Th17细胞与自身免疫性疾病关系的研究进展

CIM+辅助性T细胞(Th)通常可分为Th0、Th1、Th2和Th3等细胞亚群.Th1细胞过去一直被认为是介导迟发型超敏反应、引起组织损伤的主要细胞.近年来发现一群主要分泌白细胞介素-17(IL-17)、不同于Th1/Th2的新型CD4+T细胞亚群-11117细胞.Th17细胞与自身免疫性疾病、肿瘤、炎性反应和移植排斥等的发生发展关系密切.     

Th17细胞与肝脏疾病的研究进展

机体免疫系统是抵抗外来病原体和各种损害的防御系统,根据CD4^＋T细胞的功能经典地分为辅助性T细胞（Th1、Th2）、细胞毒性T细胞以及调节性T细胞（Treg）3个亚群。Th1介导细胞免疫,Th2介导体液免疫,而Treg则在维护机体免疫平衡中发挥重要作用。然而随着对自身免疫性疾病的研究,发现一群不同于Th1、Th2、Treg的新型CD4^＋T细胞亚群——Th17细胞。已证实Th17细胞与清除胞外病原体、炎症、自身免疫性疾病和肿瘤的发生发展有密切联系。随着人们对肝炎、肝纤维化和肝癌等肝病认识不断加深,这种新型的Th17细胞在这些疾病中发生发展的作用机制也不断的被研究者所关注。     

树突细胞与哮喘Th1/Th2失衡

特应性哮喘患者以Th2免疫反应为主,导致气道炎症,Th1／Th2失衡是特庆性哮喘重要的免疫病理机制,树突细胞（DCs）中肺部主要抗原递呈细胞,不但可以介志对吸入抗原初始的免疫反应,活化辅助性T细胞,而且在可以决定T细胞的分化方向,维持哮喘Th2免疫反应和Th1／Th2失衡机制中发挥重要作用而日益受到重视。本文就近年来对特应性哮喘免疫病理机制中DCs对Th1／Th2失衡影响认识作一综述。     

Immunopathogenesis of Allergic Asthma: More Than the Th2 Hypothesis

Asthma is a chronic obstructive airway disease that involves inflammation of the respiratory tract. Biological contaminants in indoor air can induce innate and adaptive immune responses and inflammation, resulting in asthma pathology. Epidemiologic surveys indicate that the prevalence of asthma is higher in developed countries than in developing countries. The prevalence of asthma in Korea has increased during the last several decades. This increase may be related to changes in housing styles, which result in increased levels of indoor biological contaminants, such as house dust mite-derived allergens and bacterial products such as endotoxin. Different types of inflammation are observed in those suffering from mild-to-moderate asthma compared to those experiencing severe asthma, involving markedly different patterns of inflammatory cells and mediators. As described in this review, these inflammatory profiles are largely determined by the involvement of different T helper cell subsets, which orchestrate the recruitment and activation of inflammatory cells. It is becoming clear that T helper cells other than Th2 cells are involved in the pathogenesis of asthma; specifically, both Th1 and Th17 cells are crucial for the development of neutrophilic inflammation in the airways, which is related to corticosteroid resistance. Development of therapeutics that suppress these immune and inflammatory cells may provide useful asthma treatments in the future.     

The deviated balance between regulatory T cell and Th17 in autoimmunity

Identifying the regulatory T cells (Tregs) and Th17 cells led to breaking the dichotomy of Th1/Th2 cells axis in immune responses involved in several autoimmune diseases. It is now well known that Tregs and Th17 cells are main orchestra leaders in pathogenesis symphony of autoimmunity. While Tregs are protective cells in autoimmune diseases, Th17 cells enhance the progression of autoimmune responses through induction of various pro-inflammatory reactions. It seems that the progression of autoimmunity may be associated with increase in Th17 and decrease in Treg levels, so that skewed balance between Tregs and Th17 toward Th17 is a phenomenon, which could be observed during progression of several autoimmune diseases. Although it is suggested that expansion and transfer of Tregs can be a new therapeutic target for autoimmune diseases, however, recent data about the phenotype conversion of Tregs into Th17 cells obligate us to more investigation on this approaching. Thus, identifying the new factors that induce stable phenotype in Tregs and prevent their phenotype conversion into Th17 cells as well as targeting the factor, which can modulate their balance, might be recommended as a new promising therapeutic method for autoimmune therapy. In this review, we try to clarify the factors, which can affect on this balance in various autoimmune diseases, as new targets in treatment of these diseases.     

