New mediators of immunity and inflammation in inflammatory bowel disease
New mediators of immunity and inflammation in inflammatory bowel disease
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DOI：
10.1097/01.mog.0000231808.10773.8e
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发表时间：
2006-07-01
影响因子：
2.5
通讯作者：
Pallone, F
中科院分区：
文献类型：
--
作者：
Monteleone, G;Fina, D;Pallone, F
在克罗恩病和溃疡性I型结肠炎中，组织损伤是由于对肠道菌群抗原的不适当或夸大的免疫反应引起的。本文综述了目前关于免疫炎症介质在炎症性肠病发病机制中的作用的知识。尽管对腔内抗原的过度反应有共同的基础，但克罗恩病和溃疡性结肠炎在免疫学上是不同的实体。克罗恩病与Th1 T细胞介导的反应相关，其特征是干扰素γ和肿瘤坏死因子α的产生增强。白细胞介素(IL)-12和可能的IL-23控制Th1细胞的分化，但极化Thl细胞的最佳诱导和稳定需要额外的细胞因子，如IL-15、IL-18和IL-21。在溃疡性结肠炎中，局部免疫反应较少极化，但其特征是cd1反应性自然杀伤T细胞产生IL-13。除了这些差异之外，克罗恩病和溃疡性结肠炎在肠损伤的终末期效应通路上也有共同之处，这些通路是由免疫和非免疫粘膜细胞之间的主动串扰介导的。对炎症性肠病患者肠道中运作的免疫炎症介质的复杂网络的澄清，导致了新靶点的确定，进而推动了有效生物疗法的发展。
Purpose of review In both Crohn's disease and ulcerative I colitis, the tissue damage results from an inappropriate or exaggerated immune response to antigens of the gut microflora. This review summarizes current knowledge regarding the role of immune-inflammatory mediators in the pathogenesis of inflammatory bowel disease.Recent findings Despite having a common basis in overresponsiveness to luminal antigens, Crohn's disease and ulcerative colitis are immunologically distinct entities. Crohn's disease is associated with a Th1 T cell-mediated response, characterized by enhanced production of interferon-gamma and tumor necrosis factor-alpha. Interleukin (IL)-12 and, possibly, IL-23 govern the, Th1 cell differentiation, but optimal induction and stabilization of polarized Thl cells would require additional cytokines, such as IL-15, IL-18 and IL-21. In ulcerative colitis, the local immune response is less polarized, but it is characterized by CD1-reactive natural killer T cell production of IL-13. Beyond these differences, Crohn's disease and ulcerative colitis share important end-stage effector pathways of intestinal injury, which are mediated by an active cross-talk between immune and non-immune mucosal cells.Summary The clarification of the complex network of immune-inflammatory mediators operating in the gut of patients with inflammatory bowel disease has led to the identification of new targets that could, in turn, drive the development of effective biological therapies.