Purpose of Review
Type 2 (Th2) immune responses play important roles in intestinal immunity by contributing to the maintenance of mucosal homeostasis, conferring protection against helminthic inflection, but also participating in pro-inflammatory pathways in chronic intestinal inflammatory disorders, including inflammatory bowel disease (IBD). The current review focuses on recent developments regarding the role of type 2 responses in intestinal inflammation.
Recent Findings
Th2 gut mucosal responses are promoted by mediators that are released following injury to the epithelium and act as alarmin-type danger signals. IL-33 is prominent among such factors and demonstrates a dichotomous function exerting either protective or pro-inflammatory effects, depending on its cellular compartmentalization. The pool of type 2 effector cells has been enriched recently to include not only classical CD4+ Th2 lymphocytes but also a subset of innate lymphocytes (ILC2) that express the transcriptional factor GATA3 and secrete IL-4, IL-5, and IL-13. ILC2 play important roles during infection with helminthes and bi-directionally interact with Th2 CD4+ lymphocytes, thus, establishing a transition from innate to adaptive immunological pathways. Type 2 responses are also involved in pro-inflammatory pathways at the intestinal mucosa and neutralization of the pivotal cytokines IL-4 and IL-13 has been shown to regulate experimental intestinal inflammation. In striking contrast, however, neutralization of human IL-13 had no therapeutic effect in patients with ulcerative colitis.
Summary
Further studies will be required to delineate the specific mechanisms of type 2 mucosal immunity in IBD and examine the applicability of Th2-targeted therapies for intestinal inflammation.