Departamento de Inmunología, Facultad de Medicina, Pabellón V: Planta 4, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Br J Nutr. 2013 Jan;109 Suppl 2:S3-11. doi: 10.1017/S0007114512005223.
Gut mucosal surfaces separate the external environment from the internal sterile environment and so represent a first line of defence system. This barrier faces environments rich in pathogens that have developed effective mechanisms for colonisation of epithelial surfaces and invasion of mucosal tissues, but also harmless antigens such as food, airborne antigens or commensal bacterial flora. The latter represent the vast majority of the encountered antigens and require an appropriate response characterised by either ignorance or active suppression. However, for the former, a robust immune response is needed. Mucosae have developed a complex immune system that is capable of mounting an immune response against pathogenic antigens, while maintaining the required ignorance or active suppression against non-pathogenic antigens. Taking advantage of this knowledge, strategies have been devised to induce oral tolerance to antigens involved in experimental autoimmune disease or human conditions. It is now known that oral tolerance induces the up-regulation and activation of T cells with regulatory properties, a subtype of CD4⁺ T cells whose function is to regulate functions of other T lymphocytes to avoid excessive immune activation. Amongst them, the Th3 cells (cells that express the latency-associated peptide on the surface and secrete transforming growth factor β, a cytokine with immunoregulatory properties) are especially relevant in the induction of oral tolerance. Orally fed antigens seek to generate these types of cells in the treatment of autoimmune diseases in experimental animals or human subjects.
肠道黏膜表面将外环境与内部无菌环境分隔开来,因此构成了第一道防御系统。该屏障面临着富含病原体的环境,这些病原体已开发出有效的定植上皮表面和侵袭黏膜组织的机制,但也面临着无害抗原,如食物、空气传播抗原或共生细菌菌群。后者代表了遇到的绝大多数抗原,需要适当的反应,表现为忽视或主动抑制。然而,对于前者,则需要强有力的免疫反应。黏膜已发展出一种复杂的免疫系统,能够对致病性抗原产生免疫反应,同时对非致病性抗原保持所需的忽视或主动抑制。利用这方面的知识,已经设计出策略来诱导针对实验性自身免疫疾病或人类疾病相关抗原的口服耐受。现在已知,口服耐受会诱导具有调节特性的 T 细胞上调和激活,CD4⁺T 细胞的一个亚型,其功能是调节其他 T 淋巴细胞的功能,以避免过度的免疫激活。其中,Th3 细胞(表达潜伏相关肽并分泌转化生长因子 β的细胞,转化生长因子 β是一种具有免疫调节特性的细胞因子)在诱导口服耐受方面尤为重要。口服给予的抗原旨在在实验动物或人类自身免疫性疾病的治疗中产生这些类型的细胞。