Immunological pathogenesis of primary biliary cholangitis
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摘要: 原发性胆汁性胆管炎(PBC)是一种由于免疫系统对自身肝脏进行攻击而产生的慢性胆汁淤积性自身免疫性疾病,多发于中年女性。其病理学特征表现为天然免疫细胞(NK细胞、NK/T淋巴细胞和单核细胞等)和适应性免疫细胞(T淋巴细胞和B淋巴细胞)在汇管区大量浸润,导致肝内小胆管损伤。PBC患者血清中存在高滴度的抗线粒体抗体以及较高水平的炎性细胞因子如IFNγ、TNFα、IL-6、IL-12等。目前研究表明,自身反应性T淋巴细胞是PBC致病的主要效应细胞,但是门静脉周围浸润的NK细胞、NK T淋巴细胞、单核细胞和B淋巴细胞等也直接或者间接参与了PBC的发生和发展。系统总结了天然免疫细胞、适应性免疫细胞以及相关趋化因子在PBC发病过程中的作用,为深入理解PBC的免疫学发病机制提供理论基础。Abstract: Primary biliary cholangitis (PBC) is a chronic cholestatic autoimmune disease caused by the attack of the liver by the immune system and is commonly seen in middle-aged women.The pathological features of this disease include the infiltration of a large number of innate immune cells (NK cells, NK T cells, and monocytes, etc.) and adaptive immune cells (T lymphocytes and B lymphocytes) at the portal area and injury of small intrahepatic bile ducts.In addition, PBC patients have high serum levels of anti-mitochondrial antibodies and inflammatory cytokines such as interferon-γ, tumor necrosis factor-α, interleukin-6, and interleukin-12.Although current studies have shown that autoreactive T cells are the major effector cells for PBC, NK cells, NK T cells, monocytes, and B cells around the portal vein also directly or indirectly participate in the development and progression of PBC.This article systematically summarizes the role of innate immune cells, adaptive immune cells, and related chemokines in the pathogenesis of PBC, in order to provide a theoretical basis for a deep understanding of the immunological pathogenesis of PBC.
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Key words:
- cholangitis, biliary /
- immunity, cellular /
- chemokines
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[1]HIRSCHFIELD GM, GERSHWIN ME.The immunobiology and pathophysiology of primary biliary cirrhosis[J].Annu Rev Pathol, 2013, 8 (8) :303-330. [2]SELMI C, BOWLUS CL, GERSHWIN ME, et al.Primary biliary cirrhosis[J].Lancet, 2011, 377 (9777) :1600-1609. [3]OERTELT S, LIAN ZX, CHENG CM, et al.Anti-mitochondrial antibodies and primary biliary cirrhosis in TGF-beta receptorⅡdominant-negative mice[J].J Immunol, 2006, 177 (3) :1655-1660. [4]WAKABAYASHI K, LIAN ZX, MORITOKI Y, et al.IL-2 receptor alpha (-/-) mice and the development of primary biliary cirrhosis[J].Hepatology, 2006, 44 (5) :1240-1249. [5]ZHANG W, SHARMA R, JU ST, et al.Deficiency in regulatory Tcells results in development of antimitochondrial antibodies and autoimmune cholangitis[J].Hepatology, 2009, 49 (2) :545-552. [6]BAE HR, LEUNG PS, TSUNEYAMA K, et al.Chronic expression of interferon-gamma leads to murine autoimmune cholangitis with a female predominance[J].Hepatology, 2016, 64 (4) :1189-1201. [7]YAO Y, YANG W, YANG YQ, et al.Distinct from its canonical effects, deletion of IL-12p40 induces cholangitis and fibrosis in interleukin-2Ralpha (-/-) mice[J].J Autoimmun, 2014, 51:99-108. [8] NEVENS F, ANDREONE P, MAZZELLA G, et al.A placebo-controlled trial of obeticholic acid in primary biliary cholangitis[J].N Engl J Med, 2016, 375 (7) :631-643. [9]KATSUMI T, TOMITA K, LEUNG PS, et al.Animal models of primary biliary cirrhosis[J].Clin Rev Allergy Immunol, 2015, 48 (2-3) :142-153. [10]YANG GX, LIAN ZX, CHUANG YH, et al.Adoptive transfer of CD8 (+) T cells from transforming growth factor beta receptor type II (dominant negative