Department of Pathology and Rogel Cancer Center, the University of Michigan Medical School, Ann Arbor, Michigan, USA.
Nat Rev Immunol. 2020 Jul;20(7):411-426. doi: 10.1038/s41577-019-0268-7. Epub 2020 Jan 31.
The mammalian intestine is colonized by trillions of microorganisms that have co-evolved with the host in a symbiotic relationship. The presence of large numbers of symbionts near the epithelial surface of the intestine poses an enormous challenge to the host because it must avoid the activation of harmful inflammatory responses to the microorganisms while preserving its ability to mount robust immune responses to invading pathogens. In patients with inflammatory bowel disease, there is a breakdown of the multiple strategies that the immune system has evolved to promote the separation between symbiotic microorganisms and the intestinal epithelium and the effective killing of penetrant microorganisms, while suppressing the activation of inappropriate T cell responses to resident microorganisms. Understanding the complex interactions between intestinal microorganisms and the host may provide crucial insight into the pathogenesis of inflammatory bowel disease as well as new avenues to prevent and treat the disease.
哺乳动物的肠道定植着数以万亿计的微生物，这些微生物与宿主在共生关系中共同进化。大量共生体存在于肠道的上皮表面附近，这对宿主构成了巨大的挑战，因为它必须避免对微生物激活有害的炎症反应，同时保持其对入侵病原体产生强大免疫反应的能力。在炎症性肠病患者中，免疫系统进化出的多种策略会失效，这些策略旨在促进共生微生物与肠道上皮的分离，以及有效杀灭穿透性微生物，同时抑制对常驻微生物的不适当 T 细胞反应的激活。了解肠道微生物和宿主之间的复杂相互作用可能为炎症性肠病的发病机制提供重要的见解，并为预防和治疗这种疾病开辟新的途径。
