Department of Immunology, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
IBD Center, Kurume University Hospital, Kurume, Japan.
J Gastroenterol. 2018 Apr;53(4):465-474. doi: 10.1007/s00535-017-1401-7. Epub 2017 Oct 26.
IL-22 is a relatively new cytokine that is characterized by several unique biological properties. In the intestines, the effect of IL-22 is restricted mainly to non-lymphoid cells such as epithelial cells. Interestingly, the expression pattern and major cellular source of IL-22 have distinct difference between large and small intestines. IL-22 possesses an ability to constitutively activate STAT3 for promoting epithelial cell regeneration and reinforcing mucosal barrier integrity through stimulating the expression of anti-bacterial peptide and mucins. Of note, IL-22 is characterized as a two-faced cytokine that can play not only protective but also deleterious roles in the intestinal inflammation depending on the cytokine environment such as the expression levels of IL-23, T-bet, and IL-22 binding protein. Most importantly, clinical relevance of IL-22 to inflammatory bowel disease has been well highlighted. Mucosal healing, which represents the current therapeutic goal for IBD, can be induced by IL-22. Indeed, indigo naturalis, which can activate IL-22 pathway through Ahr, has been shown in a clinical trial to exhibit a strong therapeutic effect on ulcerative colitis. Despite the beneficial effect of IL-22, continuous activation of the IL-22 pathway increases the risk of colitis-associated cancer, particularly in patients with an extended history of IBD. This review article discusses how IL-22 regulates colitis, how beneficial versus deleterious effects of IL-22 is determined, and why IL-22 represents a promising target for IBD therapy.
白细胞介素 22(IL-22)是一种相对较新的细胞因子,具有多种独特的生物学特性。在肠道中,IL-22 的作用主要局限于非淋巴样细胞,如上皮细胞。有趣的是,IL-22 的表达模式和主要细胞来源在大小肠之间存在明显差异。IL-22 具有持续激活 STAT3 的能力,通过刺激抗菌肽和粘蛋白的表达,促进上皮细胞再生和增强黏膜屏障完整性。值得注意的是,IL-22 是一种两面性的细胞因子,它在肠道炎症中可以发挥保护作用,也可以发挥有害作用,这取决于细胞因子环境,如 IL-23、T-bet 和 IL-22 结合蛋白的表达水平。最重要的是,IL-22 与炎症性肠病(IBD)的临床相关性已得到充分证实。黏膜愈合是 IBD 的当前治疗目标,而 IL-22 可以诱导黏膜愈合。事实上,通过 Ahr 激活 IL-22 通路的靛蓝天然物,在一项临床试验中已显示出对溃疡性结肠炎的强大治疗作用。尽管 IL-22 具有有益作用,但 IL-22 通路的持续激活会增加结肠炎相关癌症的风险,特别是在 IBD 病史较长的患者中。本文综述了 IL-22 如何调节结肠炎,IL-22 的有益和有害作用是如何决定的,以及为什么 IL-22 是 IBD 治疗的一个有前途的靶点。