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Allergoonkologie: was Allergologen und Onkologen voneinander lernen können

Regulatorische T‑Zellen bei Allergie und Krebserkrankungen

Allergo-oncology: what allergologists and oncologists can learn from each other

Regulatory T cells in allergy and cancer

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Zusammenfassung

Hintergrund

Bei Allergien und Krebserkrankungen ist das Immunsystem wesentlich involviert. Die Komplexität des Immunsystems ist beim gesunden Menschen in einer ausgewogenen Balance, die sog. Immunhomöostase. Bei vielen Erkrankungen, wie auch bei Allergie und Krebs, ist diese Balance verschoben. Die Toleranz gegenüber fremden, aber ungefährlichen Stoffen, wie z. B. gegen Baum- oder Gräserpollen, ist beim allergischen Patienten nicht mehr hinreichend gegeben. Beim Krebspatienten ist das Immunsystem tolerant gegenüber den schädlichen Tumorzellen. Beide Erkrankungen zeigen in Bezug auf die Immuntoleranz ein entgegengesetztes Muster. Die Gruppe der regulatorischen T‑Zellen nimmt hier eine zentrale Position ein.

Ziel der Arbeit

Diese Arbeit setzt sich mit der Funktion der regulatorischen T‑Zellen detailliert auseinander. Diese Immunzellgruppe und ihre Wechselwirkung mit anderen beteiligten Immunzellen und Botensignalen in der Pathophysiologie und Therapie der Allergie und der Krebserkrankung werden dargestellt.

Methoden

Es wurde eine Übersichtsarbeit anhand der entsprechenden Literatur erstellt.

Ergebnisse

Die regulatorischen T‑Zellen sind beim Krebspatienten ein Mechanismus des sog. Tumor-Flucht-Phänomens vor dem Immunsystem. Der Tumor nutzt Gefahrensignale, wie z. B. das Protein HMGB1, um durch diese Zellen eine Toleranz gegenüber dem Immunsystem zu entwickeln und der Elimination durch dieses zu entgehen. Beim Allergiepatienten ist diese Zellgruppe unterrepräsentiert und kann durch eine spezifische Immuntherapie induziert werden, um Toleranz gegen die Allergene und damit eine kausale Therapie zu erreichen.

Schlussfolgerung

Regulatorische T‑Zellen spielen in der Pathogenese von Krebs und Allergie eine wichtige Rolle und dienen als Ziel für die Therapie.

Abstract

Background

The immune system has substantial involvement in the pathophysiology of allergies and cancer. The complexity of the immune system is well balanced in health, in so-called immune homeostasis. In many diseases, as in allergies and cancer, this balance is disturbed. The tolerance to foreign but harmless substances, such as tree or grass pollen, is no longer sufficiently given in allergic patients. In cancer patients, the immune system is tolerant to harmful tumor cells. Thus, allergies and cancer show an opposing pattern in terms of immune tolerance. The group of regulatory T cells occupies a central position here.

Objective

This article deals with the function of regulatory T cells in detail. This group of immune cells and its interaction with other involved immune cells and messenger signals in the pathophysiology and treatment of allergies and cancer are presented.

Methods

A review article was compiled based on the pertinent literature.

Results

The regulatory T cells of cancer patients are a mechanism of the so-called tumor escape phenomenon to hide from the immune system. The tumor uses danger signals, e.g., the HMGB1 protein, to mediate tolerance to the immune system through these cells and thus avoid elimination. In allergic patients, these cells are underrepresented and can be induced by a specific immunotherapy, in order to achieve tolerance to the allergens and thus a causal treatment.

Conclusion

Regulatory T cells play an important role in the pathogenesis of cancer and allergies, and thus represent a therapeutic target.

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Author information

Correspondence to PD Dr. med. Christoph Bergmann.

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C. Bergmann gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Bergmann, C. Allergoonkologie: was Allergologen und Onkologen voneinander lernen können. HNO 68, 115–122 (2020). https://doi.org/10.1007/s00106-019-00810-2

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Schlüsselwörter

  • Phänomene des Immunsystems
  • Kopf-Hals-Karzinom
  • HMGB1-Protein
  • Regulatorische T‑Lymphozyten
  • Immuntoleranz

Keywords

  • Immune system phenomena
  • Head and neck neoplasms
  • HMGB1 protein
  • Regulatory T lymphocytes
  • Immune tolerance