CD4~+CD25~+Treg细胞在类风湿关节炎中的研究进展

调节性T细胞(Tregs)是近年来发现的一群具有免疫调节作用的CD4+T细胞亚群,如Th3、Tr1细胞等。因其能够产生多种具有免疫抑制作用的细胞因子而发挥其免疫负调节作用,不但在维持机体自身耐受方面发挥重要作用,在预防自身免疫性疾病方面也占据重要位置。其中CD4+CD25+Treg因其具有独特的作用方式及功能特征,而被学者广泛关注。近年来,关于CD4+CD25+Treg在类风湿关节炎(rheumatoid arthritis,RA)发病机制中的作用以及在RA治疗方面的应用也越来越受到人们的关注,认为其数目减少或功能失调与RA发病密切相关。RA是一种以关节破坏为主要表现的慢性炎症性疾病,病理早期主要表现为毛细血管生成,滑膜增生,后期主要表现为炎性细胞浸润,血管翳形成,并出现关节软骨以及骨的破坏,最终导致关节畸形及功能障碍。本文现将CD4+CD25+Treg与RA的研究进展做一综述。     

调节性T细胞过继回输在移植免疫耐受诱导中的临床应用研究

调节性细胞在器官移植的排斥反应和自身免疫性疾病发生发展中起到重要作用。调节性T细胞的过继回输治疗,能够维持免疫细胞的平衡,提供供体特异的免疫调节作用,达到很好的临床治疗效果。实体器官移植的调节性细胞治疗,在动物研究中,已经得到很好的验证,临床应用前景巨大。但是在临床的试验中,还有很多亟待解决的问题。新的理论突破,比如免疫互噬理论和免疫嵌合等理论能够给临床调节性细胞的应用带来新思路。     

Treg在人类免疫缺陷病毒感染中免疫调节机制的研究进展

近年来,研究发现机体内存在一种以调节机体免疫功能为主要任务的一部分T细胞——调节性T细胞(Treg)。Treg对T细胞成熟、分化的抑制及其对杀伤性T细胞的调节作用是机体维持自身内环境稳定的免疫调节机制的重要组成部分。Treg在多种病毒的慢性持续感染中发挥的免疫调节作用虽然使得病原体能够长期在机体内存活,进而导致疾病的慢性化,但同时也避免了机体由于过度的免疫应答而引起的免疫损伤。研究证实,Treg在人类免疫缺陷病毒(HIV)感染的发生和发展中发挥重要作用且与疾病预后密切相关,Treg有可能成为针对HIV感染治疗的新靶点。我们就Treg与人类免疫缺陷病毒感染机制方面的最新研究进展做简要综述。     

天然调节T 细胞与诱导调节T 细胞的生物学特性

CD4+CD25+FOXP3+的调节T细胞(regulatory T cells,Treg)在维持机体免疫平衡方面起着重要的作用。体外扩增Treg细胞用于治疗自身免疫病、哮喘及诱导器官移植免疫耐受引起人们极大的兴趣。Treg细胞可分为2个亚群,分别为nTreg和iTreg,两者有不同的生物学特性。nTreg在特定条件下,可以分泌具有促进炎症的IL-17;iTreg在体内可丢失FOXP3,失去其免疫抑制功能。Treg细胞用于临床治疗,还有许多问题需要研究解决。     

FOXP3+调节性T细胞与非感染性炎症疾病

FOXP3~+调节性T细胞(FOXP3~+Tregs)是一类具有免疫抑制等调节作用的CD4~+T淋巴细胞亚群,其正常生理功能对人体免疫稳态的维持不可或缺。基于免疫疗法的临床需求,越来越多研究着眼于深入理解FOXP3~+Treg在局部组织炎症条件下的功能紊乱及其相关分子机理。现将系统阐述近年来有关FOXP3~+Treg生理功能及其调控机制的研究新进展,重点聚焦在多种非感染性炎症疾病,如自身免疫性疾病、免疫代谢性疾病、神经退行性疾病中,FOXP3~+Treg功能稳定性及组织特异性的分子机理及其潜在干预新靶点和新策略。     

