中医药干预类风湿关节炎Th17/Treg平衡的研究进展  

Research Progress on TCM Intervention of Th17/Treg Balance in Rheumatoid Arthritis

作　　者：李平顺 周孟茹 王钢 朱琴[4] LI Pingshun;ZHOU Mengru;WANG Gang;ZHU Qin(Gansu University of Chinese Medicine,Gansu lanzhou 730000,China;Basic Medical College of Lanzhou University,Gansu lanzhou 730000,China;Department of Rheumatic Osteopathia,Affiliated Hospital of Gansu University of Chinese Medicine,Gansu lanzhou 730000,China;The Second Hospital of Lanzhou University,Gansu lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]兰州大学基础医学院,甘肃兰州730000 [3]甘肃中医药大学附属医院风湿骨病科,甘肃兰州730000 [4]兰州大学第二医院,甘肃兰州730000

出　　处：《中国医药导刊》2019年第7期421-425,共5页Chinese Journal of Medicinal Guide

基　　金：国家自然科学基金面上项目(项目编号:81860858;项目名称:基于骨免疫探讨补肾通络法对类风湿关节炎骨破坏及Treg/Th17的影响及机制研究)

摘　　要：类风湿关节炎(RA)是一种以慢性滑膜炎为特征的自身免疫性疾病,目前发病机制尚不明确。随着对RA研究的深入,学者发现调节性T细胞(Treg)和辅助性T细胞(Th,主要是Th17细胞)免疫调节异常是其发病机制研究的热点,Th17细胞主要分泌IL-17,介导炎症反应过程,是RA发病机制中的主要效应细胞;Treg细胞作为具有独特调节作用的免疫抑制细胞,主要通过分泌TGF-β、IL-10等发挥作用。两种细胞的分化发育相互制约,Th17细胞的增多,Treg细胞的减少,可导致Th17/Treg平衡失调,而出现滑膜炎症、关节破坏、骨侵蚀等,加剧RA的发生、发展。近年来,中医药针对Th17/Treg失衡的治疗发现,阻止Th17对RA的致病作用,提高Treg细胞对RA的保护作用,调节Th17/Treg的平衡成为治疗RA的新途径。本文拟就Th17、Treg细胞分化、平衡关系以及中医药对Th17/Treg失衡的干预进行综述,以期为RA的机制研究和临床防治提供新思路。Rheumatoid arthritis(RA)is an autoimmune disease characterized by chronic synovitis.The current pathogenesis is still unclear.With the in-depth study of RA,scholars have found that abnormal immunomodulation of regulatory T(Treg)cells and helper T(Th)cells(mainly Th17 cells)is the focus of pathogenesis research.Th17 cells mainly secrete IL-17,mediate the inflammatory reaction process,and are the main effector cells in the pathogenesis of RA.Treg cells,as immunosuppressive cells with unique regulatory effects,mainly play the role by secreting TGF-βand IL-10.The differentiation and development of the two types of cells are mutually restricted.The increase of Th17 cells and the decrease of Treg cells can lead to the imbalance of Th17/Treg and the occurrence of synovitis,joint destruction and bone erosion,which aggravate the occurrence and development of RA.In recent years,the treatment of Th17/Treg balance with traditional Chinese medicine has been found to prevent the pathogenic effect of Th17 on RA,improve the protective effect of Treg cells on RA,and regulating the balance of Th17/Treg has become a new way to treat RA.In this paper,the differentiation and balance of Th17 and Treg cells as well as the intervention of traditional Chinese medicine on Th17/Treg imbalance were summarized,so as to provide new ideas for the mechanism research and clinical prevention and treatment of RA.

关 键 词：类风湿关节炎 Th17/Treg细胞分化 Th17/Treg平衡 中医药 

分 类 号：R593.22[医药卫生—内科学]