Immunology & Inflammation | Commercial Potential & Clinical Frontiers

Immunology has become very good at suppressing inflammation. The next question is whether treatment can go further and reset the immune system deeply enough to give patients durable, treatment-free remission. Ellen Gravallese MD led that discussion with Alyssa Johnsen MD, PhD, Eric Mortensen and Scott Requadt.

Johnsen emphasized that cytokine-targeted therapies still have an important role, but that deeper remission may require thinking about what happens after immune depletion, including whether tolerance can be restored. Requadt focused on B-cell depletion and the possibility that reaching pathogenic cells in tissue, not just in the blood, could help explain why CAR T cells and T-cell engagers may produce more durable responses than chronic immunosuppression.

Mortensen, who joined after the session began, pushed the conversation toward a more tunable version of immune reset. Different autoimmune diseases may require different depths of depletion, different targets and different therapeutic platforms. Across the panel, the promise of CAR T cells, T-cell engagers and other emerging approaches was balanced by the same unresolved questions: how much immune depletion is enough, how long remission will last, which biomarkers can guide patient selection and how to achieve that depth of response without bringing oncology-level toxicity into chronic autoimmune disease.