Mucosal tolerance: a two-edged sword to prevent and treat autoimmune diseases.

Mucosal tolerance: a two-edged sword to prevent and treat autoimmune diseases.
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粘膜耐受:预防和治疗自身免疫性疾病的双刃剑。

DOI:
10.1006/clin.1997.4432
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发表时间:
1997
期刊:
Clinical immunology and immunopathology
影响因子:
--
通讯作者:
Hans Link
Hans Link
中科院分区:
--
文献类型:
--
作者:
B. Xiao;Hans Link

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自身抗原的粘多糖给药导致外周免疫耐受状态的发展。根据给予的抗原剂量,抗原特异性T细胞的无反应性/缺失(较高剂量)和/或产生免疫抑制细胞因子(TGF-β、IL-4和IL-10)的细胞的选择性扩增(较低剂量)是粘膜耐受诱导的两种主要机制。与相同剂量的抗原口服给药相比,鼻内给药后的粘液耐受性更有效。大量的研究已经证明,通过口服或鼻内抗原施用的粘膜耐受有效地预防了几种实验疾病模型(EAE、EAMG、EAN、EAU、IDDM和CIA)。在自身免疫性疾病的预防和治疗中,给予粘蛋白抗原是上级的。为了扩大粘膜耐受的有效性,耐受原与细胞因子/CTB的结合可能增强对临床疾病的抑制。基于粘膜耐受性的实验经验,正在MS、RA和葡萄膜炎中进行人体试验。然而,粘膜耐受性诱导与抗原给药途径(口服、鼻内、胃肠外)、抗原类型(全蛋白、肽、改变的肽)和疾病发作时间有关,可能是一把双刃剑。特别是,粘膜抗原给药使正在进行的自身免疫性疾病恶化的风险尚未完全解决。在这里,我们给出了在这一领域的一些最新发展的概述,然而,需要更多的研究来定义一个最终的和安全的程序。
Mucosal administration of autoantigens results in the development of a state of peripheral immunological tolerance. Depending upon the dose of antigen administered, anergy/deletion of antigen-specific T cells (higher doses) and/or selective expansion of cells producing immunosuppressive cytokines (TGF-beta, IL-4, and IL-10) (lower doses) are two major mechanisms in mucosal tolerance induction. Mucosal tolerance is more effective after nasal compared to oral administration of antigens at the same dose. A large series of studies have demonstrated that mucosal tolerance by oral or nasal antigen administration effectively prevents several experimental disease models (EAE, EAMG, EAN, EAU, IDDM, and CIA). Mucosal antigen administration is superior in prevention to treatment of autoimmune diseases. To broaden the effectiveness of mucosal tolerance, a conjunction of tolerogens with cytokines/CTB might enhance suppression of clinical disease. Based on experimental experience with mucosal tolerance, trials in humans are ongoing in MS, RA, and uveitis. However, mucosal tolerance induction is related to the route of antigen administration (oral, nasal, parentetal), type of antigen (whole protein, peptide, altered peptide), and timing with regard to disease onset and may represent a two-edged sword. In particular, the risks of worsening an ongoing autoimmune disease by mucosal antigen administration have been incompletely addressed. Here we give an overview on some recent developments in this field where, however, much more studies are needed to define an ultimate and safe procedure.
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