Department of Experimental Medicine, University of Perugia, Perugia, Italy.
Division of Genetics and Cell Biology, European Institute for Research in Cystic Fibrosis, San Raffaele Scientific Institute, Milan, Italy.
Front Immunol. 2019 Dec 5;10:2844. doi: 10.3389/fimmu.2019.02844. eCollection 2019.
Celiac disease (CD) is an immune-mediated disorder triggered by the ingestion of gluten and characterized by reversible small-bowel mucosal atrophy in genetically predisposed subjects. Although the prevalence of CD has increased, many aspects of this pathology are still unrecognized. , a commensal of the human gastrointestinal tract, has been linked to CD for a long time based, among others, upon the observation of similarity between the fungal wall component, hyphal wall protein 1, and CD-related gliadin T-cell epitopes. We have recently demonstrated that may switch from commensal to pathogen contingent upon several players, including mast cells, key sentinels of the immune system at the interface between the environment and the host, and the pleiotropic cytokine IL-9. However, other factors are likely to play a role by altering the balance between inflammation and tolerance. In this regard, tryptophan and its metabolites are increasingly being recognized in promoting mucosal homeostasis by balancing the immune response to external cues. Based on these premises, we will discuss how the output of colonization in the gut is highly contextual, being determined at the intersection of many immunological (IL-9/mast cells) and metabolic (tryptophan) pathways that ultimately dictate the commensalism vs. pathogenicity in CD, thus paving the way for novel therapeutic opportunities in CD.
乳糜泻(CD)是一种由麸质摄入引起的免疫介导性疾病,其特征是遗传易感性患者的小肠黏膜可逆转性萎缩。尽管 CD 的患病率有所增加,但该病理学的许多方面仍未被认识。 作为人类胃肠道的共生菌,很久以前就与 CD 有关,其依据之一是真菌壁成分菌丝壁蛋白 1 与 CD 相关的麦胶蛋白 T 细胞表位之间存在相似性。我们最近证明, 可能会由于几种因素(包括肥大细胞)从共生菌转变为病原体,肥大细胞是免疫系统在环境和宿主之间界面的关键哨兵,以及多效细胞因子 IL-9。然而,其他因素可能通过改变炎症和耐受之间的平衡而发挥作用。在这方面,色氨酸及其代谢物越来越被认为通过平衡对外界信号的免疫反应来促进黏膜稳态。基于这些前提,我们将讨论 在肠道中的定植输出是高度背景依赖的,这是由许多免疫(IL-9/肥大细胞)和代谢(色氨酸)途径的交叉决定的,这些途径最终决定了 CD 中的共生与致病性,从而为 CD 中的新型治疗机会铺平了道路。