Abstract
Autoimmune diseases primarily mediated by cellular immunity, classified as type IV hypersensitivity disorders, are driven by dysregulated T cell responses resulting in targeted tissue destruction. Unlike antibody-dominant autoimmune conditions, these disorders involve autoreactive CD4+ and CD8+ T cells that infiltrate tissues, amplify inflammatory cascades, and promote chronic organ damage through cytokine release and direct cytotoxicity. Representative diseases include type 1 diabetes mellitus (T1DM), multiple sclerosis (MS), rheumatoid arthritis (RA; with substantial T cell involvement), and inflammatory bowel disease (IBD). Their etiology reflects a multifactorial breakdown of central and peripheral tolerance, involving genetic susceptibility, environmental triggers, and regulatory T cell (Treg) dysfunction. Advancements in molecular immunology have accelerated the development of targeted therapies, ranging from Janus kinase (JAK) inhibitors and biologics to innovative chimeric antigen receptor (CAR) T cell-based strategies aimed at immune reset and durable remission. This editorial summarizes current mechanistic insights and highlights emerging therapeutic progress up to late 2025, with emphasis on strategies reshaping disease prognosis and management in refractory cases.
Keywords
Autoimmune diseases, Cellular immunity, T cells, Therapy, Treatment, CAR-T