臨牀消化器内科 Vol.34 No.5(1)


特集名 肝と免疫2019
題名 Lymphoid organとしての肝臓
発刊年月 2019年 05月
著者 原田 憲一 金沢大学医薬保健研究域医学系人体病理学
【 要旨 】 肝臓はlymphoid liverとも称され,免疫臓器の一つとして全身の免疫機能を担っている.解剖学的に肝臓は肝動脈と門脈を介して全身循環および腸管経由の血流を受け,門脈からは食物抗原や腸内細菌等のpathogen‒associated molecular pattern(PAMP)の曝露を受ける.抗原を含む肝血流は類洞内へと流入し,Kupffer細胞,リンパ球,NK/NKT細胞,樹状細胞などの免疫担当細胞への応答を示すものの,生理的な状態では免疫寛容な臓器として維持されている.この寛容の破綻は外来抗原さらには肝細胞や胆管細胞由来の自己抗原に対する制御不可能な免疫応答を引き起こし,自己免疫性肝炎や原発性胆汁性胆管炎などの肝臓特異的な疾患を形成する.
Theme Liver and Immunology 2019
Title The Liver as a Lymphoid Organ
Author Kenichi Harada Department of Human Pathology, Kanazawa University Graduate School of Medical Science
[ Summary ] The liver, which is also known as the lymphoid liver, is an organ that functions as a part of the systemic immune system. The liver is continually exposed to various pathogen‒associated molecular patterns (PAMPs) derived from food and intestinal bacterial flora. These PAMPs flow into the sinusoid and encounter immunocompetent cells, including resident Kupffer cells, lymphocytes, natural killer/natural killer T (NK/NKT) cells, and dendritic cells. In physiological conditions, these immunocompetent cells are responsible for the tolerogenic properties of the liver. Deficits in the immune tolerance for self‒antigens derived from hepatocytes and cholangiocytes cause autoimmune liver diseases, which include autoimmune hepatitis and primary biliary cholangitis.
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