肺移植是终末期肺病唯一有效的治疗方式,移植后慢性排斥反应主要表现为闭塞性细支气管炎(obliterative bronchiolitis,OB),OB是导致肺移植患者长期存活率较低的主要原因,其5年存活率仅有30%~40%。目前临床对OB的治疗效果不佳,因此寻找一种新的治疗策略具有重要的临床意义,然而OB的发生机制至今仍不清楚,探索OB的危险因素与发病机制为防治新策略的研究奠定重要的基础。Th17&Treg细胞以及相互作用与OB的发生发展存在着密切的联系,Th17&Treg细胞是CD4+T细胞的两个亚群,以分泌IL-17为特征的Th17细胞参与一系列炎症反应、自身免疫性疾病以及移植排斥反应的发生发展,而Treg细胞对移植排斥、自身免疫性疾病等具有重要的调节功能。本文就这一方面的研究进展做一简要综述。
Lung transplantation is a therapeutic modality for end-stage pulmonary diseases.The 5-year survival rate after lung transplantation is only 30%-40%,which is significantly lower than most other solid organ transplants because of the chronic rejection,known as obliterative bronchiolitis(OB). The mechanism of OB is unclear,so it is worthwhile to explore the risk factors and pathogenesis of OB, which will facilitate the new therapeutic and prevention strategies.Recent researches have identified that Thl7 and Treg cells play important roles in the development of OB.Thl7 and Treg cells are the subsets of CD4 + T helper cells.Thl7 cells are involved in the development and progression of inflammation, autoimmune diseases and transplant rejection.In contrast,Treg cells have anti-inflammatory properties and can cause quiescence of autoimmune diseases and prolongation of transplant survival.In this paper we review the recent advances of Thl7/IL-17 and Treg in obliterative bronchiolitis after lung transplantation.