Th17Treg平衡在类风湿关节炎发病和治疗中意义.docVIP

Th17Treg平衡在类风湿关节炎发病和治疗中意义 　　[摘要] 类风湿关节炎（RA）是一种慢性、进行性、系统性自身免疫病。RA发病率高、致残率高、分布广、年龄跨度大，因其病因和发病机制尚不明确，给治疗带来了一定困难。因此探索RA的发病机制及其有效的防治方法，是当前RA研究中的重要课题。近年来，人们发现了CD4+ T细胞中的两种新亚群Treg细胞和Th17细胞，Th17细胞由白介素-6（IL-6）和转化生长因子-β（TGF-β）共同诱导Th细胞分化而成，具有较强的促炎作用，Treg细胞通过释放白介素-10（IL-10）、TGF-β发挥抑制T细胞及抗原呈递细胞的功能，降低炎性细胞因子的产生及抗体分泌而发挥免疫效应，随着Treg细胞及Th17细胞在RA中作用研究的不断深入，Th17的促炎作用和Treg的抑炎作用以及Th17/Treg的平衡与RA的密切关系越来越受到研究者的重视。Th17细胞和Treg细胞的分化发育相互制约，这依赖于各种致炎和抗炎因子的相互作用，Th17细胞数量增多、功能亢进，Treg细胞数量减少、功能低下，最终导致Th17/Treg平衡失调，而出现滑膜炎症、关节破坏、骨侵蚀等，加重RA病程的发展。国内外针对Th17/Treg平衡的治疗发现，阻止Th17对RA的致病作用、提高Treg细胞对RA的保护作用、调节Th17/Treg的平衡成为治疗RA的新途径。深入研究Th17/Treg平衡、失衡机制，揭示其对发病和治疗的意义，对RA的发病机制研究及诊治具有重要价值。 　　[关键词] Th17；Treg；类风湿关节炎 　　[中图分类号] R684 [文献标识码] A [文章编号] 1673-7210（2015）08（c）-0048-05 　　[Abstract] Rheumatoid arthritis （RA） is a chronic， progressive， systemic autoimmune disease. RA has the high incidence and morbididy， wide distribution， age span， because its etiology and pathogenesis is not clear， so it has some difficulties to treatment on RA. Exploring the pathogenesis of RA and effective treatment is an important issue on RA. In recent years， It was discovered that the CD4+ T cells has two new groups， which is Treg cells and Th17 cells. Th17 cells is differentiated by Th， which is induced by IL-6 and TGF-β， Th17 cells has strong proinflammatory effects. Treg cells has the role of inhibiting T cells and antigen-presenting by releasing IL-10， TGF-β， it can reduce inflammatory cells and antibodies. With the deepening study of Treg and Th17 cells in RA， a pro-inflammatory role of Th17， anti-inflammation effect of Treg， and the role of Th17/Treg balance， which has increasing emphasis for researchers. The differentiation and development of Th17 and Treg cells has checked each other. It is depending on the interaction in a variety of inflammatory and anti-inflammatory cytokines. The number of Th17 cells increased， hyperfunction， Treg cells decreased， function is low， resulting in an imbalance of Th17/Treg， and the emergence of