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银屑病中白细胞介素-17的细胞来源:范式转变?

Cellular sources of IL-17 in psoriasis: a paradigm shift?

作者信息

Keijsers Romy R M C, Joosten Irma, van Erp Piet E J, Koenen Hans J P M, van de Kerkhof Peter C M

机构信息

Department of Dermatology, Radboud university medical center, Nijmegen, The Netherlands; Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud university medical center, Nijmegen, The Netherlands.

出版信息

Exp Dermatol. 2014 Nov;23(11):799-803. doi: 10.1111/exd.12487.

Abstract

Psoriasis is a common chronic inflammatory skin disease that results from interplay between the immune system and the epithelium. In the light of very successful anticytokine therapies for psoriasis, the focus has been directed towards the adaptive immune system. Expression studies, genetic studies and treatments specifically targeting players of the IL-23/IL-17 pathway, point at an important role for IL-17 in the pathogenesis of psoriasis. IL-17 stimulates the keratinocytes to produce psoriasis-associated molecules, eventually leading to chronic skin inflammation. The current opinion is that IL-17 is mainly produced by T cells, so-called T-helper 17 (Th17) cells, in psoriasis. However, evidence is accumulating that cells of the innate immune system, like neutrophils, mast cells, γδ T cells and innate lymphoid cells are the main source of IL-17 in psoriasis, rather than T cells. The paradigm in this field of research is shifting. With this viewpoint article, we will address this novel concept by critically summarizing the current literature on this subject. In psoriatic arthritis and atherosclerosis, important conditions related to psoriasis, it was also found that the majority of IL-17 is associated with cells of the innate immune system. This new concept changes our view of IL-17. Blocking IL-17 with targeted treatments might be more far-reaching than previously thought; not only IL-17 production by T cells but also by innate immune cells is blocked. Furthermore, therapies specifically targeting IL-17 may not only improve psoriasis, but also comorbidity that is associated with the IL-17 pathway, hereby preventing serious complications on the long term.

摘要

银屑病是一种常见的慢性炎症性皮肤病,由免疫系统与上皮细胞之间的相互作用引起。鉴于针对银屑病的抗细胞因子疗法非常成功,研究重点已转向适应性免疫系统。表达研究、基因研究以及专门针对白细胞介素-23/白细胞介素-17通路相关因子的治疗表明,白细胞介素-17在银屑病发病机制中起重要作用。白细胞介素-17刺激角质形成细胞产生与银屑病相关的分子,最终导致慢性皮肤炎症。目前的观点认为,在银屑病中白细胞介素-17主要由T细胞产生,即所谓的辅助性T细胞17(Th17)细胞。然而,越来越多的证据表明,在银屑病中,先天性免疫系统的细胞,如中性粒细胞、肥大细胞、γδT细胞和先天性淋巴细胞是白细胞介素-17的主要来源,而非T细胞。该研究领域的范式正在转变。通过这篇观点文章,我们将通过批判性总结关于该主题的当前文献来探讨这一新概念。在银屑病关节炎和动脉粥样硬化这两种与银屑病相关的重要病症中,也发现大部分白细胞介素-17与先天性免疫系统的细胞有关。这一新概念改变了我们对白细胞介素-17的看法。用靶向治疗阻断白细胞介素-17的作用可能比之前认为的更具深远影响;不仅T细胞产生的白细胞介素-17会被阻断,先天性免疫细胞产生的白细胞介素-17也会被阻断。此外,专门针对白细胞介素-17的疗法不仅可能改善银屑病,还可能改善与白细胞介素-17通路相关的合并症,从而长期预防严重并发症。

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