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Transcript
February 15th 2010
The gut microbiota shapes intestinal
immune response during health and
disease
Round and Mazmanian,
Nature Reviews Immunology, Vol.9
2009
Hannover Medical School
Gut microbiota
•
more than 1000 species
•
collective weight of about 1kg in human intestine
•
colonization begins immediately after birth
•
symbiotic bacteria provide benefits to the host:
– nutrient supply
– pathogen defense
– immune system development/ function
O´Hara and Shanahan, EMBO reports, 2006
Hannover Medical School
Gut-associated lymphoid tissue (GALT)
intestinal
epithelial
cell (IEC)
GALT
• Peyer`s patches
• appendix
• isolated lymphoid
follicles
= T-cell areas
= B-cell follicles
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Developmental defects in germ-free mice
•
IEC show decreased rates of cell-turnover
and reduced expression of MHC class II
molecules, TLR9 and antimicrobial proteins
•
fewer lymphocytes in lamina propria and
epithelium
•
fewer and smaller Peyer`s patches, isolated
lymphoid follicles and mesenteric lymph
nodes
•
reduced levels of secretory IgA
Macpherson and Harris,
Nat rev Immunol., 2004
Hannover Medical School
Defects in immune response in germ-free mice
•
decreased immune resistance to infection with Shigella flexneri
•
decreased bacterial clearence upon Listeria monocytogenes infection
•
Salmonella enterica serovar Typhimurium exploits deficiency in
colonization resistance to establish infection
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Inflammatory bowel disease (IBD)
•
chronic inflammation of the gastointestinal tract
•
two main forms:
Crohn´s disease
1. Crohn`s disease
– affects all layers of the bowel wall
– granuloma formation in up to 60% of
patients
2. Ulcerative colitis
– affects superficial mucosal layers
•
•
no pathogen has been conclusively shown to be
the causative agent
Janeway, Immunobiology, 7ed.
incidence is the highest in developed countries
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IBD is driven by T cells
mucosal homeostasis
 cytokine production by regulatory (TReg) T cells supresses pro-inflammatory responses
TH1, TH2,
TH17
TReg
mucosal inflammation
 increased production of pro-inflammatory cytokines by T helper (TH) cells
TNF, IFNγ, IL-17
 TReg transfer can prevent the
induction of experimental colitis
adapted from Bouma and Strober, Nat rev Immunol., 2003 and Vignali et al., Nat rev Immunol., 2008
Hannover Medical School
Involvement of the microbiota in regulating the balance
between TH and TReg cell subsets in the gut
TReg
TH
•
germ-free animals show
defective TH17 cell development
in the small intestine
•
germ-free mice have reduced
numbers of TReg cells in the
mesenteric lymph nodes
•
ATP generated by intestinal
bacteria increases the
production of IL-17 in the colon
•
increased numbers of Treg cells
in the small intestine of germfree mice
 Intestinal bacteria direct the differentiation of both pro- and antiinflammatory T cell populations and may therefore play a crucial role in IBD
Hannover Medical School
Evidence for the involvement of commensal
bacteria in IBD
•
IBD patients have increased antibody titres against indigenous
bacteria
•
inflammatory lesions are pronounced in areas with high numbers of
bacteria
•
genetic variants that are highly linked to IBD include mutations in
genes that are involved in bacterial sensing (NOD2) and T cell
immunity (IL23R)
•
IBD patients show abnormal microbial composition (= dysbiosis)
•
mice studies showed that dysbiosis alone may be important for the
induction of IBD
Hannover Medical School
Immunological dysregulation associated with
dysbiosis of the microbiota
Symbionts
 health promoting
functions
Commensals
 provide no benefit
or detriment
Pathobionts
 have the potential to
induce pathology
 Inflammatory responses in IBD are directed towards pathobionts
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Different bacterial species ameliorate the symptoms
of IBD
Probiotics
•
dietary microorgansims that are beneficial
to the health of the host
•
act on serveral cell types (epithelial cells,
DCs, T cells)
•
ability to limit inflammation by induction of
TReg cells
VSL#3: mixture of Lactobacillus spp., Bifidobacterium spp., Streptococcus salivarius
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Model for Bacteroides fragilis-mediated protection
from disease induced by Heliobacter hepaticus
PSA:
polysaccharid A
(= symbiotic factor)
 symbiotic factors actively maintain health
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Proposed causes of dysbiosis of the microbiota
 Increased incidence of immune-mediated disorders in developed
countries could be due to alterations in the microbiota
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Summary
• the microbiota promote the appropriate development of the
immune system
• immune-mediated disorders seem to involve reduced TReg cell
activity
• absence of beneficial microorganisms (owing to dysbiosis) can
lead to the induction of inflammatory responses and immunemediated diseases
 the microbiota plays an important role in supporting health
Hannover Medical School
Thank you for
your attention!
Hannover Medical School