支气管哮喘与Th1/Th2/Th17的相关性分析

支气管哮喘是一种涉及多种临床症状,例如咳嗽、气喘、呼吸困难等常见的呼吸系统疾病,其发病率之高严重威胁着人类的健康.哮喘的发病与遗传和环境都有着密切的联系,因其发病机制十分复杂至今尚未明了.众多的细胞及其细胞因子均参与了哮喘的发病过程,其中辅助性T细胞(Thelper,Th)及其亚群(Th1、Th2和Th17)已被证实与支气管哮喘的发生有着十分密切的关系.     

Infection of Human Dendritic Cells by Dengue Virus Activates and Primes T Cells Towards Th0-Like Phenotype Producing Both Th1 and Th2 Cytokines

Dengue viruses (DV) infection is an important public health issue all over the world. Although the pathogenesis remains unclear, the overwhelmingly triggered immune responses have been consistently observed. Recently, we and other researchers demonstrated that the natural hosts for DV are dendritic cells (DC), the primary sentinels of immune system. In light of the significance of T cells in dengue virus pathogenesis, here, we examine the possible consequences of DC-T cell interaction that is supposed to be happening in lymphoid tissues after infection. We showed that DV-infected DC induced the interacting T cells to proliferate, to produce interleukin-2 as well as to express activation markers on cell surface. Compared to mock-infected DC, the infection of DC by DV also induced T cells to produce interleukin-4, interleukin-10 and interferon-gamma, a cytokine pattern suggesting Th0 phenotype. Such an effect was either totally abolished or greatly reduced when DV were pre-inactivated with heat or ultraviolet before infection. In addition, we demonstrated that such a Th0 phenotype shift of T cells was affected neither by different dosages of viruses that infected DC nor by different durations of DC-T cell interaction. Our results provide a basic support for clinical observations and may be of help in understanding the pathogenesis of DV infection.     

Infection of human dendritic cells by dengue virus activates and primes T cells towards Th0-like phenotype producing both Th1 and Th2 cytokines

Dengue viruses (DV) infection is an important public health issue all over the world. Although the pathogenesis remains unclear, the overwhelmingly triggered immune responses have been consistently observed. Recently, we and other researchers demonstrated that the natural hosts for DV are dendritic cells (DC), the primary sentinels of immune system. In light of the significance of T cells in dengue virus pathogenesis, here, we examine the possible consequences of DC-T cell interaction that is supposed to be happening in lymphoid tissues after infection. We showed that DV-infected DC induced the interacting T cells to proliferate, to produce interleukin-2 as well as to express activation markers on cell surface. Compared to mock-infected DC, the infection of DC by DV also induced T cells to produce interleukin-4, interleukin-10 and interferon-gamma, a cytokine pattern suggesting Th0 phenotype. Such an effect was either totally abolished or greatly reduced when DV were pre-inactivated with heat or ultraviolet before infection. In addition, we demonstrated that such a Th0 phenotype shift of T cells was affected neither by different dosages of viruses that infected DC nor by different durations of DC-T cell interaction. Our results provide a basic support for clinical observations and may be of help in understanding the pathogenesis of DV infection.     

Th17 cytokines and arthritis

Th17 cells are implicated in human autoimmune diseases, such as rheumatoid arthritis (RA), although it has not been established whether this persistent destructive arthritis is driven by Th1 and/or Th17 cells. Interleukin-17A (IL-17A) contributes to the pathogenesis of arthritis as has been shown in several experimental arthritis models. Importantly, recent data from first clinical trials with anti-IL-17A antibody treatment in psoriatic arthritis patients and RA patients looks promising. This review summarizes the findings about the role of Th17 cells in arthritis and discusses the impact of the different Th17 cytokines in the pathogenesis of this disease. However, further studies are needed to unravel the interplay between IL-17A and other Th17 cytokines such as IL-17F, IL-22, and IL-21 in the pathoimmunological process of this crippling disease, in particular, whether regulating Th17 cell activity or specific combinations of Th17 cytokines will have additional value compared to neutralizing IL-17A activity alone. Moreover, tumor necrosis factor-positive Th17 cells are discussed as potential dangerous cells in driving persistent arthritis in human early RA.     

