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[丙型肝炎的免疫学:T细胞反应的临床意义]

[Immunology of hepatitis C: clinical significance of T cell response].

作者信息

Shin Eui-Cheol

机构信息

Immunology Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.

出版信息

Korean J Hepatol. 2006 Jun;12(2):140-53.

Abstract

Hepatitis C virus (HCV) infection is a worldwide problem in terms of public health. It causes chronic hepatitis C in 60-80% of patients after acute hepatitis C. Chronic hepatitis C can progress to liver cirrhosis and hepatocellular carcinoma. In the present time, combination therapy of pegylated interferon-alpha and ribavirin is the standard therapy for hepatitis C, but it results in sustained virologic response only in 45-80% of treated patients. In addition, there is no available effective vaccine for HCV. To develop effective immunotherapy or preventive vaccine, understanding of the immune response against HCV is prerequisite. Among several components of immune system, T cells play a key role in the clearance of HCV and immunopathology during hepatitis C. In the study of HCV infection, however, the most important limiting factor is the absence of small animal model as only humans and chimpanzees can be infected by HCV. In this review, T cell response against HCV, which has been known from the studies of the HCV-infected patients and chimpanzees, will be discussed in several circumstances, including acute hepatitis C, chronic hepatitis C and recovered status from hepatitis C.

摘要

就公共卫生而言,丙型肝炎病毒(HCV)感染是一个全球性问题。急性丙型肝炎后,60 - 80%的患者会发展为慢性丙型肝炎。慢性丙型肝炎可进展为肝硬化和肝细胞癌。目前,聚乙二醇化干扰素-α与利巴韦林联合治疗是丙型肝炎的标准疗法,但仅45 - 80%的接受治疗的患者能实现持续病毒学应答。此外,尚无有效的HCV疫苗。要开发有效的免疫疗法或预防性疫苗,了解针对HCV的免疫反应是先决条件。在免疫系统的几个组成部分中,T细胞在HCV清除及丙型肝炎期间的免疫病理过程中起关键作用。然而,在HCV感染研究中,最重要的限制因素是缺乏小动物模型,因为只有人类和黑猩猩会被HCV感染。在这篇综述中,将在包括急性丙型肝炎、慢性丙型肝炎和丙型肝炎康复状态等几种情况下,讨论从HCV感染患者和黑猩猩研究中已知的针对HCV的T细胞反应。

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