Physiology and Experimental Medicine, Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
Respir Res. 2013 Dec 17;14(1):138. doi: 10.1186/1465-9921-14-138.
Cystic fibrosis (CF) is a complex, multi-system, life-shortening, autosomal recessive disease most common among Caucasians. Pulmonary pathology, the major cause of morbidity and mortality in CF, is characterized by dysregulation of cytokines and a vicious cycle of infection and inflammation. This cycle causes a progressive decline in lung function, eventually resulting in respiratory failure and death. The Th17 immune response plays an active role in the pathogenesis of CF pulmonary pathology, but it is not known whether the pathophysiology of CF disease contributes to a heightened Th17 response or whether CF naïve CD4+ T lymphocytes (Th0 cells) intrinsically have a heightened predisposition to Th17 differentiation.
To address this question, Th0 cells were isolated from the peripheral blood of CF mice, human CF subjects and corresponding controls. Murine Th0 cells were isolated from single spleen cell suspensions using fluorescence-activated cell sorting. Lymphocytes from human buffy coats were isolated by gradient centrifugation and Th0 cells were further isolated using a human naïve T cell isolation kit. Th0 cells were then assessed for their capacity to differentiate along Th17, Th1 or Treg lineages in response to corresponding cytokine stimulation. The T cell responses of human peripheral blood cells were also assessed ex vivo using flow cytometry.
Here we identify in both mouse and human CF an intrinsically enhanced predisposition of Th0 cells to differentiate towards a Th17 phenotype, while having a normal propensity for differentiation into Th1 and Treg lineages. Furthermore, we identify an active Th17 response in the peripheral blood of human CF subjects.
We propose that these novel observations offer an explanation, at least in part, for the known increased Th17-associated inflammation of CF and the early signs of inflammation in CF lungs before any evidence of infection. Moreover, these findings point towards direct modulation of T cell responses as a novel potential therapeutic strategy for combating excessive inflammation in CF.
囊性纤维化(CF)是一种复杂的、多系统的、缩短寿命的常染色体隐性疾病,在白种人中最为常见。肺部病理学是 CF 发病和死亡的主要原因,其特征是细胞因子失调和感染与炎症的恶性循环。这一循环导致肺功能逐渐下降,最终导致呼吸衰竭和死亡。Th17 免疫反应在 CF 肺部病理学的发病机制中起着积极作用,但尚不清楚 CF 疾病的病理生理学是否导致 Th17 反应增强,或者 CF 幼稚 CD4+T 淋巴细胞(Th0 细胞)是否内在地具有更高的 Th17 分化倾向。
为了解决这个问题,从 CF 小鼠、人类 CF 患者和相应对照者的外周血中分离出 Th0 细胞。用荧光激活细胞分选术从单个脾细胞悬液中分离出鼠 Th0 细胞。用人外周血单个核细胞分离试剂盒从人血白细胞梯度离心中分离出淋巴细胞,并进一步分离出 Th0 细胞。然后评估 Th0 细胞在相应细胞因子刺激下向 Th17、Th1 或 Treg 谱系分化的能力。还使用流式细胞术体外评估人外周血细胞的 T 细胞反应。
在这里,我们在 CF 小鼠和人类中均发现,Th0 细胞向 Th17 表型分化的内在倾向性增强,而向 Th1 和 Treg 谱系分化的倾向性正常。此外,我们还在 CF 患者的外周血中发现了活跃的 Th17 反应。
我们提出,这些新的观察结果至少部分解释了 CF 中已知的 Th17 相关炎症增加和 CF 肺部在出现任何感染迹象之前的早期炎症迹象。此外,这些发现表明直接调节 T 细胞反应可能是对抗 CF 中过度炎症的一种新的潜在治疗策略。