尽管现有治疗方法在治疗自身免疫性风湿病（ARD）方面取得了进展，但许多患者仍然面临着反应不足、难以维持缓解和副作用等挑战。嵌合抗原受体 (CAR) T 细胞疗法最初是针对癌症而开发的，现在已成为治疗难治性 ARD 病例的有希望的选择。我们对文献进行了检索，撰写了一篇叙述性综述，探讨了当前的证据、潜在的安全性和局限性CAR-T 细胞在 ARD 中的潜在修改和未来方向。CAR-T 细胞疗法已用于难治性 ARD 患者，包括系统性红斑狼疮、抗合成酶综合征和系统性硬化症，显示出显着改善。显着的反应包括临床症状增强、血清自身抗体滴度降低以及疾病活动持续缓解。使用动物和人类样本的临床前和体外研究也支持 CAR-T 细胞对抗中性粒细胞胞浆抗体相关血管炎和类风湿关节炎的功效并详细阐述了其潜在机制。虽然谨慎监测不良事件（例如细胞因子释放综合征）至关重要，但该疗法似乎具有很高的耐受性。然而，挑战仍然存在，包括成本、由于潜在的 CAR-T 细胞耗尽而导致的耐久性以及制造复杂性，敦促开发创新解决方案，以进一步提高 ARD 中 CAR-T 细胞治疗的可及性。针对难治性 ARD 的 CAR-T 细胞疗法已被证明高效率。虽然目前没有报告明显的警告信号，但在治疗效果和安全性之间取得平衡对于采用 CAR-T 细胞疗法治疗急性呼吸道疾病至关重要。此外，技术进步在增强向患者提供这种治疗方面具有巨大潜力，从而确保患者更安全、更有效的疾病控制。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Despite advancements in managing autoimmune rheumatic diseases (ARDs) with existing treatments, many patients still encounter challenges such as inadequate responses, difficulty in maintaining remission, and side effects. Chimeric Antigen Receptor (CAR) T-cell therapy, originally developed for cancer, has now emerged as a promising option for cases of refractory ARDs.A search of the literature was conducted to compose a narrative review exploring the current evidence, potential safety, limitations, potential modifications, and future directions of CAR-T cells in ARDs.CAR-T cell therapy has been administered to patients with refractory ARDs, including systemic lupus erythematosus, antisynthetase syndrome, and systemic sclerosis, demonstrating significant improvement. Notable responses include enhanced clinical symptoms, reduced serum autoantibody titers, and sustained remissions in disease activity. Preclinical and in vitro studies using both animal and human samples also support the efficacy and elaborate on potential mechanisms of CAR-T cells against antineutrophil cytoplasmic antibody-associated vasculitis and rheumatoid arthritis. While cautious monitoring of adverse events, such as cytokine release syndrome, is crucial, the therapy appears to be highly tolerable. Nevertheless, challenges persist, including cost, durability due to potential CAR-T cell exhaustion, and manufacturing complexities, urging the development of innovative solutions to further enhance CAR-T cell therapy accessibility in ARDs.CAR-T cell therapy for refractory ARDs has demonstrated high effectiveness. While no significant warning signs are currently reported, achieving a balance between therapeutic efficacy and safety is vital in adapting CAR-T cell therapy for ARDs. Moreover, there is significant potential for technological advancements to enhance the delivery of this treatment to patients, thereby ensuring safer and more effective disease control for patients.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.