Revisiting the Th1/Th2 paradigm.

The identification of subsets of CD4+ helper cells producing distinct pattern of cytokines has provided a valuable framework for understanding how different effector populations of immune cells can be recruited in vivo during infection. In the view of most investigators, Th1 and Th2 cells produce factors that serve as their own autocrine factors and cytokines exerting suppressive activities on each other's development and activity. This concept intuitively explains the natural tendency of immune responses to become progressively polarized. However, several experimental observations appear difficult to rationalize with a simple, 'symmetrical' Th1/Th2 paradigm including those that Th1 cells do not produce their own growth factor; that both Th1 and Th2 cells can promote inflammatory responses; that interleukin-10 (IL-10) inhibits inflammatory responses in a Th1/Th2-independent fashion; that IL-10 promotes the development of Th1-type effector cells; and that IL-12 can amplify pre-established Th2 responses. The purpose of the present analysis is to provide a revised model for better understanding how cytokines regulate immune responses in vivo.