Th1细胞/Th2细胞在口腔扁平苔藓发病机制中的作用

口腔扁平苔藓是最常见口腔黏膜疾病之一,发病机制尚不明确,因其具有癌变潜能,WHO将其列为癌前状态。研究发现,Th1细胞/Th2细胞亚群与口腔扁平苔藓的发病密切相关,尤其是Th1/Th2漂移学说与OLP的关系成为近年研究热点。下文针对Th1细胞/Th2细胞在口腔扁平苔藓中的最新研究成果做一综述和展望。     

Mast cells have no impact on cutaneous leishmaniasis severity and related Th2 differentiation in resistant and susceptible mice

The genus leishmania comprises different protozoan parasites which are causative agents of muco‐cutaneous and systemic, potentially lethal diseases. After infection with the species Leishmania major, resistant mice expand Th1 cells which stimulate macrophages for Leishmania destruction. In contrast, susceptible mice generate Th2 cells which deactivate macrophages, leading to systemic spread of the pathogens. Th‐cell differentiation is determined within the first days, and Th2 cell differentiation requires IL‐4, whereby the initial IL‐4 source is often unknown. Mast cells are potential sources of IL‐4, and hence their role in murine leishmaniasis has previously been studied in mast cell‐deficient Kit mutant mice, although these mice display immunological phenotypes beyond mast cell deficiency. We therefore readdressed this question by infecting Kit‐independent mast cell‐deficient mice that are Th1 (C57BL/6 Cpa^Cre) or Th2 (BALB/c Cpa^Cre) prone with L. major. Using different parasite doses and intra‐ or subcutaneous infection routes, the results demonstrate no role of mast cells on lesion size development, parasite load, immune cell phenotypes expanding in draining lymph nodes, and cytokine production during murine cutaneous leishmaniasis. Thus, other cell types such as ILCs or T cells have to be considered as primary source of Th2‐driving IL‐4.     

Updated insight into the role of Th2-associated immunity in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organs involvement, abundant autoantibodies, complement activation, and immune complexes depositions. By regulating inflammation and immune homeostasis, cytokines have been well documented to participate in the pathogenesis of SLE. A number of studies have shown that T helper 2 (Th2)-associated immunity plays an important role in autoimmune diseases, including SLE. Key molecules underlying Th2-related immunity are expected to serve as promising targets for the diagnosis and targeted treatment of SLE. Current progress in SLE pathogenesis and biological treatment strategies has been reviewed, focusing on the latest development in Th2-associated immunity.     

Evaluation of Th1/Th2 ratio and cytokine production profile during acute exacerbation and convalescence in asthmatic children.

BACKGROUND: Th2-type cytokines, such as IL-4 and IL-5, are generally believed to play an important role in the pathogenesis of allergic asthma. In contrast, Th1-type cytokine, especially interferon (IFN)-gamma, is thought to have a downregulatory effect on Th2 immune response cells. Thus, the imbalance of Th1 and Th2 cells may be a key factor in relation to disease severity. OBJECTIVE: The aim of this study is to examine the changes in the Th1/Th2 ratios and cytokine production profiles of asthmatic children at acute attacks and convalescent stages. METHODS: Twelve asthmatic patients were included in this study. The percentages of IFN-gamma- or IL-4-producing cells were determined with a flow-cytometric method of intracellular protein detection. Fresh whole blood obtained from normal controls and patients at two stages was stimulated with brefeldin A, phorbol myristate acetate, and ionomycin for 4 hours. Cells were fixed and stained intracellularly with fluorescein isothiocyanate- or phycoerythrin-conjugated antibody specific to each cytokine in combination with anti-CD4. ELISA assays were applied to measure cytokine concentrations of supernatant from peripheral blood mononuclear cells (PBMC) activated with phorbol myristate acetate and ionomycin for 24 hours. RESULTS: Among CD4+ cells, the percentage of IL-4+ cells decreased significantly from 8.18 +/- 4.77% at acute attacks to 4.18 +/- 1.26% (P < .020) at convalescence. The percentage of IFN-gamma+ cells also decreased from 13.49 +/- 4.21% to 9.03 +/- 5.42% (P < .052). The Th1/Th2 ratios of patients at the two stages were similar, and both were lower than the normal controls. Significantly higher IL-5 and lower IFN-gamma production were detected from activated PBMC of asthmatic patients than normal controls. CONCLUSIONS: The decrease of IFN-gamma+ and IL-4+ cells detected at the single-cell level may explain the potential mechanism of convalescence from acute asthma attacks. High Th1/Th2 ratio and low IL-5 production from the PBMC of normal controls support the idea of a biased Th2 immune response in asthmatic patients.     

Quo vadis Th1 and Th2 cells in autoimmunity and infectious diseases: Th17 cells,the new kid on the block

Studies in mice, monkeys and humans suggest that invariant natural killer (iNK) T cells play a very important role in the pathogenesis of asthma, a heterogeneous disease associated with airway inflammation and airway hyper-reactivity. The requirement for iNK T cells in multiple mouse models of asthma is novel and surprising, challenging the prevailing dogma that CD4⁺ T cells responding to environmental allergens are the key cell type in asthma. In this article, we examine the recent studies of iNK T cells and asthma, and discuss how different subsets of NK T cells function in different forms of asthma, including forms that are independent of adaptive immunity and Th2 cells. Together, these studies suggest that iNK T cells, which can interact with many other cell types including Th2 cells, eosinophils and neutrophils, provide a unifying pathogenic mechanism for many distinct forms of asthma.     