form) induces autoimmune cholangitis in mice[J].Hepatology, 2008, 47 (6) :1974-1982. [11]KAWATA K, YANG GX, ANDO Y, et al.Clonality, activated antigen-specific CD8 (+) T cells, and development of autoimmune cholangitis in dn TGFbetaRII mice[J].Hepatology, 2013, 58 (3) :1094-1104. [12]COLUCCI G, SCHAFFNER F, PARONETTO F.In situ characterization of the cell-surface antigens of the mononuclear cell infiltrate and bile duct epithelium in primary biliary cirrhosis[J].Clin Immunol Immunopathol, 1986, 41 (1) :35-42. [13]KITA H, MATSUMURA S, HE XS, et al.Quantitative and functional analysis of PDC-E2-specific autoreactive cytotoxic T lymphocytes in primary biliary cirrhosis[J].J Clin Invest, 2002, 109 (9) :1231-1240. [14]CARBO A, HONTECILLAS R, ANDREW T, et al.Computational modeling of heterogeneity and function of CD4+T cells[J].Front Cell Dev Biol, 2014, 2 (2) :31. [15]YANG CY, MA X, TSUNEYAMA K, et al.IL-12/Th1 and IL-23/Th17 biliary microenvironment in primary biliary cirrhosis:implications for therapy[J].Hepatology, 2014, 59 (5) :1944-1953. [16]LAN RY, SALUNGA TL, TSUNEYAMA K, et al.Hepatic IL-17responses in human and murine primary biliary cirrhosis[J].J Autoimmun, 2009, 32 (1) :43-51. [17]WANG YH, YANG W, YANG JB, et al.Systems biologic analysis of T regulatory cells genetic pathways in murine primary biliary cirrhosis[J].J Autoimmun, 2015, 59:26-37. [18]YANG JB, WANG YH, YANG W, et al.Successful treatment of murine autoimmune cholangitis by parabiosis:Implications for hematopoietic therapy[J].J Autoimmun, 2016, 66:108-17. [19]TANAKA H, ZHANG W, YANG GX, et al.Successful immunotherapy of autoimmune cholangitis by adoptive transfer of forkhead box protein 3 (+) regulatory T cells[J].Clin Exp Immunol, 2014, 178 (2) :253-261. [20]WANG L, SUN Y, ZHANG Z, et al.CXCR5+CD4+T follicular helper cells participate in the pathogenesis of primary biliary cirrhosis[J].Hepatology, 2015, 61 (2) :627-638. [21]LLEO A, LIAO J, INVERNIZZI P, et al.Immunoglobulin M levels inversely correlate with CD40 ligand promoter methylation in patients with primary biliary cirrhosis[J].Hepatology, 2012, 55 (1) :153-160. [22]GARDAM S, BRINK R.Non-canonical NF-kappa B signaling initiated by baff influences B cell biology at multiple junctures[J].Front Immunol, 2014, 4:509. [23]BERGMANN B, GRIMSHOLM O, THORARINSDOTTIR K, et al.Memory B cells in mouse models[J].Scand J Immunol, 2013, 78 (2) :149-156. [24]CHEN RC, NAIYANETR P, SHU SA, et al.Antimitochondrial antibody heterogeneity and the xenobiotic etiology of primary biliary cirrhosis[J].Hepatology, 2013, 57 (4) :1498-1508. [25]LEUNG PS, LAM K, KURTH MJ, et al.Xenobiotics and autoimmunity:does acetaminophen cause primary biliary cirrhosis?[J].Trends Mol Med, 2012, 18 (10) :577-582. [26]MORITOKI Y, TSUDA M, TSUNEYAMA K, et al.B cells promote hepatic inflammation, biliary cyst formation, and salivary gland inflammation in the NOD.c3c4 model of autoimmune cholangitis[J].Cell Immunol, 2011, 268 (1) :16-23. [27]MORITOKI Y, ZHANG W, TSUNEYAMA K, et al.B cells suppress the inflammatory response in a mouse model of primary biliary cirrhosis[J].Gastroenterology, 2009, 136 (3) :1037-1047. [28]MORITOKI Y, LIAN ZX, LINDOR K, et al.B-cell depletion with anti-CD20 ameliorates autoimmune cholangitis but exacerbates colitis in transforming growth factor-beta receptor II dominant negative mice[J].Hepatology, 2009, 50 (6) :1893-1903. [29]DHIRAPONG A, LLEO A, YANG GX, et al.B cell depletion therapy exacerbates murine primary biliary cirrhosis[J].Hepatology, 2011, 53 (2) :527-535. [30]DYSON JK, HIRSCHFIELD GM, ADAMS DH, et al.Novel therapeutic targets in primary biliary cirrhosis[J].Nat Rev Gastroenterol Hepatol, 2015, 12 (3) :147-158. [31]YANG YQ, YANG W, YAO Y, et al.Dysregulation of peritoneal cavity B1a cells and murine primary biliary cholangitis[J].Oncotarget, 2016, 7 (19) :26992-27006. [32]CHUANG YH, LIAN ZX, TSUNEYAMA K, et al.Increased killing activity and decreased cytokine production in NK cells in patients with primary biliary cirrhosis[J].J Autoimmun, 2006, 26 (4) :232-240. [33]LIANG Y, YANG Z, LI C, et al.Characterisation of TNF-related apoptosis-inducing ligand in peripheral blood in patients with primary biliary cirrhosis[J].Clin Exp Med, 2008, 8 (1) :1-7. [34]TAKEDA K, KOJIMA Y, IKEJIMA K, et al.Death receptor 5 mediated-apoptosis contributes to cholestatic liver disease[J].Proc Natl Acad Sci U S A, 2008, 105 (31) :10895-10900. [35]SHIMODA S, HARADA K, NIIRO H, et al.Interaction between Toll-like receptors and natural killer cells in the destruction of bile ducts in primary biliary cirrhosis[J].Hepatology, 2011, 53 (4) :1270-1281. [36]SHIMODA S, HISAMOTO S, HARADA K, et al.Natural killer cells regulate T cell immune responses in primary biliary cirrhosis[J].Hepatology, 2015, 62 (6) :1817-1827. [37]PENG H, JIANG X, CHEN Y, et al.Liver-resident NK cells confer adaptive immunity in skin-contact inflammation[J].J Clin Invest, 2013, 123 (4) :1444-1456. [38]ASO-ISHIMOTO Y, YAMAGIWA S, ICHIDA T, et al.Increased activated natural killer T cells in the liver of patients with advanced stage primary biliary cirrhosis[J].Biomed Res, 2014, 35 (2) :161-169. [39]CHUANG YH, LIAN ZX, YANG GX, et al.Natural killer T cells exacerbate liver injury in a transforming growth factor beta receptor IIdominant-negative mouse model of primary biliary cirrhosis[J].Hepatology, 2008, 47 (2) :571-580. [40]MENCARELLI A, RENGA B, MIGLIORATI M, et al.The bile acid sensor farnesoid X receptor is a modulator of liver immunity in a rodent model of acute hepatitis[J].J Immunol, 2009, 183 (10) :6657-6666. [41]PENG A, KE P, ZHAO R, et al.Elevated circulating CD14low CD16+monocyte subset in primary biliary cirrhosis correlates with liver injury and promotes Th1 polarization[J].Clin Exp Med, 2016, 16 (4) :511-521. [42]CHOI J, SELMI C, LEUNG PS, et al.Chemokine and chemokine receptors in autoimmunity:the case of primary biliary cholangitis[J].Expert Rev Clin Immunol, 2016, 12 (6) :661-672. [43]SASAKI M, MIYAKOSHI M, SATO Y, et al.Chemokine-chemokine receptor CCL2-CCR2 and CX3 CL1-CX3 CR1 axis may play a role in the aggravated inflammation in primary biliary cirrhosis[J].Dig Dis Sci, 2014, 59 (2) :358-364. [44]TSUDA M, AMBROSINI YM, ZHANG W, et al.Fine phenotypic and functional characterization of effector cluster of differentiation 8positive T cells in human patients with primary biliary cirrhosis[J].Hepatology, 2011, 54 (4) :1293-1302. [45]LIMONGI F.Th1 cytokines and chemokines in primary biliary cirrhosis[J].Clin Ter, 2015, 166 (2) :e122-e125. [46]ISSE K, HARADA K, ZEN Y, et al.Fractalkine and CX3CR1 are involved in the recruitment of intraepithelial lymphocytes of intrahepatic bile ducts[J].Hepatology, 2005, 41 (3) :506-516.
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