调节性B细胞在肾小球疾病中的作用

Progress in the Role of Regulatory B Cells in Glomerular Diseases

随着人们对肾小球疾病的了解与认识,发现多种免疫机制的异常参与了肾小球疾病的发生与发展,身体对这些免疫异常的调节是否及时、有效,是影响肾小球疾病预后的关键因素。CD5+B细胞以前被认为是参与自身免疫过程的一类B细胞亚型,但近些年发现它可通过分泌细胞因子[如白细胞介素-10(IL-10)]而调节其他免疫细胞功能,因而也被称为调节性B细胞。正常情况下调节性B细胞在外周血中含量非常低,但在免疫球蛋白A(Ig A)肾病、系统性红斑狼疮性肾炎等患者中,其数量及功能可明显增加,其作用是促进疾病进展还是恢复,目前各家说法不一。最近发现,调节性B细胞数目在抗中性粒细胞胞质抗体(ANCA)相关性肾炎患者中明显下降,其作用可能与保护身体免于ANCA相关性肾炎的活动及复发有关。在终末期肾病患者中,调节性B细胞数目明显减少,移植后水平明显上升,在无须用药而抑制物长期存活的患者中尤其如此。深入研究肾小球疾病中调节性B细胞的作用,寻找干预调节性B细胞的新靶点,可为防治肾小球疾病提供新的手段。

The abnormalities of various immune mechanisms are involved in the development of glomerular diseases,and the timely and effective regulations of these immune abnormalities are the key factors affecting the prognosis of glomerular diseases.CD5+B cell was previously thought to be involved in the autoimmune process as a subtype of B cells.Recent researches show CD5+B cell can regulate other immune cells by secreting cytokines,such as interleukin-10(IL-10),therefore,it is also known as regulatory B cells.Usually,regulatory B cells in peripheral blood are rare,but in immunoglobulin A(IgA)nephropathy and lupus nephritis patients,it can significantly increase and be active.With regard to its role is to promote the progress of the disease or the recovery,the current opinions vary.Recently,it was reported the number of regulatory B cells has been significantly decreased in patients with antineutrophil cytoplasmic antibody associated glomerulonephritis,and its role may be related to the protection of the body.In patients with end-stage renal disease,the number of regulatory B cells decreased significantly,and the levels increased significantly after transplantation,especially in cases without drug use and with long-term survival of inhibitors.To investigate the role of regulatory B cells in glomerular diseases,and to find new targets for intervening regulatory B cells,can pr ovide new means for the prevention and treatment of glomerular diseases.