Protein therapeutics are indispensable in modern medicine. They are used to treat a wide range of diseases, many of which are chronic diseases otherwise untreatable by small molecule therapies. Despite extensive efforts to improve their poor pharmacokinetic properties, recurrent administration remains necessary, highlighting the need for innovative strategies that provide a sustained source of protein therapeutics. Terminally differentiated B cells, known as plasma cells (PCs), exhibit several interesting features, including high protein production capacity, long lifespan, and interactions with other immune cells. This colloquium will focus on the use of engineered plasma cell (ePC) therapy to overcome limitations of traditional therapeutic protein therapy. ePC therapy involves harvesting primary human B cells, followed by ex vivo engineering them to secrete therapeutic proteins, differentiating them into PCs, and reinfusing them into the patient. In the patient, ePCs engraft in specialised niches, where they maintain long-term and stable protein secretion. Advances in gene editing technology and animal models have led to proof-of-concept studies demonstrating the potential of ePC therapy in cancer, protein deficiency disorders and infectious diseases. Moreover, the first clinical trials using ePC therapy are ongoing. This research summarises recent advances in ePC therapy, discusses pre-clinical challenges that remain, and explores future directions for this novel therapeutic approach.
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