超越肿瘤：CAR-T 细胞疗法在自身免疫与感染性疾病中不断扩展的作用——系统综述
Beyond Oncology: Exploring the Expanding Role of CAR T Cell Therapy in Autoimmune and Infectious Diseases-A Systematic Review
嵌合抗原受体（CAR）T 细胞疗法原本用于血液肿瘤，如今正被尝试用于自身免疫病和持续性感染。本综述按 PRISMA 规范检索 2010 年至 2026 年 3 月的文献，因研究异质性大而采用描述性总结。结果显示，靶向 B 细胞的 CAR-T 在系统性红斑狼疮、系统性硬化症和炎性肌病等难治性自身免疫病中早期疗效信号最强；在艾滋病和乙肝等感染中显示出初步安全性、持久性和部分抗病毒活性，但能否彻底清除病原体尚未证明。作者认为整体仍属初步阶段，需标准化报告、长期安全监测和可扩展的生产工艺。
为什么推荐给您：系统总结 CAR-T 向非肿瘤适应证扩展的新证据，但纳入研究多为早期、异质性大。
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摘要Abstract
Background: Chimeric antigen receptor (CAR) T cell therapy has revolutionized the treatment of select hematologic malignancies and is increasingly being explored for non-oncological indications, including autoimmune diseases and persistent infectious diseases. This systematic review synthesized current evidence on CAR T cell and CAR-Treg approaches beyond oncology, with emphasis on therapeutic targets, translational and clinical outcomes, safety, and implementation barriers. Methods: The review followed PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, ClinicalTrials.gov, and major trial registries were searched for studies published from 1 January 2010 to 31 March 2026. Eligible studies included clinical, preclinical, and translational investigations of CAR T cell or CAR-Treg strategies in autoimmune or infectious diseases. Results: Because of heterogeneity in disease indications, CAR constructs, endpoints, and study designs, findings were synthesized descriptively. The strongest early clinical signals were observed with B cell-directed CAR T cell therapy for severe, refractory autoimmune diseases, particularly systemic lupus erythematosus, systemic sclerosis, and inflammatory myopathies. Infectious disease applications, mainly HIV and hepatitis B, showed preliminary safety, persistence, and partial antiviral activity, but durable pathogen eradication remains unproven. Conclusion: Overall, CAR T cell therapy beyond oncology is promising but remains preliminary, requiring standardized reporting, long-term safety monitoring, scalable manufacturing, and carefully defined risk-benefit thresholds. Human clinical evidence was interpreted separately from preclinical and mechanistic evidence, and clinical conclusions were based primarily on human studies.