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. 2016 Aug 31;24(8):1339–1341. doi: 10.1038/mt.2016.165

Figure 1.

Figure 1

How desmoglein 3–chimeric autoantigen receptor (Dsg3-CAAR) T cells lure and specifically eliminate autoreactive anti-Dsg3 B cells responsible for skin blistering in pemphigus vulgaris (PV) while sparing normal B cells. PV is a severe autoimmune disease caused by pathogenic autoreactive B cells expressing B-cell receptors (BCR) with immunoglobulins (Ig) specific for desmoglein-3 (Dsg3). These autoantibodies perturb the adhesion of keratinocytes and cause skin blistering. Dsg3-autoreactive B cells can be lured to their own demise when they engage their BCR onto genetically engineered T cells expressing a Dsg3-CAAR (Dsg3-CAAR T cells). The BCR recognizes the ectodomain of the CAAR, exposing four cadherin domains of Dsg3 as epitopes. This extracellular portion of the CAAR is linked to a CD137/CD3zeta chain that permits intracellular signaling and cytolytic activation of the T cell. A synapse forms between the Dsg3-CAAR T cell and Dsg3-specific B cells, cytokines are produced, and B-cell lysis occurs. By contrast, B cells with other BCRs (green) are not recognized and are not killed by Dsg3-CAAR T cells.