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 associated with BCMA CAR-T therapy, with JAK inhibition showing therapeutic promise.

• Why it matters: Understanding the effects of B cell-targeted therapies on mucosal immunity is crucial because their consequences remain poorly characterized, especially in severe complications like enterocolitis.
• What they did: The study analyzed intestinal biopsies from 10 patients with CAR-T EC, 7 CAR-T treated controls without EC, and 26 healthy volunteers using single-cell transcriptomics, flow cytometry, and tissue imaging to identify cellular changes.
• The result: Findings reveal profound depletion of mucosal B cells and plasma cells, expansion of cytotoxic CAR-T cells, and inflammatory tissue remodeling, with JAK inhibition improving clinical and histologic outcomes in some patients.