系统性红斑狼疮中雌激素调控Th17/Treg免疫平衡的研究进展  

Progress in the regulation of Th17/Treg immune balance by estrogen in systemic lupus erythematosus

作　　者：王会 王东明[1] 苏芮 字晓宇 苏蓉慧 李小峰[1] 王彩虹[1] Wang Hui;Wang Dongming;Su Rui;Zi Xiaoyu;Su Ronghui;Li Xiaofeng;Wang Caihong(Department of Rheumatology and Immunology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中华微生物学和免疫学杂志》2024年第5期447-452,共6页Chinese Journal of Microbiology and Immunology

基　　金：国家自然科学基金(81971543);山西省重点研发计划(社会发展领域)(201803D31119);山西省"四个一批"科技兴医创新计划项目重大科技攻关(2022XM05)。

摘　　要：系统性红斑狼疮(systemic lupus erythematosus,SLE)具有显著的性别差异。除了X染色体失活(XCI)异常等可能是导致SLE患者性别差异的原因外,雌激素在调控SLE患者Th17/Treg免疫平衡中发挥关键作用。雌激素通过作用于B细胞来间接影响Th17和Treg的数量和功能,在此过程中更多的是B细胞与T细胞的相互影响和作用,共同促进疾病发展。最新研究报道肠道微生物群存在性别差异,可能导致以SLE为代表的自身免疫性疾病的性别依赖性遗传易感性和表观遗传变化,SLE中雌激素与肠道微生物相互作用影响Th17/Treg的免疫平衡。本文主要综述雌激素的作用方式,以及调节SLE患者Th17/Treg免疫平衡和调控B细胞与T细胞的相互作用的机制,为选择性雌激素受体调节剂等新的治疗策略提供新靶点。Systemic lupus erythematosus(SLE)shows a significant gender difference.In addition to X chromosome inactivation(XCI)abnormalities,which may lead to the gender difference in SLE,studies have found that estrogen plays a key role in regulating Th17/Treg immune balance in SLE.Estrogen indirectly affects the quantity and function of Th17 and Treg cells by acting on B cells.In this process,the mutual influence and the interaction between B and T cells promote the development of SLE.Recent studies have reported gender differences in intestinal microbiota,which may lead to sex-dependent genetic susceptibility and epigenetic changes in autoimmune diseases represented by SLE.The interaction between estrogen and intestinal microbiota in SLE affects the immune balance of Th17/Treg cells.This paper mainly reviews the way estrogen works,and the mechanisms by which estrogen regulates Th17/Treg immune balance and the interaction between B and T cells in SLE,hoping to provide new targets for new therapeutic strategies such as selective estrogen receptor modulators.

关 键 词：系统性红斑狼疮 Th17/Treg免疫平衡 雌激素 肠道菌群 

分 类 号：R593.241[医药卫生—内科学]