Robinson Douglas S, Larché Mark, Durham Stephen R
Department of Allergy and Clinical Immunology, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.
J Clin Invest. 2004 Nov;114(10):1389-97. doi: 10.1172/JCI23595.
Allergic diseases such as asthma, rhinitis, and eczema are increasing in prevalence and affect up to 15% of populations in Westernized countries. The description of Tregs as T cells that prevent development of autoimmune disease led to considerable interest in whether these Tregs were also normally involved in prevention of sensitization to allergens and whether it might be possible to manipulate Tregs for the therapy of allergic disease. Current data suggest that Th2 responses to allergens are normally suppressed by both CD4+CD25+ Tregs and IL-10 Tregs. Furthermore, suppression by these subsets is decreased in allergic individuals. In animal models, Tregs could be induced by high- or low-dose inhaled antigen, and prior induction of such Tregs prevented subsequent development of allergen sensitization and airway inflammation in inhaled challenge models. For many years, allergen-injection immunotherapy has been used for the therapy of allergic disease, and this treatment may induce IL-10 Tregs, leading to both suppression of Th2 responses and a switch from IgE to IgG4 antibody production. Improvements in allergen immunotherapy, such as peptide therapy, and greater understanding of the biology of Tregs hold great promise for the treatment and prevention of allergic disease.
哮喘、鼻炎和湿疹等过敏性疾病的患病率正在上升，在西方国家影响着高达15%的人口。调节性T细胞（Tregs）被描述为可预防自身免疫性疾病发生的T细胞，这引发了人们对这些Tregs是否也正常参与预防过敏原致敏，以及是否有可能通过操纵Tregs来治疗过敏性疾病的极大兴趣。目前的数据表明，CD4+CD25+ Tregs和白细胞介素10（IL-10）Tregs通常都会抑制对过敏原的辅助性T细胞2（Th2）反应。此外，在过敏个体中，这些亚群的抑制作用会减弱。在动物模型中，高剂量或低剂量吸入性抗原可诱导产生Tregs，预先诱导产生的此类Tregs可在吸入激发模型中预防随后的过敏原致敏和气道炎症的发生。多年来，过敏原注射免疫疗法一直用于治疗过敏性疾病，这种治疗可能会诱导产生IL-10 Tregs，从而抑制Th2反应，并导致抗体产生从免疫球蛋白E（IgE）转变为免疫球蛋白G4（IgG4）。过敏原免疫疗法的改进，如肽疗法，以及对Tregs生物学特性的更深入了解，为过敏性疾病的治疗和预防带来了巨大希望。
