IL-23/Th17轴在变应性哮喘中的研究进展

变应性哮喘是一种由辅助性T细胞（T helper cell,Th cell）调节的慢性炎症性疾病。Th1/Th2的失衡一直被认为是变应性哮喘的发病机制,Th2细胞及其分泌的细胞因子白介素4（interleukin 4,IL-4）、IL-5以及IL-13在变应性哮喘特异性症状的发病中发挥重要作用。最近研究发现Th17细胞及其分泌的IL-17参与变应性哮喘的发展过程,IL-23在Th17细胞维持生存和功能成熟中发挥重要作用,并参与抗原诱导的气道炎症反应。该文对目前IL-23/Th17轴在变应性气道炎症反应中的研究进展作一综述。     

靶向IL-4主动免疫抑制屋尘螨抽提物诱导的小鼠气道炎症反应

以IL-4为主要驱动的Th2应答是过敏性哮喘的主要免疫病理特征,该文旨在探讨靶向IL-4主动免疫对屋尘螨过敏原刺激的小鼠气道炎症反应的干预作用及潜力。研究以重组制备的、呈现IL-4肽表位的乙肝核心抗原病毒样颗粒免疫BALB/c小鼠,并以屋尘螨抽提物诱导气道过敏性炎症反应。结果显示,靶向IL-4的主动免疫激发了持续的IL-4特异IgG抗体高水平应答;显著减少气道浸润的总炎性细胞以及其中占主要的嗜酸性粒细胞数目;显著降低了支气管肺泡灌洗液中Th2细胞因子IL-4、IL-13和IL-5水平,而Th1的IFN-γ有升高趋势;显著下调了血清IgG1而上调IgG2a水平;此外,显著抑制了乙酰甲胆碱刺激的过敏小鼠气道高反应性。研究表明,靶向IL-4的主动免疫具有抑制过敏性气道炎症反应的潜力。     

益肾平喘合剂防治小鼠支气管哮喘的作用机理研究

目的:探讨医院制剂益肾平喘合剂防治小鼠支气管哮喘的作用机制。方法:采用卵白蛋白(OVA)腹腔注射致敏与雾化吸入激发制作哮喘模型,观察益肾平喘合剂对小鼠支气管的气道炎症、BALF上清液相关细胞因子(IFN-γ,IL-4)和血浆氧自由基的影响。结果:益肾平喘合剂的干预治疗能显著降低哮喘小鼠BALF中炎性细胞总数及EOS数量;BALF上清液中IFN-γ水平明显升高,IL-4水平显著下降;降低血浆中MDA含量,使得GPx、SOD的含量趋于正常。结论:益肾平喘合剂可能通过抑制气道炎症,调整Th1/Th2型细胞因子平衡,清除体内过多的氧自由基,从而起到防治哮喘的作用。     

上皮源性细胞因子IL-33、IL-25和TSLP在哮喘发病机制中的作用

哮喘(asthma)是一种以气道高反应性、慢性气道炎症、气道重塑和可逆性的气流受阻为特征的常见慢性呼吸系统疾病。近年来,研究发现气道上皮细胞在霉菌、尘螨、花粉、病毒感染、空气污染物等各种损伤因素的作用下,可释放细胞因子白细胞介素-33(interleukin-33,IL-33)、白细胞介素-25(interleukin-25,IL-25)和胸腺基质淋巴细胞生成素(thymic stromal lymphopoietin,TSLP),这些细胞因子不仅可作用于2型辅助性T细胞(type 2 helper T cells,Th2 cells),同时也可作用于固有淋巴样2型细胞(group 2 innate lymphoid cells,ILC2s),通过释放Th2型细胞因子,参与哮喘的发生与发展。尽管这3种细胞因子在哮喘的发生与发展中均起到重要作用,但其在哮喘病理、生理学效应及作用方式上并非完全相同。现就这3种上皮源性细胞因子IL-33、IL-25和TSLP在哮喘发病机制中的作用作一概述。     

Ⅱ型固有淋巴细胞及其在变应性哮喘中的作用

变应性哮喘是一种以慢性气道炎症和气道高反应性为特征的异质性疾病,与白细胞介素-4(interleukin-4,IL-4)、IL-5和IL-13等II型辅助性T细胞(type 2 T helper cell,Th2)分泌的细胞因子有关。II型固有淋巴细胞(type 2 innate lymphoid cells,ILC2s)是在转录因子维甲酸相关孤核受体α(retinoic acid receptor related orphan receptorα,RORα)和GATA结合因子3(GATA-binding factor 3,GATA3)控制下由骨髓中的淋巴样祖细胞发育而来。ILC2s能分泌Th2型细胞因子如IL-5和IL-13,有助于启动和维持II型免疫反应。近期研究表明,ILC2s在变应性哮喘中发挥着不可替代的作用。研究ILC2s对于了解变应性哮喘的发病机制具有重要意义。该文将主要综述ILC2s的发现、发育、分布与功能及其与变应性哮喘关系的最新进展。     

