aDumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA bLiver Transplantation Center, Department of Liver Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing, Jiangsu Province, China.
Curr Opin Organ Transplant. 2014 Apr;19(2):115-20. doi: 10.1097/MOT.0000000000000064.
Ischemia and reperfusion injuries occur in multiple clinical settings and contribute to organ dysfunction/failures. Despite the innate inflammatory immune nature, T cells that are critically involved in the pathogenesis of ischemia reperfusion injury (IRI), include not only CD4+ T cells, but also CD8+ and γδT cells. This review focuses on questions of how putative Ag-specific T cells are involved, which include whether they function in an Ag-dependent manner; how they function, cytokine-mediated or costimulatory molecule-mediated mechanisms; and whether different T-cell subsets, Th1, Th17, regulatory T cell (Treg), are all involved and play distinctive roles?
Specific T-cell populations, such as effector memory CD4 T cells, promote inflammatory immune activation by ischemia reperfusion independent of their adaptive properties, that is Ag-independently. They function by secreting cytokines and expressing costimulatory molecules to either promote or inhibit innate immune activation, or facilitate tissue repair/homeostasis, as exemplified by Th1, Th17 or Th2, Treg cells, respectively.
T-cell-targeted therapies need to be refined with strategies to maximally eliminate the proinflammatory but spare the anti-inflammatory/immune regulatory properties of T cells, for future clinical application to ameliorate IRI.
缺血再灌注损伤发生在多种临床情况下,并导致器官功能障碍/衰竭。尽管固有炎症免疫性质,T 细胞在缺血再灌注损伤(IRI)的发病机制中起着至关重要的作用,不仅包括 CD4+T 细胞,还包括 CD8+和γδT 细胞。本综述重点讨论了假定的 Ag 特异性 T 细胞是如何参与的问题,包括它们是否以 Ag 依赖的方式发挥作用;它们通过细胞因子介导或共刺激分子介导的机制发挥作用的方式;以及不同的 T 细胞亚群,Th1、Th17、调节性 T 细胞(Treg),是否都参与并发挥独特的作用?
特定的 T 细胞群体,如效应记忆 CD4 T 细胞,通过独立于其适应性特性的方式,即非 Ag 依赖的方式,促进缺血再灌注后的炎症免疫激活。它们通过分泌细胞因子和表达共刺激分子来促进或抑制先天免疫激活,或促进组织修复/稳态,分别由 Th1、Th17 或 Th2、Treg 细胞来例证。
T 细胞靶向治疗需要通过策略进行细化,以最大程度地消除 T 细胞的促炎特性,同时保留抗炎/免疫调节特性,为未来改善 IRI 的临床应用提供参考。