Next generation strategies to recover immunological tolerance in celiac disease.

IF 4.3 4区 医学 Q2 IMMUNOLOGY International Reviews of Immunology Pub Date : 2023-01-01 DOI:10.1080/08830185.2022.2044807
Lucia Treppiccione, Diomira Luongo, Francesco Maurano, Mauro Rossi
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Abstract

Celiac disease (CD) is an autoimmune disease that occurs in genetically predisposed individuals following the ingestion of gluten. Its prevalence is rising worldwide. A gluten-free (GF) diet is mandatory for the management of CD. However, several issues persist regarding the nutritional quality of GF products. Importantly, deep knowledge about the pathogenic mechanisms in CD highlights the central role of CD4+ T cell-mediated immunity in CD. Furthermore, intestinal T regulatory cells are functional in CD, but cytokines such as IL-15, produced under inflammatory conditions, hamper their activity. This paves the way for the development of immunomodulatory strategies to the GF diet. From this perspective, microbiological approaches were considered able to modulate the gluten-specific immune response. Interestingly, gliadin peptide-based immunotherapy to abolish the inflammatory CD4+T cell-mediated response has been explored in CD patients. Furthermore, different biotechnological approaches based on the use of chemically/enzymatically modified gluten molecules have been proved effective in different models of CD. However, the choice of the right age in infants to introduce the antigen and thus induce tolerance still remains an important issue to solve. Addressing all these points should help to design an effective intervention strategy for preventing CD.

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新一代乳糜泻免疫耐受恢复策略。
乳糜泻(CD)是一种自身免疫性疾病,发生在遗传易感个体摄取谷蛋白后。它在世界范围内的流行率正在上升。无谷蛋白饮食对于乳糜泻的治疗是强制性的。然而,关于无谷蛋白产品的营养质量仍然存在一些问题。重要的是,对CD致病机制的深入了解强调了CD4+ T细胞介导的免疫在CD中的核心作用。此外,肠道T调节细胞在CD中起作用,但炎症条件下产生的IL-15等细胞因子阻碍了它们的活性。这为GF日粮免疫调节策略的发展铺平了道路。从这个角度来看,微生物学方法被认为能够调节谷蛋白特异性免疫反应。有趣的是,以麦胶蛋白肽为基础的免疫疗法已经在CD患者中探索了消除炎症性CD4+T细胞介导的反应。此外,基于化学/酶修饰面筋分子的不同生物技术方法已被证明对不同的乳糜泻模型有效。然而,在婴儿中选择合适的年龄引入抗原并诱导耐受性仍然是一个需要解决的重要问题。解决所有这些问题应有助于设计预防乳糜泻的有效干预策略。
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来源期刊
CiteScore
11.00
自引率
4.00%
发文量
24
期刊介绍: This review journal provides the most current information on basic and translational research in immunology and related fields. In addition to invited reviews, the journal accepts for publication articles and editorials on relevant topics proposed by contributors. Each issue of International Reviews of Immunology contains both solicited and unsolicited review articles, editorials, and ''In-this-Issue'' highlights. The journal also hosts reviews that position the authors'' original work relative to advances in a given field, bridging the gap between annual reviews and the original research articles. This review series is relevant to all immunologists, molecular biologists, microbiologists, translational scientists, industry researchers, and physicians who work in basic and clinical immunology, inflammatory and allergic diseases, vaccines, and additional topics relevant to medical research and drug development that connect immunology to disciplines such as oncology, cardiovascular disease, and metabolic disorders. Covered in International Reviews of Immunology: Basic and developmental immunology (innate and adaptive immunity; inflammation; and tumor and microbial immunology); Clinical research (mechanisms of disease in man pertaining to infectious diseases, autoimmunity, allergy, oncology / immunology); and Translational research (relevant to biomarkers, diagnostics, vaccines, and drug development).
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