T细胞在哮喘发病中的作用
2011/01/27
摘要
随着在哮喘患者气道中检测出Th2细胞因子，我们对T细胞亚群在哮喘免疫病理学中的复杂性、气道结构细胞的变化性和潜在作用在哮喘免疫病理中的理解得到深化。来源于气道上皮细胞的细胞因子，包括IL-25、IL-33、胸腺基质淋巴细胞分化蛋白，可能是哮喘Th2型炎症重要的驱动因素。Th2效应细胞和抑制性调节性T细胞之间的平衡在过敏症和哮喘患者，倾向于促炎性Th2细胞反应，目前对于如何恢复该平衡受到广泛关注。新的T细胞亚群，包括Th17、Th9和Th22细胞，已经发现，但这些细胞亚群在哮喘中的作用目前尚不清楚。虽然其他T细胞，包括自然杀伤细胞、γδT细胞和CD8＋T细胞在哮喘中的重要性还需进一步证实，但研究显示这些细胞参与了哮喘的发病。类似与其他生物制剂，针对Th2细胞因子的治疗策略，已经在哮喘患者中初具疗效，但有必要针对患者特异性T细胞亚群进行治疗。包括新型过敏原免疫治疗在内的针对T细胞的治疗策略目前正在进行评价。T细胞仍然是哮喘患者新治疗手段的一个潜在靶点。
（陈欣 审校）
J Allergy Clin Immunol. 2010 Aug 14. [Epub ahead of print]
The role of the T cell in asthma.
Robinson DS.
Leukocyte Biology Section, NHLI, Imperial College London, and Laboratorios Leti SL, Madrid.
Abstract
Since the initial detection of T(H)2 cytokines in asthmatic airways, our understanding of the complexity of T-cell subtypes and flexibility and of the potential role of airway structural cells in the immunopathology of asthma has increased. Cytokines derived from airway epithelium, including IL-25, IL-33, and thymic stromal lymphopoietin, might be important drivers of T(H)2-type inflammation in asthma. The balance between effector T(H)2 cells and suppressive regulatory T cells is skewed toward a proinflammatory T(H)2 response in atopy and asthma, and there is much interest in how to redress this equilibrium. Novel T-cell subsets, including T(H)17, T(H)9, and T(H)22, have been described, although their role in asthma remains unclear. Other T cells, including natural killer T cells, gammadelta T cells, and CD8 T cells, have also been implicated in asthma, although their importance remains to be confirmed. Therapeutic strategies aimed at T(H)2 cytokines are beginning to bear fruit in patients with asthma, although like many biologic agents, these might need specific targeting at subgroups of patients. Strategies directed specifically at the T cells are currently being evaluated, including novel forms of allergen immunotherapy. T cells remain an exciting potential target for new treatments in patients with asthma.
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