Kamesaki Toyomi
Center for Community Medicine, Jichi Medical University.
Rinsho Ketsueki. 2015 Jul;56(7):846-54. doi: 10.11406/rinketsu.56.846.
Autoimmune hemolytic anemia (AIHA) is an acquired immunological disease in which red blood cells (RBCs) are selectively attacked and destroyed (hemolyzed) by autoantibodies produced by the patient's own immune system. Several hypotheses regarding the mechanisms underlying the development of AIHA have been proposed, but the actual pathogenesis remains unclear. Since the major autoantigens in warm AIHA were determined to be Rh protein, band 3 and glycophorin A in 1993, helper T cells (Th1, Th2 and Th17) and regulatory T (Treg) cells specifically reacting to Rh peptides were reported in patients with AIHA. Recently, Th1 responses were found to be suppressed with synthetic peptides that are recognized by the Treg cells, and Th17 cells and interleukin 17 were shown to contribute to the induction and the development of AIHA. This approach to understanding AIHA pathogenesis may provide clues to finding novel targets for immunotherapy against AIHA.
自身免疫性溶血性贫血(AIHA)是一种获得性免疫疾病,其中红细胞(RBC)被患者自身免疫系统产生的自身抗体选择性攻击并破坏(溶血)。关于AIHA发生发展机制的几种假说已被提出,但实际发病机制仍不清楚。自1993年温抗体型AIHA中的主要自身抗原被确定为Rh蛋白、带3蛋白和血型糖蛋白A以来,AIHA患者中报道了对Rh肽特异性反应的辅助性T细胞(Th1、Th2和Th17)和调节性T(Treg)细胞。最近,发现Treg细胞识别的合成肽可抑制Th1反应,并且Th17细胞和白细胞介素17被证明有助于AIHA的诱导和发展。这种理解AIHA发病机制的方法可能为寻找针对AIHA免疫治疗的新靶点提供线索。