派亚氏淋巴丛（英语：Peyer's patches），又称培氏斑、派尔集合淋巴结，是有组织的淋巴结，以17世纪的瑞士解剖学家约翰·康拉德·派亚命名[1]。它们是肠相关淋巴组织的一个重要部分，通常在人类的小肠最低部分发现，主要在远端空肠和回肠，但也可以在十二指肠中检测到[2]。
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派亚氏淋巴丛在17世纪已经被几个解剖学家观察和描述过[3]，但在1677年，瑞士解剖学家约翰·康拉德·派亚非常清楚地描述这种结状构造，以至于它们最终以他的名字命名[1][4]。然而派亚认为它们是向小肠排放一些促进消化的物质的腺体。直到1850年，瑞士医生鲁道夫·奥斯卡·齐格勒（Rudolph Oskar Ziegler）在仔细的显微镜检查后提出，派亚氏淋巴丛实际上是淋巴腺[5]。
派亚氏淋巴丛是可观察到的肠道上皮细胞的拉长增厚，长度为几公分，在人体中发现约100个。在显微镜下，派亚氏淋巴丛显示为椭圆形或圆形的淋巴滤泡（类似于淋巴结），位于回肠的黏膜层，并延伸到黏膜下层。派亚氏淋巴丛的数量在15至25岁达到高峰，然后在成年期下降[2]。在回肠远端，它们数量众多，形成一个淋巴环。在人类中至少有46%的派亚氏淋巴丛集中在回肠远端25公分处。值得注意的是，不同个体的派亚氏淋巴丛的大小、形状和分布都有很大的差异[6]。在成年人中，B细胞被认为是卵泡生发中心的主导。T细胞存在于滤泡之间的区域。在单核细胞中，CD4+/CD25+（10%）细胞和CD8+/CD25+（5%）细胞在派亚氏淋巴丛中比外周血中更丰富[7]。
派亚氏淋巴丛的特点是滤泡相关上皮（FAE），它覆盖所有的淋巴滤泡[8]。FAE与典型的小肠绒毛上皮不同：它有较少的杯状细胞[9] ，因此黏液层较薄[10]，而且它的特点是存在专门的M细胞或微皱褶细胞，它们提供从腔内吸收和运输抗原的功能[8]。此外，与肠道绒毛相比，FAE的基底层更加多孔[11]。最后，FAE细胞对离子和大分子的渗透性较低，这基本上是由于紧密连接蛋白的较高表达[12]。
由于消化道的管腔暴露在外部环境中，其中大部分是潜在的病原微生物，因此派亚氏淋巴丛在肠腔的免疫监视和促进黏膜内免疫反应的产生方面确立了其重要性。
进入肠道的病原微生物和其他抗原会遇到巨噬细胞、树突状细胞、B细胞和T细胞，这些细胞在派亚氏淋巴丛和肠相关淋巴组织的其他部位发现。因此派亚氏淋巴丛对消化系统的作用就像扁桃体对呼吸系统的作用一样，捕获外来颗粒，监视它们，并将其消灭。
派亚氏淋巴丛被一种特殊的FAE所覆盖，该上皮含有被称为微皱褶细胞（M细胞）的特殊细胞，该细胞直接从管腔中取样抗原并将其传递给抗原呈递细胞（位于其基底面的独特口袋状结构中）。树突状细胞和巨噬细胞也可以通过将树突延伸到经细胞的M细胞特异性孔中来直接对腔体进行采样[13][14]。同时FAE细胞的旁路被紧紧关闭，以防止抗原的渗透和与免疫细胞的持续接触[15]。T细胞、B细胞和记忆细胞在派亚氏淋巴丛遇到抗原时受到刺激，然后这些细胞传到肠系膜淋巴结，免疫反应在那里被放大。被激活的淋巴细胞通过胸导管进入血流，并前往肠道，在那里执行其最终的效应器功能。 B细胞的成熟是在派亚氏淋巴丛中进行的。
尽管在免疫反应中很重要，但派亚氏淋巴丛中淋巴组织的过度生长是病理性的，因为派亚氏淋巴丛的肥大与特发性肠套叠密切相关。
拥有过多或大于正常的派亚氏淋巴丛与朊毒体疾病的风险增加有关。
沙门氏菌属和脊髓灰质炎病毒也针对肠道的这一部分[16]。
Peyer, Johann Conrad. Exercitatio Anatomico-Medica de Glandulis Intestinorum, Earumque Usu et Affectionibus [Anatomical-medical essay on the intestinal glands, and their function and diseases]. Schaffhausen, Switzerland: Onophrius à Waldkirch. 1677 （Latin）.
