CD4+ T ĆELIJSKI PROFILI U AUTOIMUNOJ HEMOLITIČNOJ ANEMIJI
Sažetak
Autoimuna hemolitična anemija (AIHA) predstavlja imunoposredovanu bolest koju karakteriše skraćenje životnog veka eritrocita usled pojačane intravaskularne i ekstravaskularne destrukcije. Tradicionalno, imunopatogeneza AIHA sagledavala se u kontekstu prekida imunske tolerancije B ćelija, budući da su autoantitela osnovni medijatori bolesti. Međutim, skorašnji podaci sugerišu da je produkcija antieritrocitnih antitela od strane B ćelija samo epifenomen i da je prekid tolerancije u odeljku CD4+ T ćelija zapravo centralni događaj u ranom razvoju AIHA. U AIHA postoje i numeričke i funkcionalne alteracije osnovnih subpopulacija CD4+ T ćelija, uključujući Th1, Th2, Th17, regulatorne T ćelije, kao i folikularne pomoćničke T ćelije. U ovom preglednom radu prikazane su osnovne karakteristike celularnog imunskog odgovora tokom razvoja AIHA, kao i potencijalni mehanizmi kojima CD4+ T ćelije promovišu inicijaciju i održanje autoimunog procesa. S obzirom na to da otvara mogućnost dizajniranja specifične imunoterapije, još uvek nedostupne bolesnicima sa AIHA, definisanje ovih karakteristika i mehanizama bilo bi od praktičnog značaja u terapiji.
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