嵌合抗原受体（CAR）是基因工程领域的一项突破，它彻底改变了过继细胞疗法（ACT）领域。表达这些受体的细胞通过在合成的CAR构建体中包含抗原特异性结合区域而被重新定向到预定的靶点。程序化特异性细胞在肿瘤学领域的优势已被临床证明，与同类未修饰的细胞相比，这种细胞具有更高的准确性、效力与更少的脱靶效应。与常规T细胞（Tconvs）不同，调节性T细胞（Treg）在抑制免疫激活和调节宿主免疫反应方面发挥着重要作用。Treg 中CAR的表达被认为是治疗自身免疫和炎症性疾病、移植物抗宿主病（GVHD）和器官移植排斥反应的一种方法。在后者中，它们作为同种异体移植受者免疫耐受的介质具有巨大的潜力。然而，目前对CAR-Treg 工程的研究非常有限，并且关于治疗用途的最佳设计存在不确定性。本文综述了CAR-Treg 发展的理论基础、其对人类移植的意义、潜在的设计、安全性考虑因素，以及迄今为止CAR-Treg在移植模型中的对比。

Chimeric antigen receptors (CARs) are a breakthrough in genetic engineering that have revolutionized the field of adoptive cellular therapy (ACT). Cells expressing these receptors are rerouted to a predefined target by the inclusion of an antigen-specific binding region within the synthetic CAR construct. The advantage of cells with programmed specificity has been demonstrated clinically in the field of oncology, and it is clear that such cells have greater accuracy, potency, and reduced off-target therapeutic effects compared with their unmodified counterparts. In contrast to conventional T cells (Tconvs), regulatory T cells (Tregs) play a major role in suppressing immune activation and regulating the host immune response. CAR expression within Tregs has been proposed as a therapy for autoimmune and inflammatory diseases, graft-versus-host disease (GvHD), and organ transplant rejection. In the latter, they hold immense potential as mediators of immune tolerance for recipients of allotransplants. However, current research into CAR-Treg engineering is extremely limited, and there is uncertainty regarding optimal design for therapeutic use. This review examines the rationale behind the development of CAR-Tregs, their significance for human transplantation, potential designs, safety considerations, and comparisons of CAR-Tregs in transplantation models to date.