特发性肺纤维化患者自然杀伤细胞的外周耗竭及调节性T细胞/辅助性T细胞17轴失衡

Peripheral depletion of NK cells and imbalance of the Treg/Th17 axis in idiopathic pulmonary fibrosis patients.

作者信息

Galati Domenico, De Martino Marina, Trotta Annamaria, Rea Gaetano, Bruzzese Dario, Cicchitto Gaetano, Stanziola Anna Agnese, Napolitano Maria, Sanduzzi Alessandro, Bocchino Marialuisa

机构信息

Dipartimento di Ematologia, IRCCS INT Fondazione Pascale, Napoli, Italy.

Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli, Italy.

出版信息

Cytokine. 2014 Apr;66(2):119-26. doi: 10.1016/j.cyto.2013.12.003. Epub 2014 Jan 10.

Abstract

The immune response plays an unsettled role in the pathogenesis of idiopathic pulmonary fibrosis (IPF), the contribution of inflammation being controversial as well. Emerging novel T cell sub-populations including regulatory T lymphocytes (Treg) and interleukin (IL)-17 secreting T helper cells (Th17) may exert antithetical actions in this scenario. Phenotype and frequency of circulating immune cell subsets were assessed by multi-parametric flow cytometry in 29 clinically stable IPF patients and 17 healthy controls. The interplay between Treg lymphocytes expressing transforming growth factor (TGF)-β and Th17 cells was also investigated. Proportion and absolute number of natural killer (NK) cells were significantly reduced in IPF patients in comparison with controls (p<0.001). Conversely, the proportion and absolute number of CD3(+)CD4(+)CD25(high)Foxp-3(+) cells were significantly increased in IPF patients (p=0.000). As in controls, almost the totality of cells (>90%) expressed TGF-β upon stimulation. Interestingly, the frequency of Th17 cells was significantly compromised in IPF patients (p=0.000) leading to an increased TGF-β/IL-17 ratio (4.2±2.3 vs 0.5±0.3 in controls, p=0.000). Depletion of NK and Th17 cells along with a not compromised Treg compartment delineate the existence of an "immune profile" that argue against the recent hypothesis of IPF as an autoimmune disease. Our findings along with the imbalance of the Treg/Th17 axis more closely suggest these immune perturbations to be similar to those observed in cancer. Clinical relevance, limitations and perspectives for future research are discussed.

摘要

免疫反应在特发性肺纤维化(IPF)的发病机制中所起的作用尚无定论,炎症的作用也存在争议。新出现的新型T细胞亚群,包括调节性T淋巴细胞(Treg)和分泌白细胞介素(IL)-17的辅助性T细胞(Th17),在这种情况下可能发挥相反的作用。通过多参数流式细胞术评估了29例临床稳定的IPF患者和17名健康对照者循环免疫细胞亚群的表型和频率。还研究了表达转化生长因子(TGF)-β的Treg淋巴细胞与Th17细胞之间的相互作用。与对照组相比,IPF患者中自然杀伤(NK)细胞的比例和绝对数量显著降低(p<0.001)。相反,IPF患者中CD3(+)CD4(+)CD25(高)Foxp-3(+)细胞的比例和绝对数量显著增加(p=0.000)。与对照组一样,几乎所有细胞(>90%)在刺激后都表达TGF-β。有趣的是,IPF患者中Th17细胞的频率显著降低(p=0.000),导致TGF-β/IL-17比值升高(对照组为0.5±0.3,IPF患者为4.2±2.3,p=0.000)。NK细胞和Th17细胞的耗竭以及未受影响的Treg区室表明存在一种“免疫特征”,这与IPF是自身免疫性疾病的最新假说相悖。我们的研究结果以及Treg/Th17轴的失衡更密切地表明,这些免疫紊乱与癌症中观察到的情况相似。讨论了临床相关性、局限性和未来研究的前景。

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