Noval Rivas Magali, Chatila Talal A
Division of Pediatric Infectious Diseases and Immunology, Department of Pediatric, Infectious and Immunologic Diseases Research Center, Cedars-Sinai Medical Center, Los Angeles, Calif.
Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
J Allergy Clin Immunol. 2016 Sep;138(3):639-652. doi: 10.1016/j.jaci.2016.06.003.
The pathogenesis of allergic diseases entails an ineffective tolerogenic immune response to allergens. Regulatory T (Treg) cells play a key role in sustaining immune tolerance to allergens, yet mechanisms by which Treg cells fail to maintain tolerance in patients with allergic diseases are not well understood. We review current concepts and established mechanisms regarding how Treg cells regulate different components of allergen-triggered immune responses to promote and maintain tolerance. We will also discuss more recent advances that emphasize the "dual" functionality of Treg cells in patients with allergic diseases: how Treg cells are essential in promoting tolerance to allergens but also how a proallergic inflammatory environment can skew Treg cells toward a pathogenic phenotype that aggravates and perpetuates disease. These advances highlight opportunities for novel therapeutic strategies that aim to re-establish tolerance in patients with chronic allergic diseases by promoting Treg cell stability and function.
过敏性疾病的发病机制涉及对过敏原的无效耐受性免疫反应。调节性T（Treg）细胞在维持对过敏原的免疫耐受中起关键作用，但在过敏性疾病患者中Treg细胞未能维持耐受性的机制尚不清楚。我们综述了关于Treg细胞如何调节过敏原触发的免疫反应的不同组分以促进和维持耐受性的当前概念和既定机制。我们还将讨论更近期的进展，这些进展强调了过敏性疾病患者中Treg细胞的“双重”功能：Treg细胞在促进对过敏原的耐受性方面如何至关重要，以及促过敏性炎症环境如何使Treg细胞偏向致病性表型从而加重和使疾病持续存在。这些进展突出了旨在通过促进Treg细胞稳定性和功能来重新建立慢性过敏性疾病患者耐受性的新型治疗策略的机会。