微卡对支气管哮喘Th1/Th2类细胞因子失衡的调节作用

目的 探讨微卡对哮喘ThⅠ/Th2类细胞因子失衡的调节作用.方法 选取确诊的轻中度哮喘40例,所有患者深部肌肉注射微卡22.5μg,每2周1次,共8周,并在治疗前、治疗后1月、2月分别抽取静脉血3 ml检测IFN-γ和IL-4水平（ELISA法）.结果 微卡治疗后1月即可纠正失衡的IFN-γ/IL-4,其中以治疗后2月作用较明显,且未见明显的药物不良反应.结论 微卡通过调节失衡的Th1/Th2平衡而达到抗气道炎症作用,可作为哮喘的防治药物.     

IL-17与肺部感染性疾病的相关性研究进展

白细胞介入17(Interleukin17,IL-17)是CD4+的T细胞亚群Th17细胞所产生的一种炎症细胞因子,由于其具有强大的募集粒细胞以及促进各种炎症细胞因子释放的作用,其与哮喘、肺部感染等疾病有密切相关性,其在肺部感染疾病中发挥重要作用,如:IL-17在气道炎症疾病中的机制等,鉴于IL-17的生物活性较多,而参加各种肺部疾病有明显的相关性.现就IL-17与肺部感染性疾病的相关性做一综述.     

人IL-37b转基因对小鼠哮喘模型作用的研究

目的通过研究人抑制性细胞因子白细胞介素37b(interleukin 37b, IL-37b)转基因(transgenic, TG)小鼠(Il37b TG)对卵清蛋白(ovalbumin, OVA)诱导的哮喘气道高反应性、气道炎症和气道重塑等指标的变化,以及IL-37b在体外对小鼠和人肺结构细胞的作用,评估IL-37b在治疗哮喘方面的潜在意义。方法采用野生型和Il37b TG的雌性C57BL/6小鼠,建立周期为24 d的OVA诱导的哮喘小鼠模型,检测其肺力学参数、炎性细胞分类和Th2细胞因子表达以及肺组织病理学改变。体外采用原核细胞表达系统,获得大量纯化的重组人IL-37b。继而分别预处理小鼠肺成纤维细胞系(MLg)和人肺泡上皮细胞系(A549细胞),随后加以脂多糖(lipopolysaccharide, LPS)刺激,收集培养上清,采用双抗体夹心ELISA检测炎性细胞因子IL-6含量。结果与野生型OVA模型组相比,Il37b TG OVA组的气道高反应性降低,差异有统计学意义(P=0.000 1,P0.05);支气管肺泡灌洗液和肺组织中嗜酸性粒细胞数量降低,差异有统计学意义(分别为P=0.000 1和P0.000 1,P0.05);肺组织炎症细胞浸润明显减少,气道炎症、杯状细胞增生和黏液分泌均明显减轻,苏木精-伊红染色和过碘酸-希夫染色评分也有所降低,差异有统计学意义(分别为P=0.000 1和P=0.000 2,P0.05),马松染色显示急性期胶原沉积的改变不明显;肺组织匀浆中Th2型细胞因子IL-5和IL-13的含量均有所降低。同时研究采用原核细胞表达系统得到的IL-37b预处理鼠肺成纤维细胞MLg和人肺上皮细胞A549,可以降低LPS所诱导IL-6的产生。结论 IL-37b可能通过对相关靶细胞的负向调控进而发挥对哮喘气道的高反应性及气道炎症的抑制作用,为IL-37b作为一种新的治疗方法在临床治疗哮喘的潜在应用提供了一定的实验依据。     

Th2型γδ T细胞参与急性RSV感染所诱发的气道炎症反应

γδ T细胞是机体重要的固有免疫细胞,参与肺组织炎性病变及哮喘的发生发展。但迄今为止,γδT细胞在呼吸道合胞病毒感染所诱发的气道炎症反应中的作用尚不十分清楚。研究通过建立RSV急性感染的实验动物模型,采用HE染色、Real-timeRT-PCR、流式细胞术等实验方法,旨在揭示γδT细胞在感染性气道炎症发生中的作用及其相关作用机制。结果显示,RSV感染导致BALA/c鼠肺炎性细胞浸润,其中嗜酸性粒细胞增加明显;同时肺组织局部Th2型细胞因子IL-4、IL-13 mRNA表达升高;RSV感染后,肺组织γδT细胞总数,特别是活化的CD69+γδT细胞数量显著增加,其中分泌Th2型细胞因子IL-4和IL-13的γδT细胞数量增加明显,而分泌Th1型细胞因子IFN-γ的γδT细胞数量显著减少,证实γδT细胞通过分泌Th2型细胞因子介导RSV感染诱发的气道炎症反应。     