Twisting the Th1/Th2 immune response via the retinoid X receptor: lessons from a genetic approach

The immune system is influenced by environmental factors such as hormones and nutrients. Previous studies have suggested that vitamins A and D influence the process of naive T helper (Th) cell differentiation into Th1 or Th2 cells. Vitamins A and D signal through the retinoid X receptor (RXR), which partners with either the retinoic acid receptor or the vitamin D receptor. Most previous studies into the role of RXR in Th differentiation have been performed in vitro and it was necessary for these to be verified in a physiological environment. However, in vivo study has been hindered since RXRalpha deficient mice are embryonic lethal. Du et al. in this issue of the European Journal of Immunology, overcome this obstacle using "pinkie" mice that harbor a hypomorphic mutation in the Rxralpha gene. The authors report that the mutant mice have an exaggerated Th1 immune response which is attributed to the aberrant antigen-presenting cell and CD4 T cell function. This study confirms previous studies indicating that RXR signaling plays an important role in Th cell differentiation and also provides a valuable tool with which to study the mechanisms and the in vivo functions of this signaling pathway.     

Expanding the effector CD4 T-cell repertoire: the Th17 lineage

The Th1/Th2 paradigm has provided the framework for understanding CD4 T-cell biology and the interplay between innate and adaptive immunity for almost two decades. Recent studies have defined a previously unknown arm of the CD4 T-cell effector response--the Th17 lineage--that promises to change our understanding of immune regulation, immune pathogenesis and host defense. The factors that specify differentiation of IL-17-producing effector T-cells from na?ve T-cell precursors are being rapidly discovered and are providing insights into mechanisms by which signals from cells of the innate immune system guide alternative pathways of Th1, Th2 or Th17 development.     

Th1 and Th2 subsets equally undergo Fas-dependent and -independent activation-induced cell death

Stimulation of previously activated T cells results in apoptosis, termed activation-induced cell death (AICD). Recent analysis revealed that the Fas/Fas ligand (FasL) interaction is predominantly involved in AICD of T cells. Furthermore, based on the analysis of various T cell clones and lines, it has been reported that FasL is expressed mainly in Th1 but not in Th2 cells. However, the exact expression pattern of FasL and its function in normal activated T cells has not been determined. In the present study, by utilizing completely differentiated Th1 and Th2 cell populations obtained from ovalbumin-specific T cell receptor (TCR)-transgenic mice, the FasL expression on Th1 and Th2 was determined. Furthermore, involvement of Fas-FasL interaction in AICD of Th1 and Th2 cells was analyzed by two approaches: one was the inhibition of AICD by anti-FasL monoclonal antibodies, and the other AICD of Th1/Th2 subsets from TCR-transgenic mice backcrossed to lpr mice. We demonstrated that Th2 cells express FasL on the cell surface at a level similar to that expressed by Th1 cells, and that both subsets were equally susceptible to the Fas-mediated AICD. These observations suggest not only that the expression of FasL is not always correlated with Th subsets as defined by the cytokine-producing profile, but also that the responses of both Th1 and Th2 subsets are regulated by Fas-mediated AICD. Finally, analysis of the kinetics of AICD revealed a novel Fas/FasL-independent pathway in its initial stage. These findings revealed the precise function of Fas/FasL-mediated as well as Fas/FasL-independent AICD in the regulation of helper T cell responses.     

Th1 and Th2 lymphocytes in autoimmune disease

This review reconsiders how the Th1/Th2 paradigm can be applied to Th1-mediated autoimmune disease. Although there is evidence that autoimmune diseases such as multiple sclerosis, type 1 insulin-dependent diabetes mellitus, and posterior uveitis are Th1 mediated and that in some cases reduction of the Th1 response or a Th2 type shift may alleviate disease, many apparent exceptions are now well documented. These exceptions center around the contradictory actions of the Th1 cytokine IFN-gamma and the evidence that Th2 lymphocytes can also cause disease. Recent information on the regulation of Th1 and Th2 lymphocytes in terms of the innate immune response and by other T cells helps to clarify the reasons for some of these discrepancies and enables the Th1/Th2 concept to be accepted as an integral part of the complex interactions occurring as autoimmune disease develops.