By Dr Pranab Gyawali, Consultant Gastroenterologist (UK-trained) in Dubai
Many patients with Crohn’s disease have asked me about CAR-T therapy after recent discussions in ulcerative colitis.
If CAR-T therapy can produce early signals in ulcerative colitis, it is natural to ask whether the same approach could work in Crohn’s disease.
The answer is more complex.
Crohn’s disease behaves differently. It is not just about excessive inflammation. It is about how the immune system is responding incorrectly, particularly in relation to gut bacteria and the intestinal environment.
This is why a different concept is now being explored.
In this video, I explain why the more relevant future direction in Crohn’s disease may not be standard CAR-T therapy, but CAR-Tregs.
What is CAR-T therapy?
CAR-T therapy involves taking immune cells, modifying them in a laboratory, and returning them to the patient.
In ulcerative colitis, early work suggests this may reduce certain immune cells, particularly B cells, that contribute to inflammation.
This has generated significant interest, but this does not mean the same approach applies directly to Crohn’s disease.
Can CAR-T therapy work in Crohn’s disease?
CAR-T therapy is not currently an established or approved treatment for Crohn’s disease.
Crohn’s disease is not simply driven by excessive immune cells. It involves abnormal immune regulation and misdirected responses in the gut.
This means that simply removing immune cells may not fully address the underlying problem.
What are CAR-Tregs?
CAR-Tregs are engineered regulatory immune cells designed to restore immune balance rather than attack.
CAR-T removes immune cells, whereas CAR-Tregs help restore immune control.
Think of the immune system like a football team.
In ulcerative colitis, removing aggressive players can improve the situation.
In Crohn’s disease, the system is misdirected. Even if players are removed, the problem persists.
CAR-Tregs act like a referee, helping restore control.
Why might CAR-Tregs be important in Crohn’s?
Crohn’s disease often reflects a loss of immune control rather than simple immune overactivity.
CAR-Tregs aim to regulate immune responses and restore balance, which may be more aligned with the biology of Crohn’s disease.
Is there real research in CAR-Tregs for Crohn’s?
Yes. Early research has explored CAR-Tregs targeting the IL-23 pathway, which is central to Crohn’s disease.
A study published in the Journal of Crohn’s and Colitis investigated IL23R-specific CAR-Tregs and demonstrated their potential relevance to Crohn’s disease.
This remains early-stage research and is not yet a clinical treatment.
Are CAR-Tregs available?
No. CAR-Tregs are not currently available as a routine treatment.
Patients should continue with established therapies and specialist-guided treatment plans.
Key takeaway
CAR-T therapy is generating interest due to early work in ulcerative colitis.
However, in Crohn’s disease, the more relevant future direction may be CAR-Tregs.
This represents a shift from removing immune cells to restoring immune control.
This is an area I will be watching closely and updating as research evolves.
Frequently Asked Questions
Is CAR-T therapy available for Crohn’s disease?
No. It is not an established treatment.
What are CAR-Tregs?
They are regulatory immune cells designed to restore balance.
Is this treatment available now?
No. It is still in early research stages.
Recommended Reading
- Crohn’s Disease – Gastroenterologist in Dubai
- Learn about Biologicals used in UC and Crohn’s in Dubai
Core Crohn’s Decision & Strategy
- Feeling Fine Isn’t Enough – Is Your Gut Really Healed
- How We Choose the Right Biologic for Crohn’s & UC in Dubai
Diet & Environment
- Crohn’s Disease Diet – 3 Gut-Friendly Foods That Help Control Flares
- Plant-Based Diet and Crohn’s Disease – Research Update
- Elemental Diet in Crohn’s Disease – When It’s Used
Gut Barrier & Regulation
- 4 Science-Backed Tips to Support Your Gut Barrier in Crohn’s & UC
- Leaky Gut in Crohn’s & UC – What It Really Means
Lifestyle & Gut–Brain Axis
- Stress and Crohn’s Disease – The Gut–Brain Connection
- Vaping and Gut Health – What Crohn’s Patients Should Know
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