Gao Xiang, Yang Cuiping, Feng Zhongsheng, Liu Ping, Liu Zhanju
Center for Inflammatory Bowel Disease Research, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China.
Chin Med J (Engl). 2025 Jun 5;138(11):1288-1300. doi: 10.1097/CM9.0000000000003615. Epub 2025 May 20.
The small intestine is essential for digestion, nutrient absorption, immune regulation, and microbial balance. Its epithelial lining, containing specialized cells like Paneth cells and tuft cells, is crucial for maintaining intestinal homeostasis. Paneth cells produce antimicrobial peptides and growth factors that support microbial regulation and intestinal stem cells, while tuft cells act as chemosensors, detecting environmental changes and modulating immune responses. Along with immune cells such as intraepithelial lymphocytes, innate lymphoid cells, T cells, and macrophages, they form a strong defense system that protects the epithelial barrier. Disruptions in this balance contribute to chronic inflammation, microbial dysbiosis, and compromised barrier function-key features of inflammatory bowel disease, celiac disease, and metabolic syndromes. Furthermore, dysfunctions in the small intestine and immune cells are linked to systemic diseases like obesity, diabetes, and autoimmune disorders. Recent research highlights promising therapeutic strategies, including modulation of epithelial and immune cell functions, probiotics, and gene editing to restore gut health and address systemic effects. This review emphasizes the pivotal roles of small intestinal epithelia and immune cells in maintaining intestinal homeostasis, their involvement in disease development, and emerging treatments for intestinal and systemic disorders.
小肠对于消化、营养吸收、免疫调节和微生物平衡至关重要。其上皮衬里包含潘氏细胞和簇状细胞等特殊细胞，对维持肠道内稳态至关重要。潘氏细胞产生抗菌肽和生长因子，支持微生物调节和肠道干细胞，而簇状细胞充当化学传感器，检测环境变化并调节免疫反应。它们与上皮内淋巴细胞、固有淋巴细胞、T细胞和巨噬细胞等免疫细胞一起，形成一个强大的防御系统，保护上皮屏障。这种平衡的破坏会导致慢性炎症、微生物失调和屏障功能受损，这些是炎症性肠病、乳糜泻和代谢综合征的关键特征。此外，小肠和免疫细胞的功能障碍与肥胖、糖尿病和自身免疫性疾病等全身性疾病有关。最近的研究突出了有前景的治疗策略，包括调节上皮和免疫细胞功能、益生菌和基因编辑，以恢复肠道健康并解决全身影响。这篇综述强调了小肠上皮细胞和免疫细胞在维持肠道内稳态中的关键作用、它们在疾病发展中的参与以及针对肠道和全身性疾病的新兴治疗方法。
