糖皮质激素诱导移植耐受的免疫细胞调控效应及机制

Immunomodulation and Mechanism of Transplantation Immune Tolerance Induced by Glucocorticoids

糖皮质激素(Glucocorticoid;GC)是强有效的甾体类抗炎药和免疫抑制剂,在重症感染、休克、自身免疫病和器官移植等疾病中广泛应用。在器官移植领域GC一直发挥着基础性作用,它是器官移植围手术期免疫诱导必不可少的药物,是经典免疫抑制维持三联方案的重要组成部分,也是治疗急性排斥的首选用药。其作用广泛,能调节代谢、细胞发育和分化;作用机制复杂,不仅有经典的细胞核糖皮质激素受体(glucocorticoid receptor;GCR)信号通路调节DNA的转录,还有其他多种快速作用机制调节细胞功能。本文对GC诱导移植免疫耐受的免疫细胞学调控效应及其机制做以简要综述。

Glucocorticoids (GCs) are potent steroidal anti-inflammatory drugs and immunosuppressants, which are widely used in severe infection, shock, autoimmune diseases, organ transplantation and other diseases. GCs have played a fundamental role in the field of organ transplantation, including induction of immune tolerance, maintenance of immunosuppression and therapy for graft rejection. They act on various cells, and regulate metabolism, cell growth and differentiation. The modulatory mechanisms of GCs are very complex. Through the classic cytoplasmic glucocorticoid receptor (GCR) signaling pathway, it can regulate the transcription of DNA. And, it also has rapid effects on immunity via non-genomic mechanisms. This review summarized the current progresses of immunomodulation and mechanisms of glucocorticoids on the transplantation immune tolerance.