The mechanisms underlying innate immune memory have been extensively explored in the last decades but are in fact largely unknown. While the specificity of adaptive immune memory in vertebrates is ensured through the recombination of immunoglobulin family genes and clonal expansion, the basic mechanisms of innate immune cells' non-specific increased responsiveness rely on epigenetic, transcriptional, and metabolic programs after transient stimulation. Changes in these programs result in enhanced responsiveness to secondary challenges with a wide variety of stimuli. This phenomenon is termed 'trained immunity' or 'innate immune memory'. On the one hand, trained immunity improves the response to infections and vaccination, facilitating stronger innate immune responses and enhanced protection against a variety of microbial stimuli. Conversely, trained immunity may contribute to the pathophysiology of cardiovascular, autoinflammatory and neurodegenerative diseases. In this review, we will gather the current body of knowledge in this field and summarize the foundations and mechanisms of trained immunity, the different cell types involved, its consequences for health and disease and the potential of its modulation as a therapeutic tool.

中文翻译：

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训练有素的免疫：先天免疫机制内的适应

在过去的几十年里，先天免疫记忆的机制已经被广泛探索，但实际上在很大程度上是未知的。虽然脊椎动物适应性免疫记忆的特异性是通过免疫球蛋白家族基因的重组和克隆扩增来确保的，但先天免疫细胞非特异性增加反应性的基本机制依赖于瞬时刺激后的表观遗传、转录和代谢程序。这些计划的变化导致对各种刺激的次要挑战的响应能力增强。这种现象被称为“训练有素的免疫”或“先天免疫记忆”。一方面，训练有素的免疫力提高了对感染和疫苗接种的反应，促进了更强的先天免疫反应，并增强了对各种微生物刺激的保护。相反，训练有素的免疫力可能有助于心血管、自身炎症和神经退行性疾病的病理生理学。在这篇综述中，我们将收集该领域当前的知识体系，并总结训练免疫的基础和机制、所涉及的不同细胞类型、其对健康和疾病的影响以及其作为治疗工具的调节潜力。