- Reprinted as: Peyer, Johann Conrad. Exercitatio Anatomico-Medica de Glandulis Intestinorum, Earumque Usu et Affectionibus. Amsterdam, Netherlands: Henrik Wetstein. 1681 [2022-10-02]. （原始内容存档于2022-10-02） （Latin）.
- Peyer referred to Peyer's patches as plexus or agmina glandularum (clusters of glands). From (Peyer, 1681), p. 7: "Tenui a perfectiorum animalium Intestina accuratius perlustranti, crebra hinc inde, variis intervallis, corpusculorum glandulosorum Agmina sive Plexus se produnt, diversae Magnitudinis atque Figurae." (I knew from careful study of more advanced animals, the intestines bear — often here and there, at various intervals — clusters of glandular small bodies or "plexuses" of diverse size and shape.) From p. 15: "(has Plexus seu agmina Glandularum voco)" (I call them "plexuses" or clusters of glands) He described their appearance. From p. 8: "Horum vero Plexuum facies modo in orbem concinnata; modo in Ovi aut Olivae oblongam, aliamve angulosam ac magis anomalam disposita figuram cernitur." (But the configurations of these "plexuses" are arranged at one time in a circle; at another time, it is seen in an egg [shape] or an oblong olive [shape] or other faceted and more irregularly arranged shape.) Drawings of Peyer's patches appear after pages 22 and 24.
Haller, Albrecht von. Elementa Physiologiae corporis humani [Elements of the physiology of the human body] 7. Bern, Switzerland: Societas Typographica. 1765: 35 [2022-10-02]. （原始内容存档于2022-10-04） （Latin）. Anatomists who mentioned Peyer's patches included:
- Johann Theodor Schenck (1619 – 1671): Schenck, Johann Theodor. Exercitationes Anatomicæ ad Usum Medicum Accommodatæ [Anatomical Exercises Suited to Medical Practice]. Jena, (Germany): Johann Ludwig Neuenhahn. 1672: 334 [2022-10-02]. （原始内容存档于2022-10-07） （Latin）. Schenk thought that intestinal worms resided in Peyer's patches and that the orifices of the patches were the worms' mouths. From p. 334: "In canibus saepissime observavi non ad ventriculum … a praeter labente chylo sibi conveniens allicerent." (In dogs, I very often noticed — not only near the stomach but also on the walls of their small intestines — flesh-colored or glandular blisters, [appearing] to swim one after another, [in] which, when we dissected [them], I observed some smooth reddish worms [vermium] living there in clusters [with] their heads facing towards the cavity of the intestines, in which part there were glands with orifices, [but] reversed, so that from there they obtained, from the chyle flowing past, nourishment [that was] suitable for them.)
- Jeremias Loss (1643 – 1684): Loss, Jeremias. Dissertatio Medica de Glandulis in Genere [Medical Discourse on Glands in [Various] Species]. Wittenberg, (Germany): Martin Schultz. 1683: 12 [2022-10-02]. （原始内容存档于2022-10-07） （Latin）. On page 12, Loss states that some glands are located "inter Membranas viscerum quorundam" (between the membranes of certain internal organs) " … prout id in Glandulis Intestinorum satis manifestum est." (as it is quite clear in the glands of the intestines), where "In Intestinis ita congregantur, interdum pauciores, interdum plures, ut areolas quasdam constituant: … " (in the intestines there are thus gathered sometimes fewer [glands], sometimes more [glands], so that they form certain round patches.)