趋化因子及受体介导CD4~+CD25~+Foxp3~+Treg迁移研究进展

CD4~+CD25~+Foxp3~+调节性T细胞可以有效抑制同种异体反应时细胞介导的免疫反应,近年来是器官移植领域学者关注热点之一。既往研究表明,Tregs既存在于移植器官受体的各级淋巴组织中,而且也分布在移植物内部中。因为Tregs的活化位置不同,其免疫抑制功能也不同,如果Tregs用来预防免疫排斥反应的话,那么Tregs在体定位和迁移信息特别关键。趋化因子受体是CD4~+CD25~+Foxp3~+Treg进行靶向迁移、在特定部位发挥免疫调节作用的结构基础。Tregs在体迁移是一个由多个细胞、多种趋化因子及其受体参与的运动过程。随着淋巴组织中新的趋化因子受体和Tregs特异性趋化因子的发现,提示Tregs在体复杂的迁移过程和活化主要是由趋化因子及受体介导。因此,趋化因子领域的研究将会为器官移植病人提供新的治疗思路。     

调节性T细胞与自身免疫性疾病

自身免疫性疾病是由于机体正常免疫耐受功能受损导致免疫系统对自身组织结构和功能的破坏,并出现一定临床表现的一类疾病.调节性T细胞作为一类具有负向免疫调节功能的淋巴细胞亚群在免疫自稳和免疫耐受中起关键作用,既能抑制不恰当的免疫反应,又能限制免疫应答的范围、程度及作用时间,对效应性T细胞的增殖及免疫活性的发挥产生抑制,因此在许多自身免疫性疾病的发病中扮演重要角色.近年来的研究表明调节性T细胞可以通过细胞接触、分泌细胞因子、基因调控等多种途径发挥作用,在不同的疾病,不同的内环境因素作用下可以表现出不同的特点,转录因子Foxp3作为调节性T细胞的特异性标志是其分化成熟及功能维持的根本.     

免疫调节剂的研究及应用进展

免疫调节剂是能调节免疫功能的药物,在临床上能够有效的治疗与免疫有关的疾病。免疫调节剂的作用是增强或抑制免疫功能,可以根据来源不同进行分类。免疫调节剂的作用主要是影响免疫系统中任一环节的反应和作用,如刺激免疫细胞的功能或是拮抗免疫分子发挥作用。免疫调节剂在临床上应用广泛,肿瘤、器官移植、类风湿性关节炎等的治疗都依赖于免疫调节荆的作用。因此,研究免疫调节剂的作用机理、开发有效的免疫调节剂具有重要的意义。免疫调节剂的发展将为人类健康带来新的希望。     

调节性T细胞在动脉粥样硬化发病中的作用

CD4^＋CD25^＋调节性T细胞（CD4^＋CD25^＋Treg）是一个具有独特免疫调节功能的T细胞亚群,它不仅抑制自身免疫性疾病的发生,而且可能参与诱导移植耐受以及肿瘤免疫调节,在维持机体内环境稳态中起重要作用。本文综述了CD4^＋CD25^＋调节性T细胞的特点和调节机制,以及在动脉粥样硬化发生发展中的可能作用。最新研究提示其可能是机体内源性有效的抑制动脉粥样硬化的因子。这些研究成果为理解动脉粥样硬化的免疫病理机制提供了新的观点,并可能为应用调节性T细胞作为靶点,寻找治疗动脉粥样硬化的免疫调节制剂提供新的策略。     

间充质干细胞在治疗癫痫所致炎症反应中的作用研究进展

间充质干细胞(MSCs)的免疫调节功能成为近年来的研究热点之一。癫痫是一种以反复发作为特征的复杂性神经系统疾病,而炎症反应是癫痫发生和反复发作的一个重要因素。研究表明,MSCs能够有效治疗多种退行性疾病造成的炎性反应,且发现MSCs可以通过炎症微环境发挥免疫调节功能。简要综述了MSCs在治疗癫痫所致炎症中的作用,旨在为临床应用MSCs防治癫痫提供理论依据。     

Kinetics and activation requirements of contact-dependent immune suppression by human regulatory T cells

