Only about 3.5 years have passed since the March 2022 prediction, which was explicitly framed as a decades‑long forecast (“down the road… in the long run, over the next couple of decades”). That time horizon has not elapsed, so we cannot yet definitively judge whether CAR‑T and related T‑cell therapies will become established, routine treatments for autoimmune disease and specific pathogens.

However, developments so far are strongly directionally consistent with what Friedberg described:

• Autoimmune diseases (including lupus): A 2024 New England Journal of Medicine case series of 15 patients with severe systemic lupus erythematosus (SLE), idiopathic inflammatory myositis, or systemic sclerosis found that a single CD19 CAR‑T infusion led to clinical remission in all patients and allowed complete discontinuation of immunosuppressive therapy, with follow‑up up to 29 months.(ovid.com) A 2024 Phase 1 trial of BCMA–CD19 “compound” CAR‑T in lupus nephritis reported medication‑free remission and durable depletion of disease‑causing autoantibodies in nearly all treated SLE patients, with follow‑up up to 46 months.(ovid.com) Reports from European centers indicate ~100–200 autoimmune patients worldwide (including SLE and other autoimmune cytopenias) have received CAR‑T with often striking remissions, but experts emphasize high cost and lack of long‑term safety data.(welt.de) Multiple companies (e.g., CRISPR Therapeutics’ CTX112, Allogene’s ALLO‑329, Fate’s FT819, IASO’s Eque‑cel) are now running or initiating trials of CAR‑T for a range of autoimmune indications, confirming substantial investment in this direction.(ir.crisprtx.com)

• Multiple sclerosis and other CNS autoimmunity: Several early‑phase clinical trials are testing CD19‑ or BCMA‑targeted CAR‑T products in progressive and relapsing MS (e.g., KYV‑101, Eque‑cel, NEX‑T). Trial listings from UCSF and Yale describe Phase 1 studies of CD19 CAR‑T in treatment‑refractory or progressive MS, and an MS‑focused review in 2025 notes six ongoing CAR‑T trials in MS and related disorders.(clinicaltrials.ucsf.edu) Early data presented at the 2025 American Academy of Neurology meeting showed KYV‑101 to be generally well tolerated with preliminary efficacy signals in progressive MS.(multiplesclerosisnewstoday.com) Separately, IASO Bio reported in Cell the first clinical evidence that its anti‑BCMA CAR‑T (equecabtagene autoleucel) can be safe and effective in progressive MS.(prnewswire.com) This matches the specific diseases (e.g., MS) Friedberg mentioned as targets.

• Pathogen‑targeted T‑cell therapies (HIV, EBV, etc.): Multiple Phase 1/2 studies are using CAR‑T against HIV, such as the UCSF‑led LVgp120duoCAR‑T trial aiming for long‑term ART‑free control, with patients already dosed and follow‑up ongoing through 2029.(cirm.ca.gov) Animal and translational studies (e.g., PD‑1–targeted CAR‑T in SIV/HIV models) further support the concept of using engineered T cells to clear infected reservoirs.(fredhutch.org) In the EBV space, an engineered EBV‑specific T‑cell product (tabelecleucel/Ebvallo) is already approved in Europe for EBV‑positive post‑transplant lymphoproliferative disease, and the FDA’s 2025 refusal was based on manufacturing issues rather than lack of efficacy.(reuters.com) While not always classical CAR‑T, these are clearly “related engineered T‑cell therapies” directed at specific pathogens, as the prediction envisioned.

• Regulatory status as of late 2025: Despite these advances, no CAR‑T therapy is yet approved anywhere for an autoimmune disease or for chronic viral infections; all marketed CAR‑T products remain in oncology indications (hematologic malignancies and, more recently, some solid tumors).(en.wikipedia.org) Autoimmune and infectious‑disease uses are still confined to early‑phase trials, case series, and compassionate‑use settings.

Given (1) the explicitly long, decades‑scale horizon and (2) the fact that current evidence shows promising proof‑of‑concept but not yet widespread, established clinical adoption or regulatory approval in autoimmunity or infections, there is not enough time or outcome data yet to call the prediction clearly right or wrong. The trajectory so far supports the plausibility of his claim, but the ultimate success or failure by his stated time horizon remains undetermined.