The role of Schwann cells, T cells and Mycobacterium leprae in the immunopathogenesis of nerve damage in leprosy.
The role of Schwann cells, T cells and Mycobacterium leprae in the immunopathogenesis of nerve damage in leprosy.
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DOI：
10.5935/0305-7518.20000083
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发表时间：
2000-12
期刊：
影响因子：
0.6
通讯作者：
E. Spierings;T. Boer;L. Zulianello;T. Ottenhoff
中科院分区：
文献类型：
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作者：
E. Spierings;T. Boer;L. Zulianello;T. Ottenhoff
周围神经损伤是麻风逆转（I型）反应的主要并发症。神经损伤的潜在机制在很大程度上仍未得到解决;然而，1型T细胞的重要作用已被提出。麻风分枝杆菌对周围轴突周围的许旺细胞具有显著的嗜性。因为麻风的逆转反应通常伴随着严重的和不可逆的神经破坏，并且与针对M.麻风病雪旺氏细胞和周围神经损伤的一个可能的免疫病理机制是受感染的雪旺氏细胞加工并呈递M.麻风对抗原特异性、炎性、1型T细胞的反应，这些T细胞随后损伤并裂解受感染的许旺细胞。先前的CD 8 + T细胞动物研究揭示了这种机制存在的证据。CD 4 + T细胞也有类似的作用。考虑到M.麻风皮损中以雪旺氏细胞为主，CD 4+、丝氨酸酯酶+Th 1细胞在麻风皮损中占主导地位。M.因此，对麻风病雪旺细胞和炎性T细胞的研究可能为预防麻风病雪旺细胞和神经损伤提供了一种合理的策略。
Damage to peripheral nerves is the major complication of reversal (type I) reactions in leprosy. The underlying mechanism of nerve damage remains largely unresolved; however, an important role for type-1 T cells has been suggested. Mycobacterium leprae has a remarkable tropism for the Schwann cells that surround peripheral axons. Because reversal reactions in leprosy are often accompanied by severe and irreversible nerve destruction, and are associated with increased cellular immune reactivity against M. leprae, a likely immunopathogenic mechanism of damage to Schwann cells and peripheral nerves in leprosy is that infected Schwann cells process and present antigens of M. leprae to antigen-specific, inflammatory, type-1 T cells, and that these T cells subsequently damage and lyse infected Schwann cells. Previous animal studies with CD8+ T cells revealed evidence for the existence of such a mechanism. A similar role has been suggested for CD4+ T cells. These latter cells may be more important in causing nerve damage in vivo, given the predilection of M. leprae for Schwann cells, and the dominant role of CD4+, serine esterase+ Th1 cells in the lesions of leprosy. Antagonism of the molecular interactions among M. leprae, Schwann cells and inflammatory T cells may therefore provide a rational strategy for prevention of damage of Schwann cell and nerves in leprosy.