中性粒细胞胞外陷阱在炎症性肠病中的作用:发病机制与临床转化。

Neutrophil Extracellular Traps in Inflammatory Bowel Disease: Pathogenic Mechanisms and Clinical Translation.

机构信息

Centre for Inflammation Research, University of Edinburgh, Scotland, United Kingdom.

Centre for Inflammation Research, University of Edinburgh, Scotland, United Kingdom.

出版信息

Cell Mol Gastroenterol Hepatol. 2021;12(1):321-333. doi: 10.1016/j.jcmgh.2021.03.002. Epub 2021 Mar 6.

Abstract

The Inflammatory Bowel Diseases (IBD), Ulcerative Colitis (UC) and Crohn's Disease (CD) are characterised by chronic non-resolving gut mucosal inflammation involving innate and adaptive immune responses. Neutrophils, usually regarded as first responders in inflammation, are a key presence in the gut mucosal inflammatory milieu in IBD. Here, we review the role of neutrophil extracellular trap (NET) formation as a potential effector disease mechanism. NETs are extracellular webs of chromatin, microbicidal proteins and oxidative enzymes that are released by neutrophils to contain pathogens. NETs contribute to the pathogenesis of several immune-mediated diseases such as systemic lupus erythematosus and rheumatoid arthritis; and recently, as a major tissue damaging process involved in the host response to severe acute respiratory syndrome coronavirus 2 infection. NETs are pertinent as a defence mechanism at the gut mucosal interphase exposed to high levels of bacteria, viruses and fungi. On the other hand, NETs can also potentiate and perpetuate gut inflammation. In this review, we discuss the broad protective vs. pathogenic roles of NETs, explanatory factors that could lead to an increase in NET formation in IBD and how NETs may contribute to gut inflammation and IBD-related complications. Finally, we summarise therapeutic opportunities to target NETs in IBD.

摘要

炎症性肠病(IBD)、溃疡性结肠炎(UC)和克罗恩病(CD)的特征是慢性非解决性肠道黏膜炎症,涉及先天和适应性免疫反应。中性粒细胞通常被认为是炎症的第一反应者,是 IBD 肠道黏膜炎症环境中的主要存在。在这里,我们回顾中性粒细胞胞外陷阱(NET)形成作为一种潜在的效应疾病机制的作用。NET 是由中性粒细胞释放的染色质、杀菌蛋白和氧化酶的细胞外网络,用于容纳病原体。NET 有助于几种免疫介导的疾病的发病机制,如系统性红斑狼疮和类风湿关节炎;最近,作为宿主对严重急性呼吸综合征冠状病毒 2 感染的严重反应中涉及的主要组织损伤过程。NET 作为暴露于高水平细菌、病毒和真菌的肠道黏膜界面的防御机制是相关的。另一方面,NET 也可以增强和持续肠道炎症。在这篇综述中,我们讨论了 NET 的广泛保护与致病作用、可能导致 IBD 中 NET 形成增加的解释因素,以及 NET 如何促进肠道炎症和 IBD 相关并发症。最后,我们总结了针对 IBD 中 NET 的治疗机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a460/8166923/1111c09a7ba4/gr2.jpg

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