Building on these clinical and regulatory approvals, several next-generation strategies are now entering the clinic, including armoured CAR T cells (e.g., IL-18-secreting huCART19-IL18 which rescue patients after the failure of standard CD19 CAR-T [4], direct in vivo CAR-T engineering which simplifies the clinical application complexity [5], solid-tumour CAR T therapies with clinically meaningful efficacy such as CLDN18.2-directed CAR-T cells in gastroesophageal cancer [6], and the extension of CAR T-cell therapy to refractory autoimmune diseases through resetting the immune cells [7]. This evidence concerns the gene IL18 and autoimmune disease.