重复 TLR9 刺激会导致小鼠出现类似于巨噬细胞活化综合征的疾病。
Repeated TLR9 stimulation results in macrophage activation syndrome-like disease in mice.
机构信息
Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
出版信息
J Clin Invest. 2011 Jun;121(6):2264-77. doi: 10.1172/JCI43157. Epub 2011 May 16.
Hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS) are 2 similar diseases characterized by a cytokine storm, overwhelming inflammation, multiorgan dysfunction, and death. Animal models of HLH suggest that disease is driven by IFN-γ produced by CD8⁺ lymphocytes stimulated by persistent antigen exposure. In these models and patients with "primary" HLH, the antigen persists due to genetic defects, resulting in ineffective cytotoxic responses by CD8⁺ T cells and poor pathogen clearance. However, infectious triggers are often not identified in patients with MAS, and some patients with HLH or MAS lack defects in cytotoxic T cell killing. Herein, we show that repeated stimulation of TLR9 produced an HLH/MAS-like syndrome on a normal genetic background, without exogenous antigen. Like previous HLH models, TLR9-induced MAS was IFN-γ dependent; however, unlike other models, disease did not require lymphocytes. We further showed that IL-10 played a protective role in this model and that blocking IL-10 signaling led to the development of hemophagocytosis. IL-10 may therefore be an important target for the development of effective therapeutics for MAS. Our data provide insight into MAS-like syndromes in patients with inflammatory diseases in which there is chronic innate immune activation but no genetic defects in cytotoxic cell function.
噬血细胞性淋巴组织细胞增生症 (HLH) 和巨噬细胞活化综合征 (MAS) 是两种相似的疾病,其特征为细胞因子风暴、炎症过度、多器官功能障碍和死亡。HLH 的动物模型表明,疾病由持续抗原暴露刺激的 CD8⁺ 淋巴细胞产生的 IFN-γ 驱动。在这些模型和“原发性”HLH 患者中,由于遗传缺陷,抗原持续存在,导致 CD8⁺ T 细胞的细胞毒性反应无效和病原体清除不良。然而,MAS 患者的感染性触发因素通常无法确定,一些 HLH 或 MAS 患者缺乏细胞毒性 T 细胞杀伤缺陷。在此,我们表明,TLR9 的重复刺激在正常遗传背景下产生了 HLH/MAS 样综合征,而无需外源性抗原。与先前的 HLH 模型一样,TLR9 诱导的 MAS 依赖于 IFN-γ;然而,与其他模型不同,疾病不需要淋巴细胞。我们进一步表明,IL-10 在该模型中发挥保护作用,阻断 IL-10 信号会导致噬血细胞现象的发展。因此,IL-10 可能是 MAS 有效治疗药物开发的重要靶点。我们的数据为炎症性疾病中出现类似 MAS 的综合征提供了见解,这些疾病存在慢性先天免疫激活,但细胞毒性细胞功能无遗传缺陷。