Naturally occurring regulatory T cells (Tregs) maintain self tolerance by dominant suppression of potentially self-reactive T cells in peripheral tissues. However, the activation requirements, the temporal aspects of the suppressive activity, and mode of action of human Tregs are subjects of controversy. In this study, we show that Tregs display significant variability in the suppressive activity ex vivo as 54% of healthy blood donors examined had fully suppressive Tregs spontaneously, whereas in the remaining donors, anti-CD3/CD2/CD28 stimulation was required for Treg suppressive activity. Furthermore, anti-CD3/CD2/CD28 stimulation for 6 h and subsequent fixation in paraformaldehyde rendered the Tregs fully suppressive in all donors. The fixation-resistant suppressive activity of Tregs operated in a contact-dependent manner that was not dependent on APCs, but could be fully obliterated by trypsin treatment, indicating that a cell surface protein is directly involved. By add-back of active, fixed Tregs at different time points after activation of responding T cells, the responder cells were susceptible to Treg-mediated immune suppression up to 24 h after stimulation. This defines a time window in which effector T cells are susceptible to Treg-mediated immune suppression. Lastly, we examined the effect of a set of signaling inhibitors that perturb effector T cell activation and found that none of the examined inhibitors affected Treg activation, indicating pathway redundancy or that Treg activation proceeds by signaling mechanisms distinct from those of effector T cells.     

Regulatory T Cells and Human Myeloid Dendritic Cells Promote Tolerance via Programmed Death Ligand-1

Immunotherapy using regulatory T cells (Treg) has been proposed, yet cellular and molecular mechanisms of human Tregs remain incompletely characterized. Here, we demonstrate that human Tregs promote the generation of myeloid dendritic cells (DC) with reduced capacity to stimulate effector T cell responses. In a model of xenogeneic graft-versus-host disease (GVHD), allogeneic human DC conditioned with Tregs suppressed human T cell activation and completely abrogated posttransplant lethality. Tregs induced programmed death ligand-1 (PD-L1) expression on Treg-conditioned DC; subsequently, Treg-conditioned DC induced PD-L1 expression in vivo on effector T cells. PD-L1 blockade reversed Treg-conditioned DC function in vitro and in vivo, thereby demonstrating that human Tregs can promote immune suppression via DC modulation through PD-L1 up-regulation. This identification of a human Treg downstream cellular effector (DC) and molecular mechanism (PD-L1) will facilitate the rational design of clinical trials to modulate alloreactivity.     

FoxP3+ Regulatory T Cells Determine Disease Severity in Rodent Models of Inflammatory Neuropathies

Inflammatory neuropathies represent disabling human autoimmune disorders with considerable disease variability. Animal models provide insights into defined aspects of their disease pathogenesis. Forkhead box P3 (FoxP3)+ regulatory T lymphocytes (Treg) are anti-inflammatory cells that maintain immune tolerance and counteract tissue damage in a variety of immune-mediated disorders. Dysfunction or a reduced frequency of Tregs have been associated with different human autoimmune disorders. We here analyzed the functional relevance of Tregs in determining disease manifestation and severity in murine models of autoimmune neuropathies. We took advantage of the DEREG mouse system allowing depletion of Treg with high specificity as well as anti-CD25 directed antibodies to deplete Tregs in mice in actively induced experimental autoimmune neuritis (EAN). Furthermore antibody-depletion was performed in an adoptive transfer model of chronic neuritis. Early Treg depletion increased clinical EAN severity both in active and adoptive transfer chronic neuritis. This was accompanied by increased proliferation of myelin specific T cells and histological signs of peripheral nerve inflammation. Late stage Treg depletion after initial disease manifestation however did not exacerbate inflammatory neuropathy symptoms further. We conclude that Tregs determine disease severity in experimental autoimmune neuropathies during the initial priming phase, but have no major disease modifying function after disease manifestation. Potential future therapeutic approaches targeting Tregs should thus be performed early in inflammatory neuropathies.     

