Gostner Johanna M, Becker Katrin, Kofler Heinz, Strasser Barbara, Fuchs Dietmar
Division of Medical Biochemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria.
Int Arch Allergy Immunol. 2016;169(4):203-15. doi: 10.1159/000445500. Epub 2016 May 4.
Allergic diseases such as asthma and rhinitis, as well the early phase of atopic dermatitis, are characterized by a Th2-skewed immune environment. Th2-type cytokines are upregulated in allergic inflammation, whereas there is downregulation of the Th1-type immune response and related cytokines, such as interferon-x03B3; (IFN-x03B3;). The latter is a strong inducer of indoleamine 2,3-dioxygenase-1 (IDO-1), which degrades the essential amino acid tryptophan, as part of an antiproliferative strategy of immunocompetent cells to halt the growth of infected and malignant cells, and also of T cells - an immunoregulatory intervention to avoid overactivation of the immune system. Raised serum tryptophan concentrations have been reported in patients with pollen allergy compared to healthy blood donors. Moreover, higher baseline tryptophan concentrations have been associated with a poor response to specific immunotherapy. It has been shown that the increase in tryptophan concentrations in patients with pollen allergy only exists outside the pollen season, and not during the season. Interestingly, there is only a minor alteration of the kynurenine to tryptophan ratio (Kyn/Trp, an index of tryptophan breakdown). The reason for the higher tryptophan concentrations in patients with pollen allergy outside the season remains a matter of discussion. To this regard, the specific interaction of nitric oxide (NO∙) with the tryptophan-degrading enzyme IDO-1 could be important, because an enhanced formation of NO∙ has been reported in patients with asthma and allergic rhinitis. Importantly, NO∙ suppresses the activity of the heme enzyme IDO-1, which could explain the higher tryptophan levels. Thus, inhibitors of inducible NO∙ synthase should be reconsidered as candidates for antiallergic therapy out of season that may abrogate the arrest of IDO-1 by decreasing the production of NO∙. Considering its association with the pathophysiology of atopic disease, tryptophan metabolism may play a relevant role in the pathophysiology of allergic disorders.
哮喘和鼻炎等过敏性疾病以及特应性皮炎的早期阶段,其特征是免疫环境向Th2倾斜。在过敏性炎症中,Th2型细胞因子上调,而Th1型免疫反应及相关细胞因子(如干扰素-γ;IFN-γ;)则下调。后者是吲哚胺2,3-双加氧酶-1(IDO-1)的强诱导剂,IDO-1可降解必需氨基酸色氨酸,这是免疫活性细胞阻止感染细胞和恶性细胞生长的抗增殖策略的一部分,也是T细胞的一种免疫调节干预措施,以避免免疫系统过度激活。与健康献血者相比,花粉过敏患者的血清色氨酸浓度有所升高。此外,较高的基线色氨酸浓度与特异性免疫治疗反应不佳有关。研究表明,花粉过敏患者色氨酸浓度的升高仅存在于花粉季节之外,而非花粉季节期间。有趣的是,犬尿氨酸与色氨酸的比值(Kyn/Trp,色氨酸分解指标)仅有轻微变化。花粉过敏患者在季节外色氨酸浓度较高的原因仍有待探讨。在这方面,一氧化氮(NO∙)与色氨酸降解酶IDO-1的特异性相互作用可能很重要,因为哮喘和过敏性鼻炎患者中NO∙的生成有所增加。重要的是,NO∙会抑制血红素酶IDO-1的活性,这可以解释色氨酸水平较高的原因。因此,应重新考虑将诱导型NO∙合酶抑制剂作为季节性过敏治疗的候选药物,通过减少NO∙的产生来消除IDO-1的抑制作用。鉴于色氨酸代谢与特应性疾病的病理生理学相关,其可能在过敏性疾病的病理生理学中发挥相关作用。