Hemolysis and immune regulation

被引:39
作者
Zhong, Hui [1 ]
Yazdanbakhsh, Karina [1 ]
机构
[1] New York Blood Ctr, Lab Complement Biol, 310 E 67th St, New York, NY 10065 USA
关键词
heme; hemolysis; macrophage; neutrophil; regulatory T cell; SICKLE-CELL-DISEASE; NEUTROPHIL EXTRACELLULAR TRAPS; IRON HOMEOSTASIS; HEME OXYGENASE-1; SPI-C; MACROPHAGES; INFECTION; CHILDREN; MALARIA; ALLOIMMUNIZATION;
D O I
10.1097/MOH.0000000000000423
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of reviewHemolytic anemias caused by premature destruction of red blood cells occur in many disorders including hemoglobinopathies, autoimmune conditions, during infection or following reaction to drugs or transfusions. Recent studies which will be reviewed here have uncovered several novel mechanisms by which hemolysis can alter immunological functions and increase the risk of severe complications in hemolytic disorders.Recent findingsPlasma-free heme can induce the formation of neutrophil extracellular traps (NETs) through reactive oxygen species signaling. Although NETs protect the host against infections, in patients with sickle disease, they are associated with vaso-occlusive crises. Heme may increase host susceptibility to infections by inducing heme oxygenase 1 (HO-1) in immature neutrophils, thereby inhibiting oxidative burst required for clearance of engulfed bacteria. In addition, heme impairs macrophage phagocytosis and microbial clearance through inhibition of cytoskeletal remodeling. Hemolysis can also favor anti-inflammatory immune cell polarization by inhibiting dendritic cell maturation necessary for effector T-cell responses, inducing differentiation of monocytes into red pulp macrophages, important for iron recycling from senescent erythrocytes, and driving regulatory T-cell expansion through modulation of HO-1 expression in nonclassical monocytes.SummaryHemolysis breakdown products show remarkable effects on the regulation of immune cell differentiation and function.
引用
收藏
页码:177 / 182
页数:6
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