensive analysis[J]. Int Immunopharmacol, 2025, 166: 115562. doi:10.1016/j.intimp.2025.115562
[31] Dai M N, Zhu X H, Yu J, et al. CCR3 gene knockout in bone marrow cells ameliorates combined allergic rhinitis and asthma syndrome(CARAS)by reducing airway inflammatory cell infiltration and Th2 cytokines expression in mice model[J]. Int Immunopharmacol, 2022, 104: 108509. DOI: 10.1016/j.intimp.2021.108509
[32] 陈高莹. 靶向CCR3的嵌合抗原受体T细胞治疗哮喘的研究[D]. 浙江大学, 2023
[33] Matucci A, Maggi E, Vultaggio A. Eosinophils, the IL-5/IL-5Rα axis, and the biologic effects of benralizumab in severe asthma[J]. Respir Med, 2019, 160: 105819. DOI: 10.1016/j.rmed.2019.105819
[34] Pitlick M M, Pongdee T. Combining biologics targeting eosinophils(IL-5/IL-5R), IgE, and IL-4/IL-13 in allergic and inflammatory diseases[J]. World Allergy Organ J, 2022, 15(11): 100707. DOI: 10.1016/j.waojou.2022.100707
[35] Eschenbacher W, Straesser M, Knoeddler A, et al. Biologics for the treatment of allergic rhinitis, chronic rhinosinusitis, and nasal polyposis[J]. Immunol Allergy Clin North Am, 2020, 40(4): 539-547. DOI: 10.1016/j.iac.2020.06.001
[36] Morris E C, Neelapu S S, Giavridis T, et al. Cytokine release syndrome and associated neurotoxicity in cancer immunotherapy[J]. Nat Rev Immunol, 2022, 22(2): 85-96. DOI: 10.1038/s41577-021-00547-6
[37] Chohan K L, Siegler E L, Kenderian S S. CAR-T cell therapy: the efficacy and toxicity balance[J]. Curr Hematol Malig Rep, 2023, 18(2): 9-18. DOI: 10.1007/s11899-023-00687-7
[38] Jain M D, Smith M, Shah N N. How I treat refractory CRS and ICANS after CAR T-cell therapy[J]. Blood, 2023, 141(20): 2430-2442. DOI: 10.1182/blood.2022017414
[39] Norelli M, Camisa B, Barbiera G, et al. Monocyte-derived IL-1 and IL-6 are differentially required for cytokine-release syndrome and neurotoxicity due to CAR T cells[J]. Nat Med, 2018, 24(6): 739-748. DOI: 10.1038/s41591-018-0036-4
[40] Sterner R C, Sterner R M. Immune effector cell associated neurotoxicity syndrome in chimeric antigen receptor-T cell therapy[J]. Front Immunol, 2022, 13: 879608. DOI: 10.3389/fimmu.2022.879608
[41] Suarez Montero J C, Caballero Gonzalez A C, Aguilar L M, et al. Immune effector cell-associated neurotoxicity syndrome: a therapeutic approach in the critically ill[J]. Med Intensiva(Engl Ed), 2020: S0210-5691(20)30244-8. DOI: 10.1016/j.medin.2020.06.014
[42] Wehrli M, Gallagher K, Chen Y B, et al. Single-center experience using anakinra for steroid-refractory immune effector cell-associated neurotoxicity syndrome(ICANS)[J]. J Immunother Cancer, 2022, 10(1): e003847. DOI: 10.1136/jitc-2021-003847
[43] 施婷婷, 卢根. 儿童呼吸道过敏性疾病与感染[J]. 中华实用儿科临床杂志, 2021, 36(6): 452-456. DOI: 10.3760/cma.j.cn101070-20201014-01620
[44] Wudhikarn K, Perales M A. Infectious complications, immune reconstitution, and infection prophylaxis after CD19 chimeric antigen receptor T-cell therapy[J]. Bone Marrow Transplant, 2022, 57(10): 1477-1488. DOI: 10.1038/s41409-022-01756-w
[45] Shimabukuro-Vornhagen A, Böll B, Schellongowski P, et al. Critical care management of chimeric antigen receptor T-cell therapy recipients[J]. CA Cancer J Clin, 2022, 72(1): 78-93. DOI: 10.3322/caac.21702
[46] Vora S B, Waghmare A, Englund J A, et al. Infectious complications following CD19 chimeric antigen receptor T-cell therapy for children, adolescents, and young adults[J]. Open Forum Infect Dis, 2020, 7(5): ofaa121. DOI: 10.1093/ofid/ofaa121
[47] Wudhikarn K, Pennisi M, Garcia-Recio M, et al. DLBCL patients treated with CD19 CAR T cells experience a high burden of organ toxicities but low nonrelapse mortality[J]. Blood Adv, 2020, 4(13): 3024-3033. DOI: 10.1182/bloodadvances.2020001972
[48] Moturi K R, Lingamaneni P, Baral B, et al. Temporal trends in inpatient outcomes and resource utilization in patients with tumor lysis syndrome(TLS)with solid and hematologic cancers: a nationwide analysis[J]. J Clin Oncol, 2020, 38(15_suppl): e19102. DOI: 10.1200/jco.2020.38.15_suppl.e19102
[49] Umair M M, Lai X, Xue Y B, et al. Influence of CAR T-cell therapy associated complications[J]. Front Oncol, 2025, 15: 1494986. DOI: 10.3389/fonc.2025.1494986
[50] Cappell K M, Kochenderfer J N. Long-term outcomes following CAR T cell therapy: what we know so far[J]. Nat Rev Clin Oncol, 2023, 20(6): 359-371. DOI: 10.1038/s41571-023-00754-1
[51] Brudno J N, Natrakul D, Lam N, et al. Acute and delayed cytopenias following CAR T-cell therapy: an investigation of risk factors and mechanisms[J]. Leuk Lymphoma, 2022, 63(8): 1849-1860. DOI: 10.1080/10428194.2022.2056172
[52] Strati P, Varma A, Adkins S, et al. Hematopoietic recovery and immune reconstitution after axicabtagene ciloleucel in patients with large B-cell lymphoma[J]. Haematologica, 2021, 106(10): 2667-2672. DOI: 10.3324/haematol.2020.254045
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