中国寄生虫学与寄生虫病杂志

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蠕虫感染在预防与治疗炎症性肠病中的作用及机制

唐春莲1,申志琴1,雷家慧2,王力霞1*   

  1. 1 湖北省武汉市武昌医院检验科,武汉430063;2华中科技大学同济医学院寄生虫学教研室,武汉430030
  • 出版日期:2016-12-30 发布日期:2017-01-10

Effect of Helminthic Infection on the Prevention and Treatment of Inflammatory Bowel Disease and the Mechanisms

TANG Chun-lian1, SHEN Zhi-qin1, LEI Jia-hui2, WANG Li-xia1*   

  1. 1 Department of Clinical Laboratory, Wuchang Hospital, Wuhan 430063, China;2 Department of Parasitology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  • Online:2016-12-30 Published:2017-01-10

摘要:

炎症性肠病包括克罗恩氏病(Crohn′s disease)和溃疡性结肠炎,是机体对肠道内各种抗原的过度炎症反应所致的自身免疫性疾病。卫生假说为蠕虫感染治疗炎症性肠病提供了新的思路,蠕虫感染也在多种炎症性肠病动物模型中具有预防及治疗作用。在动物实验基础上陆续展开临床实验,如用一定剂量的猪鞭虫(Trichuris suis)卵感染治疗炎症性肠病,显示出较好的治疗效果。但感染活体蠕虫也存在一定潜在风险,故亟待研制开发蠕虫相关的免疫活性物质提取物,以提高治疗安全性。治疗性蠕虫感染在炎症性肠病中的作用机制主要为免疫学机制,传统观念认为,与Th1/Th2轴有关,近来研究表明与Tregs/Th17轴关系更为密切。其他免疫调节通路,如上皮屏障、Toll样受体和巨噬细胞在蠕虫感染预防与治疗炎症性肠病中也具有重要作用。本文就蠕虫感染在预防与治疗炎症性肠病中的作用及免疫学机制的研究进展作一综述。

关键词: 蠕虫感染, 防治, 炎症性肠病, 免疫调节

Abstract:

Crohn’s disease and ulcerative colitis are two forms of inflammatory bowel diseases. They are autoimmune disorders caused by excessive inflammatory response to antigens in the intestine. In addition to the hygiene hypothesis which suggests the potential application of helminthic infection in the treatment of inflammatory bowel diseases, helminthic infection has shown preventive and treatment effects in animal models of inflammatory bowel disease. Clinical trials have been initiated. For example, Trichuris suis ova infection at a certain dose has a promising efficacy in the treatment of inflammatory bowel diseases. Helminthic infection may also have adverse effects. Therefore, helminth-derived immunomodulatory molecules are needed to overcome these problems. It is traditionally considered that the Th1/Th2 axis is involved in the mechnisms of the efficacy of helminthic infection. More recent research has pointed out the much more participation of the Tregs/Th17 axis. The mechanisms may also involve other palyers such as mucosal barrier, Toll like receptor and macrophages. This paper reviews the effect and mechanism of helminthic infection on the prevention and treatment of inflammatory bowel disease.

Key words: Helminthic infection, Prevention and treatment, Inflammatory bowel disease, Immune regulation