关键词: 风湿免疫性疾病, 儿童, 嵌合抗原受体T 细胞疗法, 靶向治疗

Abstract: Pediatric rheumatic diseases comprise a group of immune dysregulation–mediated disorders that may involve multiple systems and organs，including juvenile idiopathic arthritis（JIA），childhood-onset systemic lupus erythematosus（cSLE），juvenile dermatomyositis（JDM），systemic sclerosis（SSc），Sjögren’s syndrome（SS），and vasculities.Aberrant B-cell activation，autoantibody production，and dysregulated humoral immunity play pivotal roles in the occurrence and progression of various pediatric rheumatic diseases，thereby providing theoretical evidence for B-cell–targeted therapies.In recent years，chimeric antigen receptor T-cell（CAR-T）therapy has attracted increasing attention in the treatment of autoimmune diseases.In particular，CAR-T therapies targeting B-cell–associated molecules，such as CD19 and B-cell maturation antigen（BCMA），offer a novel therapeutic strategy for severe，refractory，or relapsing pediatric rheumatic diseases in children through eliminating aberrantly activated or pathogenic B cells，reducing autoantibody production，and facilitating the restoration of immune homeostasis. Nevertheless，the application of CAR-T therapy in pediatric rheumatic and immune-mediated diseases remains at an early stage of clinical investigation.Current evidence is largely derived from case reports，small case series，hospital-exemption programs，and early-phase clinical studies. Randomized controlled trials and long-term follow-up data are still lacking；therefore，the durability of therapeutic responses，risk of relapse，and long-term safety require further validation.

Key words: rheumatic immune diseases, child, chimeric antigen receptor T-cell therapy, targeted therapy