国际口腔医学杂志

国际口腔医学杂志 ›› 2016, Vol. 43 ›› Issue (2): 181-186.doi: 10.7518/gjkq.2016.02.015

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嗜酸性粒细胞增生性淋巴肉芽肿的免疫研究进展

陈青立,Srijana Dwa,Karmesh Bajracharya,龚忠诚   

  1. 新疆医科大学第一附属医院颌面肿瘤外科 乌鲁木齐 830054
  • 收稿日期:2015-09-15 修回日期:2015-12-08 出版日期:2016-03-01 发布日期:2016-03-01
  • 通讯作者: 龚忠诚，副教授，博士，Email：gump0904@aliyun.com
  • 作者简介:陈青立，硕士，Email：qingli-chen@hotmail.com

Research progress on the immunity of eosinophilic hyperplastic lymphogranuloma

Chen Qingli, Srijana Dwa, Karmesh Bajracharya, Gong Zhongcheng   

  1. Dept. of Maxillofacial Tumor Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China)
  • Received:2015-09-15 Revised:2015-12-08 Online:2016-03-01 Published:2016-03-01

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摘要： 嗜酸性粒细胞增生性淋巴肉芽肿也称木村病（KD），伴有嗜酸性粒细胞和血清免疫球蛋白（Ig）E升高。低亲和力IgE受体表达于B细胞、T细胞、嗜酸性粒细胞表面，调节各种免疫应答。在KD初发和复发患者中，IgG4均增高，被看作非主要致病性抗体。滤泡树突细胞分泌的趋化因子、黏附分子和营养因子可调控B细胞免疫应答并作用于局部微环境。嗜酸性粒细胞分泌的嗜酸性粒细胞阳离子蛋白在KD发病过程中起着重要的作用。肥大细胞可促进嗜酸性粒细胞的浸润并诱导B细胞合成IgE。KD患者血清补体C5a高反应性可以调节补体活化后介导的细胞免疫应答。白细胞介素（IL）-4可诱导IgE合成，IL-5、粒细胞-巨噬细胞集落刺激因子和IL-3可促使嗜酸性粒细胞局灶浸润。嗜酸性粒细胞趋化因子与调节正常T细胞表达和分泌因子一起参与嗜酸性粒细胞在炎症处的聚集。Th细胞又分为Th1和Th2细胞，Th1细胞参与细胞免疫反应，Th2细胞参与体液免疫及变态反应性免疫反应。嗜酸性粒细胞增多及IgE升高，可能系Th2细胞在KD发病机制中起着重要的作用。

关键词: 嗜酸性粒细胞增生性淋巴肉芽肿, 木村病, 免疫紊乱, 嗜酸性粒细胞增生性淋巴肉芽肿, 木村病, 免疫紊乱

Abstract: Eosinophilic hyperplastic lymphogranuloma, is also known as Kimura’s disease(KD), causes elevated eosinophils and serum IgE. The low-affinity IgE receptor is expressed on the surface of B and T cells, as well as eosinophils, and regulates various immune responses. Increased IgG4 is deemed a benign antibody without pathogenicity in primary and recurrent KD. Provision of chemokines, adhesion molecules, and trophic factors induce follicular dendritic cells to participate in the shaping of B cell responses and molding of the local microenvironment. Eosinophil cationic protein from eosinophils is an important agent in KD mechanism. The hyper-responsiveness of C5a in KD plasma may be important in regulating cellular response after complementary activation. Interleukin(IL)-4 induces IgE synthesis. IL-5, granulocyte macrophage colony-stimulating factor, and IL-3 lead to focal eosinophil infiltration. Eotaxin and regulated upon activation normal T cell expressed and secreted factor would also help to boost eosinophils concentration in inflammation. T helper(Th) cells are subdivided into the Th1 and Th2 subsets. Th1 cells are primarily involved in cellmediated immune responses, whereas Th2 cells fulfill an important role in humoral and allergic immune responses. Lifted eosinophils and serum IgE may be caused by Th2 polarization in the KD mechanism.

Key words: eosinophilic hyperplastic lymphogranuloma, Kimura’s disease, immunologic derangement, eosinophilic hyperplastic lymphogranuloma, Kimura’s disease, immunologic derangement

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