中医药干预溃疡性结肠炎Th17/Treg平衡的研究进展
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摘要
溃疡性结肠炎(UC)是一种常见的慢性非特异性的肠道炎症,其病程长且难以治愈,发病率逐年上升。辅助性T细胞17(Th17)是免疫促进细胞之一,而调节性T细胞(Treg)是一种免疫抑制细胞,Th17和Treg细胞共同维持着机体免疫微环境的平衡。在UC进展期间,引起炎症的Th17群体通常增加,而抑制Th17活性的Treg减少。其中,Th17介导免疫应答反应,Treg介导免疫抑制,两者协调平衡在溃疡性结肠炎的炎症和免疫过程中起关键作用。UC的西医治疗虽具有一定的效果,然而,副作用的频率和严重程度,不方便的剂量调节,以及部分价格过高限制了他们的临床应用。中药作为我国的传统医药,具有多靶点、多环节、多途径的治疗特点,在抗溃疡性结肠炎方面具有独特优势和广阔前景。近年来,中医药领域以Th17/Treg平衡为切入点,开展了大量中医药干预UC中Th17/Treg平衡的临床和实验研究,并取得了一定的成果,临床和实验证据明确表明干预Th17/Treg是中医药治疗溃疡性结肠炎的重要作用机制。本文主要对前人关于中药单体、组分或有效成分、中药复方对UC中Th17/Treg平衡的干预作用研究进行了总结与分析,有利于人们更为准确、全面地认识中医药干预UC中Th17/Treg平衡的作用机制,为临床合理设计抗溃疡性结肠炎治疗方案提供参考。
Ulcerative colitis( UC) is a common chronic non-specific intestinal inflammation,which has a long course and is difficult to cure,and the incidence is increasing year by year. Helper T cells 17( Th17) are one of immune-promoting cells,while regulatory sputum cells( Treg) are immunosuppressive cells,and Th17 cells and regulatory T cells together maintain the balance of the body's immune microenvironment. During progression of UC,the population of sputum helper cells 17( Th17 cells) that cause inflammation generally increases,while the number of sputum regulatory T cells that inhibit Th17 cell activity decreases. Among them,Th17 cells mediate immune response,regulatory T cell-mediated immunosuppression,and the balance between the two plays a key role in the inflammation and immune process of ulcerative colitis. Although Western medicine treatment of UC has certain effects,however,The frequency and severity of side effects,inconvenient dose adjustments,and partial price excessions limit their clinical application. As a traditional medicine in China,traditional Chinese medicine( TCM) has multi-target,multi-link and multi-channel treatment characteristics,and has unique advantages and broad prospects in anti-ulcerative colitis. In recent years,the TCM field has taken Th17/Treg balance as the entry point,and carried out a large number of clinical and experimental studies on the intervention of TCM in Th17/Treg balance in UC,and achieved certain results. Clinical and experimental evidence clearly indicates intervention in Th17/Treg. It is an important mechanism of action of TCM in the treatment of ulcerative colitis. This paper mainly summarizes and analyzes the intervention effects of TCM monomer,component or active ingredient and TCM compound on Th17/Treg balance in UC,which is helpful for people to understand Chinese medicine intervention in UC more accurately and comprehensively. The mechanism of action of Th17/Treg balance provides a reference for the clinical design of a treatment plan for anti-ulcerative colitis.
Ulcerative colitis( UC) is a common chronic non-specific intestinal inflammation,which has a long course and is difficult to cure,and the incidence is increasing year by year. Helper T cells 17( Th17) are one of immune-promoting cells,while regulatory sputum cells( Treg) are immunosuppressive cells,and Th17 cells and regulatory T cells together maintain the balance of the body's immune microenvironment. During progression of UC,the population of sputum helper cells 17( Th17 cells) that cause inflammation generally increases,while the number of sputum regulatory T cells that inhibit Th17 cell activity decreases. Among them,Th17 cells mediate immune response,regulatory T cell-mediated immunosuppression,and the balance between the two plays a key role in the inflammation and immune process of ulcerative colitis. Although Western medicine treatment of UC has certain effects,however,The frequency and severity of side effects,inconvenient dose adjustments,and partial price excessions limit their clinical application. As a traditional medicine in China,traditional Chinese medicine( TCM) has multi-target,multi-link and multi-channel treatment characteristics,and has unique advantages and broad prospects in anti-ulcerative colitis. In recent years,the TCM field has taken Th17/Treg balance as the entry point,and carried out a large number of clinical and experimental studies on the intervention of TCM in Th17/Treg balance in UC,and achieved certain results. Clinical and experimental evidence clearly indicates intervention in Th17/Treg. It is an important mechanism of action of TCM in the treatment of ulcerative colitis. This paper mainly summarizes and analyzes the intervention effects of TCM monomer,component or active ingredient and TCM compound on Th17/Treg balance in UC,which is helpful for people to understand Chinese medicine intervention in UC more accurately and comprehensively. The mechanism of action of Th17/Treg balance provides a reference for the clinical design of a treatment plan for anti-ulcerative colitis.