天然辅助细胞在初次和再次RSV感染所诱发气道炎症反应中的作用

天然辅助细胞(natural helper cell,NHC)是近期发现的二型固有淋巴细胞的一种,因其在病毒感染后分泌大量Th2型细胞因子,故在病毒感染所诱发的气道炎症反应中发挥重要作用。呼吸道合胞病毒(Respiratory Syncytial Virus,RSV)是最常见的呼吸道病毒,也是一个反复感染的过程。NHC在RSV感染过程发挥的作用尤其是在再次感染中具体作用尚不清楚,故本研究建立初次及再次感染模型,通过计数肺泡灌洗液(BALF)中炎性细胞数量,HE染色观察肺病理炎症反应,Real-time RT-PCR法检测肺组织及NHC内Th1/Th2型细胞因子IFN-γ、IL-5、IL-13mRNA的表达,膜表面染色检测肺组织内CD45+Lin-ST2+标记的NHC数量,细胞膜内染色检测分泌Th1/Th2型细胞因子IFN-γ、IL-5、IL-13的NHC数量,探讨NHC在初次及再次RSV感染所诱发导致气道炎症反应中的作用。结果显示与再次RSV感染相比,初次RSV感染引起的肺炎症反应明显加重,且肺组织内Th2型细胞因子IL-5、IL-13mRNA表达水平亦明显增多,提示与再次RSV感染相比,初次RSV感染可能通过诱导机体产生更多的Th2型细胞因子,进而导致较重的气道炎症。流式细胞分析术发现初次RSV感染鼠肺组织内NHC总数及IL-5+NHC,IL-13+NHC数量明显多于再次RSV感染组,提示与再次RSV感染相比,初次RSV感染诱导更多的Th2型NHC进入肺组织,参与气道炎症。研究证实NHC通过分泌Th2型细胞因子,尤其是IL-5和IL-13,介导RSV感染所诱发的气道炎症反应。     

Analysis of IL-12 receptor beta 2 chain expression of circulating T lymphocytes in patients with atopic asthma

Th2 cell predominance relative to Th1 cells contributes to pathological immune responses in patients with atopic asthma. IL-12 is a key cytokine in the induction of Th1 cells, and downregulation of IL-12 production is reported in these patients. However, IL-12 receptor expression of their T lymphocytes has not been clarified. In this study, expression of IL-12 receptor beta 2 on T cells and secretion of cytokines which affect IL-12 receptor beta 2 expression by their PBMC were examined. We found that IL-12 receptor beta 2 expression of the T cells is reduced. This is partly due to the diminished production of IL-12 and enhanced secretion of IL-4 by their PBMC. IL-18 production is not significantly modulated in these patients. Furthermore, intrinsic defects of the CD4(+) T cells, which reduce their IL-12 receptor beta 2 expression in response to IL-12 and/or IL-18 stimulation, are evident and are importantly involved in the Th1/Th2 imbalance of patients with atopic asthma.     

双歧杆菌对过敏性哮喘儿童树突状细胞分泌IL-10、IL-12等细胞因子的影响

目的探讨双歧杆菌对过敏性哮喘儿童外周血单核细胞（PBMC）来源的树突状细胞（DC）分泌IL-1β、IL-6、IL-10、IL-12、IL-23和IFN-γ的影响。方法从15例过敏性哮喘儿童和15例非哮喘儿童的外周血单个核细胞诱导生成未成熟DC,加入双歧杆菌后继续培养DC2d,用ELISA方法检测培养上清中IL-1β、IL-6、IL-10、IL-12、IL-23和IFN-γ的水平。结果双歧杆菌能明显刺激哮喘儿童DC分泌IL-12、IFN-γ,IL-1β及IL-6和非哮喘儿童DC分泌IL-12、IL-10、IL-1β及IL-23水平增高。结论双歧杆菌能够刺激过敏性哮喘儿童DC分泌IL-12和IFN-γ,可能改变Th2优势分化,纠正Th1／Th2失衡。同时双歧杆菌还能刺激哮喘儿童DC分泌IL-1p及IL-6增高,达到促进,Th17细胞分化的作用。     

