原发性胆汁性胆管炎与调节性T细胞、吲哚胺2,3-双加氧酶的相关性研究

Correlation of primary biliary cholangitis,regulatory T cells and indoleamine 2,3-dioxygenase

原发性胆汁性胆管炎(primary biliary cholangitis,PBC)是一种以慢性胆汁淤积为特征的自身免疫性肝病,目前发病原因、发病机制仍不完全明确,熊去氧胆酸(ursodeoxycholic acid,UDCA)为多个指南推荐的一线用药,但仍有30%~40%的患者对其反应不佳,且UDCA不能改善PBC患者乏力、瘙痒等症状。调节性T细胞(regulatory T cells,Tregs)具有免疫抑制、维持免疫稳定的作用,研究发现,PBC患者血清中Treg低于健康对照者。吲哚胺2,3-双加氧酶(indoleamine 2,3-dioxygenase,IDO)是催化色氨酸(tryptophan,Trp)-犬尿氨酸(kynurenine,Kyn)途径代谢的限速酶。大量研究表明,色氨酸这一代谢通路有调节免疫的作用,且有研究表明这一代谢通路可能与PBC相关。本文就前PBC与Treg、IDO相关性的研究现状作一概述,期望能为PBC的诊断及治疗提供新的方向。

Primary biliary cholangitis(PBC)is an autoimmune liver disease characterized by chronic cholestasis.At present,the factors leading up to disease initiation are not understood well.Ursodeoxycholic acid(UDCA)is the first-line drug recommended by many guidelines.However,30%-40%of the patients still have poor response to UDCA,and it can not improve the symptoms of fatigue and pruritus.Tregs have the function of immunosuppression and maintaining immune stability.Some studies found that the serum tregs of PBC patients were lower than those in normal control group.Indoleamine 2,3-dioxygenase(IDO)is a rate-limiting enzyme that catalyzes the catabolism of tryptophan along the kynurenine pathway.A large number of studies have shown that the metabolic pathway can regulate immunity,and it may be related to PBC.This paper reviews the current research status of PBC,IDO and their correlation,hoping to provide a new direction for the diagnosis and treatment of PBC.