寄生虫治疗类风湿关节炎研究进展

The Progression of Parasites Treat Rheumatoid Arthritis

在西方国家自身免疫性疾病的发病率增高,这可能是因为卫生条件改善,儿童时期感染的几率下降(卫生假说)。目前寄生虫感染是预防还是促进自身免疫性疾病还在讨论中。多种寄生虫用于不同的动物模型显示了其在多种疾病中限制疾病活动的能力,包括炎性肠病、多发硬化、1型糖尿病、类风湿关节炎和系统性红斑狼疮。目前大多数研究还在动物实验阶段,然而已经有一些临床试验在进行中。因此本文回顾了评估寄生虫的抗炎作用的几个临床试验及针对类风湿关节炎的动物实验。寄生虫诱导免疫调节的主要途径是抑制IFN-γ和IL-17产生,促进IL-4、IL-10和TGF-β释放,诱导CD4+T细胞Fox P3表达及调节性巨噬细胞细胞、树突状细胞和B细胞产生,然而寄生虫调节自身免疫性疾病的机制尚不完全清楚。目前寄生虫治疗类风湿关节炎在动物实验方面已经取得一定进展,进一步的研究是针对寄生虫调节免疫反应的有效成分模拟的人造类似物。

The incidence of autoimmune diseases is increasing in Western countries, possibly due to sanitary conditions improved and infections reduced in childhood（the hygiene hypothesis）. There is an discussion on whether infection improves or precipitates autoimmune dieases. Many parasites species used in several animal models shown their ability of limiting inflammatory activity in a variety of diseases including multiple sclerosis, inflammatory bowel disease, type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus. For now, most data based on experimental animal models, but several clinical trials are underway. Herein we review several clinical trials evaluating the anti-inflammatory ability of parasites and animal experiments of rheumatoid arthritis. The common pathway of parasites modulate immune response are through inhibition IFN-γ and IL-17 production, improve IL-4, IL-10 and TGF-β release, induction CD4＋T cell Fox P3＋ expression, and the generation of regulatory macrophages, dendritic cells, and B cells. But the mechanism of parasites modulating autoimmune diseases is not fully understood. There has been some progresses of parasites therapy in rheumatoid arthritis in animal experiments. Further research is aimed at synthetic analogues of parasites＇ potent products that mimic the parasite induced immunomodulation effect.