Allergen rush immunotherapy increases interleukin (IL)-12 production and IL-12 receptor beta2 chain expression in patients with allergic asthma

Interleukin (IL)-12 production and IL-12 receptor (IL-12R) beta2 chain expression were investigated in patients with allergic asthma successfully treated with rush immunotherapy (RIT) and control patients with mild allergic asthma. Peripheral blood mononuclear cells (PBMCs) were stimulated with Dermatophagoides farinae (Der f), and production of cytokines was measured. Furthermore, the effects of cytokines on IL-12R beta2 chain expression on CD4(+) T cells were investigated. Production by PBMCs of IL-12 and IFN-gamma was significantly higher and production of IL-4 was significantly lower after stimulation with Der f allergen in RIT-treated patients than in control patients. Significant increases in the expression of IL-12R beta2 chain before and after stimulation of CD4(+) T cells with IL-12 or IFN-gamma were observed in RIT-treated patients compared with that in control patients. Allergen RIT increases IL-12 production and IL-12R beta2 chain expression and thus may convert cytokine production from Th2 to Th1 or Th0 type in allergic asthma.     

Association study between interleukin-12 receptor beta1/beta2 genes and type 1 diabetes or asthma in the Japanese population

Interleukin-12 (IL-12) secreted from macrophages or dendritic cells plays an important role in the protection against intracellular pathogens as well as the developmental commitment of T helper 1 cells. IL-12 exerts its biological effects through binding to specific IL-12 receptors (IL-12Rs) termed IL-12Rbeta1 and IL 12Rbeta2. In this paper, we performed association studies between the three reported polymorphisms (Q214R, M365T and G378R) of the IL-12Rbeta1 gene or the newly identified polymorphisms (P238L, IVS9 -7G>A, IVS13 -121G>A, A643T, P779P and c.3283T>G) of the IL-12Rbeta2 gene, and the development of type 1 diabetes or atopic asthma as representative Th1- and Th2- dominant diseases, respectively. The association study of each polymorphism of the IL-12Rbeta1 or IL-12Rbeta2 gene and type 1 diabetes or asthma showed that these IL-12R genes did not contribute to the development of type 1 diabetes or asthma in the Japanese population. Further analysis in individuals with susceptibility to intracellular pathogens may elucidate the importance of the IL-12R genes.     

Helicobacter pylori, asthma and allergy

Bronchial asthma and allergic diseases are orchestrated by T-cells producing T-helper type 2 (Th2) cytokines, such as interleukin-4 (IL-4) and IL-5, and are inhibited by Th1 responses. Helicobacter pylori has chronically infected the human population for c . 100 000 years and preferentially elicits a Th1 mucosal immune response with the production of interferon-γ and IL-12. Among several bacterial factors, the neutrophil-activating protein of H. pylori (HP-NAP) not only plays a key role in driving Th1 inflammation but it is also able to inhibit Th2 responses in vitro and in vivo in allergic bronchial asthma, in humans and mice. Both systemic and mucosal administrations of HP-NAP are successful in reducing eosinophilia, immunoglobulin E and systemic Th2 cytokines at the bronchial level. Thus, these results identify HP-NAP as a candidate for novel strategies for the prevention and treatment of allergic diseases.     

Th1 and Th2 cells are required for both eosinophil- and neutrophil-associated airway inflammatory responses in mice

Most current animal models focus on eosinophil-mediated asthma, despite compelling evidence that a neutrophil-mediated disease occurs in some asthma patients. Using intranasal challenge of mice sensitized either orally or nasally with whole peanut protein extract in the presence of cholera toxin, we developed mouse models of eosinophil- and neutrophil-mediated asthma, respectively. In this study, mice deficient in Th1 (IL-12 and IFN-gamma) or Th2 (IL-4 and IL-13) pathways were used to characterize the role played by Th1 and Th2 cytokines during the initial priming phase in the two models. Antigen-specific Ab responses were controlled primarily by Th2 cytokines in mice sensitized by the oral route, whereas Th1 cytokines appeared to play a predominant role in mice sensitized by the nasal route. Furthermore, the absence of key Th1 or Th2 cytokines during the initial phase of priming reduced lung reactivity in both mouse models of airway inflammation.     

