Sorbonne Université, APHP, Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière France.
Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy, Paris, France.
Curr Opin Rheumatol. 2023 Jan 1;35(1):25-30. doi: 10.1097/BOR.0000000000000915. Epub 2022 Oct 20.
Emerging data suggest that regulatory T-cells (Treg) alterations play a major role in systemic vasculitis pathophysiology. We performed a systematic review of recent advances in the role of Treg and interleukin (IL)-10 in the pathogenesis and treatment of systemic vasculitis, including giant cell arteritis (GCA), Takayasu arteritis, Behçet's disease, antineutrophil cytoplasm antibodies (ANCA) associated vasculitis (AAV), and cryoglobulinemia associated vasculitis.
Emerging data suggest that Treg deficiencies are disease-specific, affecting distinct pathways in distinct vasculitides. Decreased peripheral blood frequencies of Treg are described in all vasculitis when compared to healthy donors. Altered Treg functions are reported in GCA, Takayasu arteritis, AAV, and Behçet's disease with different mechanisms proposed. Treatment with biologics, and sometimes other immunosuppressants, may restore Treg frequencies and/or immune activity with significant differences in active disease or disease in remission in several systemic vasculitis. IL-10 is elevated in GCA, AAV, cryoglobulinemia associated vasculitis. In Behçet's disease, IL-10 is decreased in peripheral blood and elevated in saliva. In Takayasu arteritis, IL-10 levels were essentially elevated in patients' vessel wall. Several new therapeutic approaches targeting Treg and Il-10 (low dose IL-2, CAR Treg…) are developed to treat patients with systemic vasculitis.
Treg and IL-10 play a central role in the regulation of inflammation in vasculitis and new targeting approaches are emerging.
新出现的数据表明，调节性 T 细胞（Treg）的改变在系统性血管炎的发病机制中起着重要作用。我们对 Treg 和白细胞介素（IL）-10在巨细胞动脉炎（GCA）、Takayasu 动脉炎、贝赫切特病、抗中性粒细胞胞质抗体（ANCA）相关性血管炎（AAV）和冷球蛋白血症相关性血管炎的发病机制和治疗中的作用的最新进展进行了系统评价。
新出现的数据表明，Treg 缺乏是疾病特异性的，影响不同血管炎中的不同途径。与健康供体相比，所有血管炎患者的外周血 Treg 频率均降低。报道称，GCA、Takayasu 动脉炎、AAV 和 Behcet 病中的 Treg 功能发生改变，提出了不同的机制。生物制剂治疗，有时还有其他免疫抑制剂治疗，可能会恢复 Treg 频率和/或免疫活性，在几种系统性血管炎中，在活动性疾病或缓解期疾病中存在显著差异。GCA、AAV 和冷球蛋白血症相关性血管炎中 IL-10 升高。在 Behcet 病中，外周血中 IL-10 减少，唾液中 IL-10 增加。在 Takayasu 动脉炎中，患者血管壁中的 IL-10 水平基本升高。目前正在开发几种针对 Treg 和 Il-10（低剂量 IL-2、CAR Treg……）的新治疗方法，以治疗系统性血管炎患者。
Treg 和 IL-10 在血管炎的炎症调节中起着核心作用，新的靶向治疗方法正在出现。