- Johannes Nicolaus Pechlin (1646 – 1706): Pechlin, Johannes Nicolaus. De Purgantium Medicamentorum Facultatibus [On the Means of Medicinal Purges]. Leiden and Amsterdam, Netherlands: Daniel, Abraham, and Adrian à Gaasbeek. 1672: 510 [2022-10-02]. （原始内容存档于2022-10-02） （Latin）. From p. 510: " … ego tenuium glandularum glomeratum agmen esse ratus, … " (… I considered the heaped cluster of fine glands, … )
- Martin Lister (ca. 1638 – 1712): Lister, Martin. A letter of Mr Lister dated May 21. 1673. in York, partly taking notice of the foregoing intimations, partly communicating some anatomical observations and experiments concerning the unalterable character of the whiteness of the chyle within the lacteous veins; together with divers particulars observed in the guts, especially several sorts of worms found in them.. Philosophical Transactions of the Royal Society of London. 23 June 1673, 8 (95): 6060–6065 [2022-10-02]. Bibcode:1673RSPT....8.6060L. doi:10.1098/rstl.1673.0026. （原始内容存档于2022-10-06）. From p. 6062: "As 1. Glandulae miliares of the small Guts, which may also in some Animals be well call'd fragi-formes, from the figure of the one half of a Strawberry, and which yet I take to be Excretive glanduls, because Conglomerate."
- Nehemiah Grew (1641 – 1712): Grew, Nehemiah. The Comparative Anatomy of Stomachs and Guts Begun. Being Several Lectures Read before the Royal Society. In the Year, 1676.. London, England: Self-published. 1681: 3 [2022-10-02]. （原始内容存档于2022-10-02）. Grew called Peyer's patches pancreas intestinale.
There were many earlier names for Peyer's patches:
Ziegler, Rudolph Oskar (1850) Ueber die solitären und Peyerschen Follikel : Inaugural-Abhandlung, der medicinischen Facultät der Julius-Maximilians-Universität zu Würzburg vorgelegt [On solitary and Peyer's follicles: Inaugural treatise, submitted to the medical faculty of the Julius-Maximilians-University of Würzburg] (in German) Würzburg, (Germany): Friederich Ernst Thein. From p. 37: "Ebensogross, wo nicht grösser ist die Aehnlichkeit der sogenannten Peyer'schen Drüsen und der Lymphdrüsen." (Just as great, if not greater, is the resemblance between the so-called Peyer's glands and the lymph glands.) From p. 38: " … ja, man könnte selbst versucht sein, die letzteren für nichts als eine Art von zwischen den Wänden der Darmsschleimhaut eingebetteten Lymphdrüsen zu halten." ( … indeed, one could even be tempted to regard the latter [i.e., the Peyer's patches] as nothing but some type of lymph glands [which are] embedded between the walls of the intestinal mucosa.) Owen RL, Jones AL. Epithelial cell specialization within human Peyer's patches: an ultrastructural study of intestinal lymphoid follicles. Gastroenterology. February 1974, 66 (2): 189–203. PMID 4810912. doi:10.1016/s0016-5085(74)80102-2 
. Takeuchi T, Gonda T. Distribution of the pores of epithelial basement membrane in the rat small intestine. The Journal of Veterinary Medical Science. June 2004, 66 (6): 695–700. PMID 15240945. doi:10.1292/jvms.66.695 . Bonnardel J, Da Silva C, Henri S, Tamoutounour S, Chasson L, Montañana-Sanchis F, Gorvel JP, Lelouard H. Innate and adaptive immune functions of peyer's patch monocyte-derived cells. Cell Reports. May 2015, 11 (5): 770–84. PMID 25921539. doi:10.1016/j.celrep.2015.03.067 . Pascall, C R; Stearn, E J; Mosley, J G, Short Reports, British Medical Journal 281 (6232), 1980-07-05: 26, PMC 1713722 , PMID 7407483, doi:10.1136/bmj.281.6232.26-a, Unlike S hadar peritonitis, S typhi peritonitis is due to perforation of Peyer's patches.
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