Department of Respiratory and Critical Care Medicine, The Center for Biomedical Research, NHC Key Laboratory of Respiratory Disease, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Rheumatology and Immunology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Immunol. 2022 Jun 10;13:902318. doi: 10.3389/fimmu.2022.902318. eCollection 2022.
Asthma is a multifactorial disorder characterized by the airway chronic inflammation, hyper-responsiveness (AHR), remodeling, and reversible obstruction. Although asthma is known as a heterogeneous group of diseases with various clinical manifestations, recent studies suggest that more than half of the clinical cases are ''T helper type 2 (Th2)-high'' type, whose pathogenesis is driven by Th2 responses to an inhaled allergen from the environmental exposures. The intensity and duration of inflammatory responses to inhaled allergens largely depend on the balance between effector and regulatory cells, but many questions regarding the mechanisms by which the relative magnitudes of these opposing forces are remained unanswered. Regulatory T cells (Tregs), which comprise diverse subtypes with suppressive function, have long been attracted extensive attention owing to their capability to limit the development and progression of allergic diseases. In this review we seek to update the recent advances that support an essential role for Tregs in the induction of allergen tolerance and attenuation of asthma progression once allergic airway inflammation established. We also discuss the current concepts about Treg induction and Treg-expressed mediators relevant to controlling asthma, and the therapies designed based on these novel insights against asthma in clinical settings.
哮喘是一种多因素疾病，其特征为气道慢性炎症、高反应性（AHR）、重塑和可逆性阻塞。尽管哮喘被认为是一组具有不同临床表现的异质性疾病，但最近的研究表明，超过一半的临床病例为“辅助性 T 细胞 2（Th2）-高”型，其发病机制是由 Th2 对环境暴露的吸入性过敏原的反应驱动的。对吸入性过敏原的炎症反应的强度和持续时间在很大程度上取决于效应细胞和调节细胞之间的平衡，但对于这些对抗力量的相对大小的机制仍有许多问题尚未得到解答。调节性 T 细胞（Tregs），具有抑制功能的多种亚型，由于其能够限制过敏性疾病的发展和进展，因此长期以来一直受到广泛关注。在这篇综述中，我们试图更新最近的进展，这些进展支持 Tregs 在诱导过敏原耐受和减轻已建立的过敏性气道炎症中的哮喘进展方面的重要作用。我们还讨论了与控制哮喘相关的 Treg 诱导和 Treg 表达介质的当前概念，以及基于这些针对哮喘的临床新见解设计的疗法。
