Department of Pediatrics, Division of Gastroenterology, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA.
Department of Neurology, Division of Multiple Sclerosis and Neuroimmunology, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA.
Adv Exp Med Biol. 2021;1278:191-203. doi: 10.1007/978-981-15-6407-9_10.
Autoimmune conditions affect 23 million Americans or 7% of the US population. There are more than 100 autoimmune disorders, affecting every major organ system in humans. This chapter aims to further explain Treg dysfunction autoimmune disorders, including monogenic primary immune deficiency such as immune dysregulation polyendocrinopathy, enteropathy, X-linked inheritance (IPEX) syndrome, and polygenic autoimmune diseases with Treg dysfunction such as multiple sclerosis (MS), inflammatory bowel disease (IBD), and food allergy. These conditions are associated with an abnormal small intestinal and colonic microbiome. Some disorders clearly improve with therapies aimed at microbial modification, including probiotics and fecal microbiota transplantation (FMT). Approaches to prevent and treat these disorders will need to focus on the acquisition and maintenance of a healthy colonic microbiota, in addition to more focused approaches at immune suppression during acute disease exacerbations.
自身免疫性疾病影响着 2300 万美国人，即美国总人口的 7%。有超过 100 种自身免疫性疾病，影响着人类的每一个主要器官系统。本章旨在进一步解释 Treg 功能障碍性自身免疫性疾病，包括单基因原发性免疫缺陷，如免疫失调多内分泌腺病肠病伴外胚层发育不良（IPEX）综合征，以及伴有 Treg 功能障碍的多基因自身免疫性疾病，如多发性硬化症（MS）、炎症性肠病（IBD）和食物过敏。这些疾病与异常的小肠和结肠微生物组有关。一些疾病通过针对微生物修饰的治疗方法，包括益生菌和粪便微生物移植（FMT），明显得到改善。预防和治疗这些疾病的方法需要侧重于获得和维持健康的结肠微生物组，除了在急性疾病恶化期间更有针对性地进行免疫抑制。
