Gastroenterology Unit, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Mol Nutr Food Res. 2018 Apr;62(7):e1700931. doi: 10.1002/mnfr.201700931. Epub 2018 Mar 1.
Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a serious, costly, and persistent health problem with an estimated prevalence in Western countries around 0.5% of the general population; its socioeconomic impact is comparable with that for chronic diseases such as diabetes. Conventional treatment involves escalating drug regimens with concomitant side effects followed, in some cases, by surgical interventions, which are often multiple, mainly in Crohn's disease. The goal of finding a targeted gut-specific immunotherapy for IBD patients is therefore an important unmet need. However, to achieve this goal we first must understand how dendritic cells (DC), the most potent antigen present cells of the immune system, control the immune tolerance in the gastrointestinal tract and how their properties are altered in those patients suffering from IBD. In this review, we summarize the current available information regarding human intestinal DC subsets composition, phenotype, and function in the human gastrointestinal tract describing how, in the IBD mucosa, DC display pro-inflammatory properties, which drive disease progression. A better understanding of the mechanisms inducing DC abnormal profile in IBD may provide us with novel tools to perform tissue specific immunomodulation.
炎症性肠病(IBD),包括克罗恩病和溃疡性结肠炎,是一种严重、昂贵且持续存在的健康问题,据估计,在西方国家,普通人群中有 0.5%左右的人患有该病;其对社会经济的影响可与糖尿病等慢性疾病相媲美。常规治疗包括逐步升级药物治疗方案,同时伴有伴随而来的副作用,随后在某些情况下进行手术干预,这些手术干预通常是多次的,主要是在克罗恩病中。因此,为 IBD 患者寻找一种靶向肠道特异性免疫疗法是一个重要的未满足需求。然而,要实现这一目标,我们首先必须了解树突状细胞(DC),即免疫系统中最有效的抗原呈递细胞,如何控制胃肠道中的免疫耐受,以及它们在患有 IBD 的患者中的特性是如何改变的。在这篇综述中,我们总结了目前关于人类肠道 DC 亚群组成、表型和功能的可用信息,描述了在 IBD 黏膜中,DC 如何表现出促炎特性,从而推动疾病的进展。更好地了解导致 IBD 中 DC 异常表型的机制可能为我们提供新的工具,以进行组织特异性免疫调节。