Targan S R, Kagnoff M F, Brogan M D, Shanahan F
Ann Intern Med. 1987 Jun;106(6):853-70. doi: 10.7326/0003-4819-106-6-853.
The intestine is a unique immunologic organ that comprises an afferent and efferent compartment and provides the host with the ability to respond through several different effector mechanisms against environmental factors. We discuss mechanisms in three intestinal diseases in this overview of the mucosal immune system. Genetic and immunologic factors are important in the pathogenesis of celiac disease, which is characterized by damage to the mucosa of the small intestine with resultant malabsorption. Pathogenic microbes are important environmental agents that interact with the intestinal mucosa and initiate local immune responses. Advances in the understanding of the mucosal immune response to these pathogenic microbes have produced a clear picture of the way in which this specialized immune system works in concert with systemic immunity. As to the autoimmune nature of inflammatory bowel disease, no specific antigen has been shown to incite the inflammatory reactions and neither the target cells nor the effector mechanism involved have been identified. Several factors exist, however, to suggest an autoimmune mechanism and the role of mucosal immunologic factors in this disease.
肠道是一个独特的免疫器官，由传入和传出部分组成，使宿主能够通过几种不同的效应机制对环境因素作出反应。在本黏膜免疫系统综述中，我们讨论三种肠道疾病的机制。遗传和免疫因素在乳糜泻的发病机制中很重要，其特征是小肠黏膜受损并导致吸收不良。致病微生物是与肠道黏膜相互作用并引发局部免疫反应的重要环境因素。对这些致病微生物的黏膜免疫反应的理解进展，已清晰呈现出这个特殊免疫系统与全身免疫协同工作的方式。至于炎症性肠病的自身免疫性质，尚未发现特定抗原来引发炎症反应，所涉及的靶细胞和效应机制也未确定。然而，有几个因素表明存在自身免疫机制以及黏膜免疫因素在该疾病中的作用。
