ANCA vasculitis is a systemic autoimmune small-vessel vasculitis characterized by autoantibodies targeting either MPO or PR3. While patients with ANCA vasculitis are successfully treated with broad-spectrum immunosuppression, these treatments often leave patients vulnerable to infections. Research in the field has made positive gains in regards to understanding autoantigen specificity and immune cell subset involvement in disease pathogenesis, relapse and remission. This review examines the state of the research field as it relates to possible new antigen- and cell-specific therapies in the vasculitis field. Potential avenues of therapeutic interest include selective elimination of autoreactive B cells by bispecific antibodies, tolerogenic liposomes or engineered T cells. Additionally, restoration of regulatory T-cell function is an attractive avenue to prolong remission of disease. Collectively, the field is well poised to begin investigating new and emerging cell therapies.
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