Stat3 phosphorylation mediates resistance of primary human T cells to regulatory T cell suppression

Human autoimmune diseases are characterized by systemic T cell dysfunction, resulting in chronically activated Th1 and Th17 cells that are inadequately suppressed by regulatory T cells (Tregs). IL-6, which is overexpressed in tissue and serum of patients with autoimmune diseases, inhibits human Treg function. We sought to determine the mechanism for the antitolerogenic properties of IL-6 by examining the signaling pathways downstream of IL-6R in primary human T cells. Inhibition of Stat3 signaling in MLCs containing IL-6 restores Treg-mediated suppression, demonstrating that IL-6-mediated loss of Treg suppression requires phosphorylation of Stat3. Cultures in which either effector T cells (Teffs) or Tregs were pretreated with Stat3 inhibitors indicate that phosphorylated (p)Stat3 is required in both T cell populations for IL-6-mediated reversal of Treg function. IL-21, which signals preferentially through pStat3, also reverses Treg suppression, in contrast to IL-27 and IFN-γ, which signal preferentially through Stat1 and do not inhibit Treg function. Interestingly, both Teffs and Tregs respond to IL-6 stimulation through strong Stat3 phosphorylation with minimal MAPK/Erk activation and moderate Stat1 phosphorylation. Finally, Teffs stimulated strongly through the TCR are also resistant to suppression by Tregs and show concurrent Stat3 phosphorylation. In these cultures, inhibition of pStat3 restores functional suppression by Tregs. Taken together, our findings suggest that an early dominance of Stat3 signaling, prior to subsequent T cell activation, is required for the loss of functional Treg suppression and that kinase-specific inhibitors may hold therapeutic promise in the treatment of autoimmune and chronic inflammatory diseases.     

Characterization of the Treg Response in the Hepatitis B Virus Hydrodynamic Injection Mouse Model

Regulatory T cells (Tregs) play an important role in counter-regulating effector T cell responses in many infectious diseases. However, they can also contribute to the development of T cell dysfunction and pathogen persistence in chronic infections. Tregs have been reported to suppress virus-specific T cell responses in hepatitis B virus (HBV) infection of human patients as well as in HBV animal models. However, the phenotype and expansion of Tregs has so far only been investigated in other infections, but not in HBV. We therefore performed hydrodynamic injections of HBV plasmids into mice and analyzed the Treg response in the spleen and liver. Absolute Treg numbers significantly increased in the liver but not the spleen after HBV injection. The cells were natural Tregs that surprisingly did not show any activation or proliferation in response to the infection. However, they were able to suppress effector T cell responses, as selective depletion of Tregs significantly increased HBV-specific CD8+ T cell responses and accelerated viral antigen clearance. The data implies that natural Tregs infiltrate the liver in HBV infection without further activation or expansion but are still able to interfere with T cell mediated viral clearance.     

Immune tolerance: Are regulatory T cell subsets needed to explain suppression of autoimmunity?

The potential for self-reactive T cells to cause autoimmune disease is held in check by Foxp3(+) regulatory T cells (Tregs), essential mediators of peripheral immunological tolerance. Tregs have the capacity to suppress multiple branches of the immune system, tightly controlling the different subsets of effector T cells across multiple different tissue environments. Recent genetic experiments have found mutations that disrupt specific Treg: effector T cell relationships, leading to the possibility that subsets of Tregs are required to suppress each subset of effector T cells. Here we review the environmental factors and mechanisms that allow Tregs to suppress specific subsets of effector T cells, and find that a parsimonious explanation of the genetic data can be made without invoking Treg subsets. Instead, Tregs show a functional and chemotactic plasticity based on microenvironmental influences that allows the common pool of cells to suppress multiple distinct immune responses.     

Rapid reconstitution of regulatory T-cell subsets is associated with reduced rates of acute graft-versus-host disease and absence of viremia after cord blood transplantation in children with reduced-intensity conditioning using alemtuzumab

