IV. 閱讀測驗 10% They lie buried- their long, tentaclelike arms outstretched—in all the tissues of our bodies that interact with
the environment. In the lining of our nose and lungs, lest we inhale the influenza virus in a crowded subway car.
In our gastrointestinal tract, to alert our immune system if we swallow a dose of salmonella bacteria. And most
importantly, in our skin, they lie in wait as stealthy sentinels should microbes breach the leathery fortress of our
epidermis.
They are dendritic cells, a class of white blood cells that encompasses some of the least understood but
most fascinating actors in the immune system. Over the past several years, researchers have begun to unravel
the mysteries of how dendritic cells educate the immune system about what belongs in the body and what is
foreign and potentially dangerous. Intriguingly, they have found that dendritic cells initiate and control the
overall immune response. For instance, the cells are crucial for establishing immunological “memory,” which is
the basis of all vaccines. Indeed, physicians, including those at a number of biotechnology companies, are
taking advantage of the role that dendritic cells play in immunization by “vaccinating” cancer patients with
dendritic cells loaded with bits of their own tumors to activate their immune system against their cancer.
Dendritic cells are also responsible for the phenomenon of immune tolerance, the process through which the
immune system learns not to attack other components of the body.
Dendritic cells are relatively scarce: they constitute only 0.2 percent of white blood cells in the blood and
are present in even smaller proportions in tissues such as skin. In part because of their rarity, their true function
eluded scientists for nearly a century after they were first identified in 1868 by German anatomist Paul
Langerhans, who mistook them for nerve endings in the skin.
In 1973 Ralph M. Steinman of the Rockefeller University rediscovered the cells in mouse spleens and
recognized that they are part of the immune system. The cells were unusually potent in stimulating immunity in
experimental animals. He renamed the cells “dendritic” because of their spiky arms, or dendrites, although the
subset of dendritic cells that occur in the epidermis layer of the skin are still commonly called Langerhans cells.
There are several subsets of dendritic cells, which arise from precursors that circulate in the blood and then
take up residence in immature form in the skin, mucous membranes, and organs such as the lungs and spleen.
Immature dendritic cells are endowed with a wealth of mechanisms for capturing invading microbes: they reel
in invaders using suction cup-like receptors on their surfaces, they take microscopic sips of the fluid surround
them, and they suck in viruses or bacteria by engulfing them in sacks known as vacuoles. Once they devour
foreign objects, the immature cells chop them into fragments (antigens) that can be recognized by the rest of the
immune system.
Dendritic cells are very efficient at capturing and presenting antigens: they can pick up antigens that occur in
only minute concentrations. As they process antigens for presentation, they travel to the spleen through the
blood or to lymph nodes through a clear fluid known as lymph. Once at their destinations, the cells complete
their maturation and present their antigen-laden molecules to naïve helper T cells, those that have never
encountered antigens before. Dendritic cells are the only cells that can educate naïve helper T cells to recognize
an antigen as foreign or dangerous. This unique ability appears to derive from costimulatory molecules on their
surfaces that can bind to corresponding receptors on the T cells.
Once educated, the helper T cells go on to prompt so-called B cells to produce antibodies that bind to and
inactivate the antigen. The dendritic cells and helper cells also activate killer T cells, which can destroy cells
infected by microbes. Some of the cells that have been educated by dendritic cells become “memory” cells that
remain in the body for years—to combat the invader in case it ever returns.
Activating naive helper T cells is the basis of vaccines for everything from pneumonia to tetanus to
influenza. Scientists are now turning the new knowledge of the role that dendritic cells play in immunity against
microbes and their toxins into a strategy to fight cancer.
Cancer cells are abnormal and as such are thought to generate molecules that healthy cells don’t. If
researchers could devise drugs and vaccines that exclusively targeted those aberrant molecules, they could
combat cancer more effectively while leaving normal cells and tissues alone—thereby eliminating some of the
pernicious side effects of chemotherapy and radiation, such as hair loss, nausea and weakening of the immune
system caused by destruction of the bone marrow.
Such trials generally employ vaccines made of dendritic cells precursors that have been isolated from cancer
patients and grown in the laboratory together with tumor antigens. During this process, the dendritic cells pick
up the antigens, chop them up and present them on their surfaces. When injected back into the patients, the
antigen-loaded dendritic cells are expected to ramp up patients’ immune response against their own tumors.
Several researchers fear that such vaccines might induce patients’ immune systems to attack healthy tissue
by mistake. In addition, tailoring a dendritic cell vaccine to fight a particular patient’s tumors might not be
economically feasible. But many scientists are working to circumvent the costly and time-consuming steps of
isolating cells from patients and manipulating them in the laboratory for reinjection.
As we learn more about the molecules that control dendritic cells, we will find ways to harness their
therapeutic potential. The increasing number of scientists and corporations working on dendritic cells portends
that we will soon be able to maximize the biological power of these cells to treat and prevent the diseases that
plague humankind.