引文
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[5] YU X T,XU Y F,HUANG Y F,et al. Berberrubine attenuates mucosal lesions and inflammation in dextran sodium sulfate-induced colitis in mice[J]. PLo S One,2018,13(3):e0194069.
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[8] HUANG Y,CHEN Z. Inflammatory bowel disease related innate immunity and adaptive immunity[J]. Am J Transl Res,2016,8(6):2490-2497.
[9] HUANG Y F,ZHOU J T,QU C,et al. Anti-inflammatory effects of Brucea javanica oil emulsion by suppressing NF-κB activation on dextran sulfate sodium-induced ulcerative colitis in mice[J]. J Ethnopharmacol,2017,198(23):389-398.
[10] ZHENG L,ZHANG Y L,DAI Y C,et al. Jianpi Qingchang decoction alleviates ulcerative colitis by inhibiting nuclear factor-κB activation[J]. World J Gastroenterol,2017,23(7):1180-1188.
[11] JIANG W,SU J,ZHANG X,et al. Elevated levels of Th17 cells and Th17-related cytokines are associated with disease activity in patients with inflammatory bowel disease[J]. Inflamm Res,2014,63(11):943-950.
[12] Ivanova E A,Orekhov A N. T helper lymphocyte subsets and plasticity in autoimmunity and cancer:an overview[J]. Biomed Res Int,2015,2015:327470.
[13] Lee G R. The balance of Th17 versus Treg cells in autoimmunity[J]. Int J Mol Sci,2018,19(3):730.
[14]王程玉林,曾琳岚,耿煜,等.电针对溃疡性结肠炎小鼠脾脏淋巴细胞Treg/Th17免疫平衡的影响[J].针刺研究,2016,41(1):55-59.
[15] Haque M,Fino K,LEI F,et al. Utilizing regulatory T cells against rheumatoid arthritis[J]. Front Oncol,2014,4:209.
[16]李承琴,杨红,饶悬,等. Th17细胞与Treg细胞调控肿瘤免疫的研究进展[J].药物生物技术,2017,24(5):426-430.
[17]李佩容,危蓉,吴志平,等. Th17/Treg细胞及其相关细胞因子在溃疡性结肠炎发病中的作用及其研究进展[J].世界科技研究与发展,2017,39(2):194-197.
[18] Omenetti S,Pizarro T T. The Treg/Th17 axis:a dynamic balance regulated by the gut microbiome[J]. Front Immunol,2015,doi:10. 3389/fimmu. 2015. 00639.
[19] Lee S Y,Lee S H,YANG E J,et al. Metformin ameliorates inflammatory bowel disease by suppression of the STAT3 signaling pathway and regulation of the between Th17/Treg balance[J]. PLo S One,2015,10(9):e0135858.
[20] GAO L,ZHAO Y,WANG P,et al. Detection of Th17/Treg cells and related factors in gingival tissues and peripheral blood of rats with experimental periodontitis[J]. Iran J Basic Med Sci,2017,20(3):294-300.
[21]卓玛,邱思远,王玉芳,等.难治性溃疡性结肠炎治疗进展[J].中国实用内科杂志,2018,38(9):829-834.
[22]王兵,关江锋,颜琳琳,等.消水方联合顺铂对肺癌移植瘤胸腔积液小鼠模型Th17/Treg免疫平衡的影响[J].中国实验方剂学杂志,2018,24(21):131-137.
[23] SUN J,ZHANG H,WANG C,et al. Regulating the balance of Th17/Treg via electroacupuncture and moxibustion:an ulcerative colitis mice model based study[J]. Evid Based Complement Alternat Med,2017,doi:10. 1155/2017/7296353.
[24] GONG Y,LIN Y, ZHAO N,et al. The Th17/Treg immune imbalance in ulcerative colitis disease in a Chinese Han population[J]. Mediators Inflamm,2016,2016:7089137.
[25]马海芹,赵小静,张红杰.血清炎性活动指标、Th17/Treg细胞在溃疡性结肠炎患者中的改变及其临床意义[J].胃肠病学和肝病学杂志,2018,27(8):885-890.
[26]王坤,宣秀敏,王莲,等. Treg/Th17细胞、钙卫蛋白在溃疡性结肠炎模型大鼠血清及肠组织中的表达变化[J].四川大学学报:医学版,2014,45(6):946-949.
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