Immunotherapy-related cognitive impairment after CAR T cell therapy in mice Monje 2025

Highlights
•
CAR T cell therapy for CNS and non-CNS cancers can impair cognition in mice
•
CAR T cell therapy induces white matter microglial reactivity and neuroinflammation
•
Consequent dysregulation of oligodendroglial cells contributes to impaired cognition
•
Microglial depletion or CCR3 blockade rescues cellular and cognitive dysfunction
Summary
Immunotherapies have revolutionized cancer care for many tumor types, but their potential long-term cognitive impacts are incompletely understood. Here, we demonstrated in mouse models that chimeric antigen receptor (CAR) T cell therapy for both central nervous system (CNS) and non-CNS cancers impaired cognitive function and induced a persistent CNS immune response characterized by white matter microglial reactivity, microglial chemokine expression, and elevated cerebrospinal fluid (CSF) cytokines and chemokines. Consequently, oligodendroglial homeostasis and hippocampal neurogenesis were disrupted. Single-nucleus sequencing studies of human frontal lobe from patients with or without previous CAR T cell therapy for brainstem tumors confirmed reactive states of microglia and oligodendrocytes following treatment. In mice, transient microglial depletion or CCR3 chemokine receptor blockade rescued oligodendroglial deficits and cognitive performance in a behavioral test of attention and short-term memory function following CAR T cell therapy. Taken together, these findings illustrate targetable neural-immune mechanisms underlying immunotherapy-related cognitive impairment.
Graphical abstract


https://www.cell.com/cell/fulltext/S0092-8674(25)00391-5

 

Isn’t it bad to deplete your microglia? Don’t you need them around?

 

It says 'transiently'...but I don't really know what any of it means. It sounds like good news if it can help people who need this therapy avoid some of the cognitive issues, though.

 

of potential wider relevance
https://twitter.com/user/status/1921969261506953559

 

I am not sure it is helpful to call behavioural change is mice brain fog. I doubt this has anything much to do with ME/CFS.