Abstract
For many years the heterogeneity of CD4+ T-helper (Th) cells has been limited to Th1 and Th2 cells, which have been considered not only to be responsible for different types of protective responses, but also for the pathogenesis of many disorders. Th1 cells are indeed protective against intracellular microbes and they are thought to play a pathogenic role in organ-specific autoimmune and other chronic inflammatory disorders. Th2 cells provide protection against helminths, but are also responsible for the pathogenesis of allergic diseases. The identification and cloning of new cytokines has allowed one to enlarge the series of functional subsets of CD4+ Th effector cells. In particular, CD4+ Th cells producing IL-17 and IL-22, named Th17, have been initially implicated in the pathogenesis of many chronic inflammatory disorders instead of Th1 cells. However, the more recent studies in both humans and mice suggest that Th17 cells exhibit a high plasticity toward Th1 cells and that both Th17 and Th1 cells may be pathogenic. More recently, another two subsets of effector CD4+ Th cells, named Th9 and Th22 cells, have been described, even if their pathophysiological meaning is still unclear. Despite the heterogeneity of CD4+ effector Th cells being higher than previously thought and some of their subsets exhibiting high plasticity, the Th1/Th2 paradigm still maintains a strong validity.
Highlights
CD4+ T-helper (Th) lymphocytes represent a heterogeneous population of cells that play an essential role in adaptive immunity
The prototypic cell-mediated immune response was considered to be the skin papular reaction induced by intradermal injection of tuberculin or purified protein derivative (PPD) in animals infected with tubercular bacilli or in humans naturally infected by Mycobacterium tuberculosis or vaccinated with Bacillus CalmetteGuérin (BCG)
Our studies demonstrate that the CD161+ precursors of human Th17 cells present in the umbilical cord blood and thymus already express RORC and IL-23R ex vivo [58], and that exogenous TGFβ may only have an indirect role in the development of Th17 cells, mainly due to its strong suppressive activity on the proliferation of Th1 cells [68]
Summary
CD4+ T-helper (Th) lymphocytes represent a heterogeneous population of cells that play an essential role in adaptive immunity. Based on the observation that IL-12 and IFNα, two cytokines produced by dendritic cells, acted as powerful inducers of human Th1 polarization [10,11,12], I hypothesized that the type of innate immunity response was the main conditioning mechanism for the type of subsequent adaptive immunity [13].
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