Neuro-Immune Interactions in the Gut
关键词
抽象
描述
Hirschsprung`s disease (HD) is diagnosed shortly after birth and is characterized by the absence of enteric nerves in parts of colon [Amiel et al.]. Following surgical correction many patients develop HD-associated enterocolitis (HAEC), a condition distinguished by intestinal inflammation resulting in abdominal distension, severe diarrhea, fever and sepsis [Demehri et al.]. The underlying factors leading to HAEC remain poorly understood and likely involve a defect in epithelial barrier, including decreased mucin production and insufficient immunoglobulin translocation. The establishment of the epithelial barrier is dependent on epithelial recognition of microbial products by innate immune receptors, like toll-like receptors (TLRs) [Peterson et al.]. TLR-dependent epithelial recognition of microflora also coordinates the immune response away from harmless commensal bacteria and towards pathogenic invaders. Both innate and adaptive effector cell functions are influenced by epithelial-derived signals. Under homeostatic conditions commensal bacteria induce anti-inflammatory cytokines in epithelial cells which trigger a tolerogenic phenotype in mucosal antigen presenting cells (APC) resulting in generation of commensal-specific regulatory T cells (Tregs) [Curotto de Lafaille et al.]. During infection, recognition of pathogenic organisms by epithelial cells leads to secretion of inflammatory cytokines thereby inducing an inflammatory APC phenotype which promotes T effector cell (Th1, Th17) generation. The enteric nervous system is directly located underneath the epithelium and controls epithelial cell function. Ablation of enteric glia cells, one of the two cell types of the ENS, in mice is associated with inflammation and enterocolitis [Cornet et al.]. In a study from 2011 Flamant and co-workers demonstrate that enteric glia cells protect from a shigella flexneri invasion by preventing lesions in the epithelial barrier mediated by the glia cell derived neurothrophic factor S-nitrosoglutathione (GSNO) [Flamant et al.]. We hypothesize that the lack of an enteric nervous system in HD patients modulates the microbial recognition of epithelial cells and thereby the phenotype of underlying mucosal APCs and effector T cells; this might be associated with the manifestation of HAEC.
日期
最后验证: | 06/30/2018 |
首次提交: | 07/23/2018 |
提交的预估入学人数: | 07/30/2018 |
首次发布: | 08/05/2018 |
上次提交的更新: | 07/30/2018 |
最近更新发布: | 08/05/2018 |
实际学习开始日期: | 02/27/2015 |
预计主要完成日期: | 02/27/2020 |
预计完成日期: | 02/27/2020 |
状况或疾病
相
手臂组
臂 | 干预/治疗 |
---|---|
Hirschsprung's disease patients Children diagnosed with Hirschsprung's disease or Hirschsprung's disease associated enterocolitis | |
control patients Children diagnosed and treated for miscellaneous bowel diseases |
资格标准
有资格学习的性别 | All |
取样方式 | Non-Probability Sample |
接受健康志愿者 | 是 |
标准 | Inclusion Criteria: Informed consent Exclusion Criteria: No signed informed consent No blood from patients with weak general state of health |
结果
主要结果指标
1. Phenotypic analysis of immune and nervous cell populations [5 years]
2. Expression profil [5 years]
3. Histological analysis [5 years]
次要成果指标
1. Microbial metagenomics sequencing [5 years]
2. Identifying genetic defect [5 years]