Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, Larissa, Greece.
Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, Larissa, Greece.
Front Immunol. 2018 Oct 24;9:2432. doi: 10.3389/fimmu.2018.02432. eCollection 2018.
Interleukin 33 (IL-33) is highly expressed in barrier sites, acting via the suppression of tumorigenicity 2 receptor (ST2). IL-33/ST2 axis has long been known to play a pivotal role in immunity and cell homeostasis by promoting wound healing and tissue repair. However, it is also involved in the loss of balance between extensive inflammation and tissue regeneration lead to remodeling, the hallmark of fibrosis. The aim of the current review is to critically evaluate the available evidence regarding the role of the IL-33/ST2 axis in organ fibrosis. The role of the axis in tissue remodeling is better understood considering its crucial role reported in organ development and regeneration. Generally, the IL-33/ST2 signaling pathway has mainly anti-inflammatory/anti-proliferative effects; however, chronic tissue injury is responsible for pro-fibrogenetic responses. Regarding pulmonary fibrosis mature IL-33 enhances pro-fibrogenic type 2 cytokine production in an ST2- and macrophage-dependent manner, while full-length IL-33 is also implicated in the pulmonary fibrotic process in an ST2-independent, Th2-independent fashion. In liver fibrosis, evidence indicate that when acute and massive liver damage occurs, the release of IL-33 might act as an activator of tissue-protective mechanisms, while in cases of chronic injury IL-33 plays the role of a hepatic fibrotic factor. IL-33 signaling has also been involved in the pathogenesis of acute and chronic pancreatitis. Moreover, IL-33 could be used as an early marker for ulcer-associated activated fibroblasts and myofibroblast trans-differentiation; thus one cannot rule out its potential role in inflammatory bowel disease-associated fibrosis. Similarly, the upregulation of the IL-33/ST2 axismay contribute to tubular cell injury and fibrosis via epithelial to mesenchymal transition (EMT) of various cell types in the kidneys. Of note, IL-33 exerts a cardioprotective role via ST2 signaling, while soluble ST2 has been demonstrated as a marker of myocardial fibrosis. Finally, IL-33 is a crucial cytokine in skin pathology responsible for abnormal fibroblast proliferation, leukocyte infiltration and morphologic differentiation of human endothelial cells. Overall, emerging data support a novel contribution of the IL-33/ST2 pathway in tissue fibrosis and highlight the significant role of the Th2 pattern of immune response in the pathophysiology of organ fibrosis.
白细胞介素 33 (IL-33) 在屏障部位高表达,通过抑制肿瘤发生 2 受体 (ST2) 发挥作用。IL-33/ST2 轴一直被认为通过促进伤口愈合和组织修复在免疫和细胞稳态中发挥关键作用。然而,它也参与了广泛的炎症和组织再生之间平衡的丧失,导致纤维化的标志性重塑。本综述的目的是批判性地评估关于 IL-33/ST2 轴在器官纤维化中的作用的现有证据。考虑到该轴在器官发育和再生中的关键作用,它在组织重塑中的作用得到了更好的理解。一般来说,IL-33/ST2 信号通路主要具有抗炎/抗增殖作用;然而,慢性组织损伤导致促纤维化反应。关于肺纤维化,成熟的 IL-33 以 ST2 和巨噬细胞依赖性方式增强促纤维化 2 型细胞因子的产生,而全长 IL-33 也以 ST2 独立、Th2 独立的方式参与肺纤维化过程。在肝纤维化中,有证据表明,当发生急性和大量肝损伤时,IL-33 的释放可能作为组织保护机制的激活剂,而在慢性损伤的情况下,IL-33 发挥肝纤维化因子的作用。IL-33 信号也参与了急性和慢性胰腺炎的发病机制。此外,IL-33 可作为与溃疡相关的激活成纤维细胞和肌成纤维细胞转分化的早期标志物;因此,不能排除其在炎症性肠病相关纤维化中的潜在作用。同样,IL-33/ST2 轴的上调可能通过各种细胞类型的上皮间质转化 (EMT) 导致肾脏管状细胞损伤和纤维化。值得注意的是,IL-33 通过 ST2 信号发挥心脏保护作用,而可溶性 ST2 已被证明是心肌纤维化的标志物。最后,IL-33 是负责异常成纤维细胞增殖、白细胞浸润和人内皮细胞形态分化的皮肤病理学中的关键细胞因子。总的来说,新出现的数据支持 IL-33/ST2 途径在组织纤维化中的新作用,并强调了 Th2 免疫反应模式在器官纤维化发病机制中的重要作用。