Let-7a在哮喘T淋巴细胞失衡中的作用研究

目的:探讨let-7a在哮喘中的表达水平及调节T淋巴细胞亚群失衡的功能作用。方法:收集39例哮喘患者及19例非哮喘对照,Real-time PCR检测let-7a的表达。从哮喘患者外周血单核细胞(Peripheral blood mononuclear cell,PBMC)中分选Th1,Th2和Th17细胞,检测let-7a在T淋巴细胞亚群中的表达。磁珠分选naive T细胞,分别诱导分化成Th1、Th2和Th17细胞,分析let-7a在T淋巴细胞亚群中的表达。Let-7a mimic分别转染Th2和Th17细胞,ELISA检测IL-13和IL-17的表达。结果:与对照组比较,let-7a在哮喘患者肺组织和血清中低表达,并随着哮喘病程进展,let-7a的表达水平也越低。哮喘患者来源的CD4~+T细胞中,let-7a表达明显低于非哮喘对照组。Let-7a在哮喘来源和体外刺激分化的哮喘炎性Th2和Th17细胞中的表达明显下调,而在Th1细胞中的表达没有变化。Let-7a mimic改变了Th2和Th17相关细胞因子IL-13和IL-17的表达。结论:Let-7a在哮喘中低表达,调节哮喘T淋巴细胞亚群失衡,改变了Th2和Th17细胞的功能,是哮喘理想的诊断和治疗靶点。     

Th17 Immunity in Children with Allergic Asthma and Rhinitis: A Pharmacological Approach

Th17 cells and IL-17A play a role in the development and progression of allergic diseases. We analyzed the IL-17A levels in sputum supernatants (Ss), nasal wash (NW) and plasma (P) from Healthy Controls (HC) and children with Asthma/Rhinitis. We tested the expression of IL-17A, RORγ(t) and FOXP3 in peripheral blood T-lymphocytes from intermittent and mild-moderate asthma. The effect of Budesonide and Formoterol was tested “in vitro” on IL-17A, RORγ(t) and FOXP3 expression in cultured T-lymphocytes from mild-moderate asthma/persistent rhinitis patients, and on nasal and bronchial epithelial cells stimulated with NW and Ss from mild-moderate asthma/persistent rhinitis. Further, the effect of 12 weeks of treatment with Budesonide and Formoterol was tested “in vivo” in T-lymphocytes from mild-moderate asthma/persistent rhinitis patients. IL-17A was increased in Ss, NW and P from children with mild-moderate asthma compared with intermittent and HC. In cultured T-lymphocytes IL-17A and RORγ(t) expression were higher in mild-moderate asthma/persistent rhinitis than in mild-moderate asthma/intermittent rhinitis, while FOXP3 was reduced. Budesonide with Formoterol reduced IL-17A and RORγ(t), while increased FOXP3 in cultured T-lymphocytes from mild-moderate asthma/persistent rhinitis, and reduced the IL-8 release mediated by IL-17A present in NW and Ss from mild-moderate asthma/persistent rhinitis in nasal and bronchial epithelial cells. Finally, Budesonide with Formoterol reduced IL-17A levels in P and Ss, CD4⁺IL-17A⁺T-cells, in naïve children with mild-moderate asthma/persistent rhinitis after 12 weeks of treatment. Th17 mediated immunity may be involved in the airway disease of children with allergic asthma and allergic rhinitis. Budesonide with Formoterol might be a useful tool for its therapeutic control.     

TH1/TH2 cytokine balance in patients with both type 1 diabetes mellitus and asthma

BACKGROUND AND OBJECTIVE: T1DM and asthma are mediated by opposite arms of the cellular immune system namely T helper (Th)1 and Th2 CD4(+) cells, respectively. Our aim was to characterize the Th1/Th2 cytokine balance in patients with both T1DM and asthma. METHODS: Forty-four patients, mean age 19 years were matched by gender and age, to 4 paired groups: T1DM and asthma, asthma only, T1DM only and healthy controls. Peripheral blood mononuclear cells (PBMC) were stimulated in vitro with disease-specific recombinant antigens; glutamic acid decarboxylase and house dust mite (Der p1 antigen) for T1DM and asthma, respectively, and non-specific mitogens; phytohemaglutinin (PHA), tetanus toxin and anti-CD3 mAb. ELISPOT and ELISA technique were used to determine INF-gamma, IL-2, IL-4, IL-13 and IL-10 expression. RESULTS: Patients with T1DM and asthma demonstrated a similar cytokine pattern but lower Th1/Th2 ratio compared to patients with T1DM only. The Th2 cytokines response to Der p1 was enhanced in patients with both diseases compared to controls. The IL-10 overall secretion was higher in patients with both diseases compared to one disease only. CONCLUSION: The Th1 and Th2 secretory pattern of patients with T1DM and asthma combines features of both diseases suggesting a unique Th1/Th2 balance.