The Role of the High-Affinity IgE Receptor, FcεRI, in Eosinophilic Gastrointestinal Diseases
The Role of the High-Affinity IgE Receptor, FcεRI, in Eosinophilic Gastrointestinal Diseases
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DOI：
10.1016/j.iac.2008.09.004
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发表时间：
2009-02-01
影响因子：
2.6
通讯作者：
Fiebiger, Edda
中科院分区：
文献类型：
--
作者：
Dehlink, Eleonora;Fiebiger, Edda
原发性嗜酸性胃肠道疾病是一组异质性疾病，包括嗜酸性食管炎、嗜酸性胃炎、嗜酸性胃肠炎、嗜酸性肠炎和嗜酸性结肠炎。EGIDs的统一标志和诊断标志是胃肠道粘膜富含嗜酸性粒细胞的炎性浸润物，在没有已知原因的情况下，嗜酸性粒细胞增多。EGID的病因尚不完全清楚。然而，发病机制似乎涉及遗传易感性、暴露于食物和环境过敏原以及IgE介导的免疫系统激活的复杂相互作用。越来越多的证据表明，EGID与T辅助细胞(Th)2介导的免疫紊乱有关，如IgE介导的过敏。在这篇文章中，我们讨论了通过高亲和力的IgE受体Fc epsilon RI介导的免疫激活在原发EGID发病机制中的可能作用。除了在I型变态反应中的明确作用外，我们在此推测，四聚体Fc epsilon RI对肥大细胞和嗜碱性粒细胞的激活以及三聚体Fc epsilon RI对人嗜酸性粒细胞和胃肠粘膜中的抗原提呈细胞的激活在EGIDs的病理过程中起关键作用。我们还讨论了不依赖于IgE的Fc epsilon RI的触发可能是EGID患者免疫系统激活的一种机制。
Primary eosinophilic gastrointestinal diseases (EGIDs) are a heterogeneous group of diseases including eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, and eosinophilic colitis. The unifying hallmark and diagnostic marker of EGIDs is an eosinophil-rich inflammatory infiltrate of the GI mucosa, in the absence of known causes for eosinophilia. The etiology of EGIDs is not yet fully understood. The pathogenesis however seems to involve a complex interplay of genetic predisposition, exposure to food- and environmental allergens and IgE-mediated activation of the immune system. Accumulating evidence relates EGIDs to the group of T-helper (Th) 2 mediated immune disorders, like IgE-mediated allergy. In this article we discuss a possible role of IgE-mediated immune-activation via the high affinity receptor for IgE, Fc epsilon RI, in the pathogenesis of primary EGIDs. Beyond its defined role in type I allergic reactions, we here hypothesize that activation of tetrameric Fc epsilon RI on mast cells and basophils as well as trimeric Fc epsilon RI on human eosinophils and antigen presenting cells in the gastrointestinal mucosa is critically involved in the pathology of EGIDs. We also discuss how IgE-independent triggering of Fc epsilon RI could be a mechanisms responsible for activation of the immune system in patients with EGID.