自身免疫中的卫生假说:病原体和共生体的作用。

The hygiene hypothesis in autoimmunity: the role of pathogens and commensals.

机构信息

Université Paris Descartes, Sorbonne Paris Cité, Paris, France.

INSERM U1151, Institut Necker-Enfants Malades, Hôpital Necker-Enfants Malades, Paris, France.

出版信息

Nat Rev Immunol. 2018 Feb;18(2):105-120. doi: 10.1038/nri.2017.111. Epub 2017 Oct 16.

Abstract

The incidence of autoimmune diseases has been steadily rising. Concomitantly, the incidence of most infectious diseases has declined. This observation gave rise to the hygiene hypothesis, which postulates that a reduction in the frequency of infections contributes directly to the increase in the frequency of autoimmune and allergic diseases. This hypothesis is supported by robust epidemiological data, but the underlying mechanisms are unclear. Pathogens are known to be important, as autoimmune disease is prevented in various experimental models by infection with different bacteria, viruses and parasites. Gut commensal bacteria also play an important role: dysbiosis of the gut flora is observed in patients with autoimmune diseases, although the causal relationship with the occurrence of autoimmune diseases has not been established. Both pathogens and commensals act by stimulating immunoregulatory pathways. Here, I discuss the importance of innate immune receptors, in particular Toll-like receptors, in mediating the protective effect of pathogens and commensals on autoimmunity.

摘要

自身免疫性疾病的发病率一直在稳步上升。与此同时,大多数传染病的发病率也有所下降。这种观察结果催生了卫生假说,该假说认为感染频率的降低直接导致了自身免疫性和过敏性疾病的高发。这一假说得到了强有力的流行病学数据的支持,但潜在机制尚不清楚。病原体是很重要的,因为在各种实验模型中,感染不同的细菌、病毒和寄生虫可以预防自身免疫性疾病。肠道共生细菌也起着重要作用:尽管与自身免疫性疾病的发生尚没有建立因果关系,但在患有自身免疫性疾病的患者中观察到肠道菌群失调。病原体和共生体都是通过刺激免疫调节途径起作用的。在这里,我讨论了先天免疫受体(特别是 Toll 样受体)在介导病原体和共生体对自身免疫的保护作用中的重要性。

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