Forkhead box P3 (FOXP3)+ regulatory T cell (Treg) reconstitution after unrelated donor umbilical cord blood transplantation in chemotherapy-naïve children is incompletely characterized. We studied 21 children with nonmalignant diseases receiving an identical alemtuzumab-containing regimen. We hypothesized that Treg recovery may be perturbed in patients not only by acute graft-versus-host disease (aGVHD) but also by viremia. Tregs and their memory and naïve subsets were serially monitored for proliferation and apoptosis along with conventional T cells (Tcon). A “reconstitution index” (RI) was calculated relative to pretransplantation values for each parameter. At 3 months post-UCBT, the RI of Tregs was faster compared with other immune components tested and was most rapid in patients free of aGVHD and viremia. There were significantly fewer Tregs in patients experiencing grade I–II aGVHD and/or viremia, leading to an imbalance between Tregs-Tcon ratios. Central and effector memory Tregs were most affected at this time point when they dominated in the circulation. Impaired Treg proliferation without increased apoptosis accounted for the reduced Treg-Tcon ratio. In patients affected with grade II aGVHD and viremia, the overall reduction in circulating Treg pool were associated with a more oligoclonal T-cell receptor β repertoire. Taken together, aGVHD and viremia can lead to defective Treg expansion homeostasis.     

TLR2 stimulation drives human naive and effector regulatory T cells into a Th17-like phenotype with reduced suppressive function

Naturally occurring CD4(+)CD25(+)FOXP3(+) regulatory T cells suppress the activity of pathogenic T cells and prevent development of autoimmune responses. There is growing evidence that TLRs are involved in modulating regulatory T cell (Treg) functions both directly and indirectly. Specifically, TLR2 stimulation has been shown to reduce the suppressive function of Tregs by mechanisms that are incompletely understood. The developmental pathways of Tregs and Th17 cells are considered divergent and mutually inhibitory, and IL-17 secretion has been reported to be associated with reduced Treg function. We hypothesized that TLR2 stimulation may reduce the suppressive function of Tregs by regulating the balance between Treg and Th17 phenotype and function. We examined the effect of different TLR2 ligands on the suppressive functions of Tregs and found that activation of TLR1/2 heterodimers reduces the suppressive activity of CD4(+)CD25(hi)FOXP3(low)CD45RA(+) (naive) and CD4(+)CD25(hi)FOXP3(hi)CD45RA(-) (memory or effector) Treg subpopulations on CD4(+)CD25(-)FOXP3(-)CD45RA(+) responder T cell proliferation while at the same time enhancing the secretion of IL-6 and IL-17, increasing RORC, and decreasing FOXP3 expression. Neutralization of IL-6 or IL-17 abrogated Pam3Cys-mediated reduction of Treg suppressive function. We also found that, in agreement with recent observations in mouse T cells, TLR2 stimulation can promote Th17 differentiation of human T helper precursors. We conclude that TLR2 stimulation, in combination with TCR activation and costimulation, promotes the differentiation of distinct subsets of human naive and memory/effector Tregs into a Th17-like phenotype and their expansion. Such TLR-induced mechanism of regulation of Treg function could enhance microbial clearance and increase the risk of autoimmune reactions.     

Potential role of melatonin in autoimmune diseases

Autoimmune diseases are a broad spectrum of disorders involved in the imbalance of T-cell subsets, in which interplay or interaction of Th1, Th17 and Tregs are most important, resulting in prolonged inflammation and subsequent tissue damage. Pathogenic Th1 and Th17 cells can secrete signature proinflammatory cytokines, including interferon (IFN)-γ and IL-17, however Tregs can suppress effector cells and dampen a wide spectrum of immune responses. Melatonin (MLT) can regulate the humoral and cellular immune responses, as well as cell proliferation and immune mediators. Treatment with MLT directly interferes with T cell differentiation, controls the balance between pathogenic and regulatory T cells and regulates inflammatory cytokine release. MLT can promote the differentiation of type 1 regulatory T cells via extracellular signal regulated kinase 1/2 (Erk1/2) and retinoic acid-related orphan receptor-α (ROR-α) and suppress the differentiation of Th17 cells via the inhibition of ROR-γt and ROR-α expression through NFIL3. Moreover, MLT inhibits NF-κB signaling pathway to reduce TNF-α and IL-1β expression, promotes Nrf2 gene and protein expression to reduce oxidative and inflammatory states and regulates Bax and Bcl-2 to reduce apoptosis; all of which alleviate the development of autoimmune diseases. Thus, MLT can serve as a potential new therapeutic target, creating opportunities for the treatment of autoimmune diseases. This review aims to highlight recent advances in the role of MLT in several autoimmune diseases with particular focus given to novel signaling pathways involved in Th17 and Tregs as well as cell proliferation and apoptosis.