Giannandrea Matthew, Pierce Robert H, Crispe Ian Nicholas
David H. Smith Center for Vaccine Biology and Immunology, Aab Institute for Biomedical Research, University of Rochester Medical Center, Rochester NY 14642-8609, USA.
Hepatology. 2009 Jun;49(6):2010-20. doi: 10.1002/hep.22869.
CD8+ T cells can cause hepatocellular injury by two distinct mechanisms. In addition to their direct cytotoxic effect, there is also collateral liver injury, which occurs when cells are killed in an antigen-independent manner. Whereas immune effector cytokines interferon-gamma (IFNgamma) and tumor necrosis factor-alpha (TNFalpha) have both been implicated in various forms of hepatitis, their respective roles in direct and/or collateral liver damage remains unclear. In order to investigate these elements of liver injury, we developed a new experimental model of CD8+ T-cell-mediated hepatitis based on an adeno-associated virus-based gene therapy vector. This vector is used to deliver antigen to hepatocytes, and CD8+ T cells specific for the vector-encoded transgene are adoptively transferred to produce liver immunopathology. In this experimental model, CD8+ T-cell IFNgamma acts on Kupffer cells, inducing TNFalpha secretion and liver injury. Both IFNgamma and TNFalpha are important in this injury process, but TNFalpha acts as an autocrine amplifier of Kupffer cell function, rather than as a direct effector of hepatocellular damage.
TNFalpha indirectly promotes liver damage and is not a direct hepatotoxic agent. IFNgamma also indirectly contributes to liver injury through Kupffer cell activation while, in parallel, directly promoting hepatitis through induction of hepatocyte major histocompatability complex class I. In principle, it may be possible to ameliorate this immunopathologic indirect mechanism by developing therapies that target Kupffer cells, without impairing CD8+ T-cell-mediated antiviral immunity. This would have great therapeutic potential in chronic viral hepatitis.
CD8 + T细胞可通过两种不同机制导致肝细胞损伤。除了直接细胞毒性作用外,还存在间接肝损伤,即细胞以抗原非依赖方式被杀伤时发生的损伤。虽然免疫效应细胞因子γ干扰素(IFNγ)和肿瘤坏死因子α(TNFα)均与多种形式的肝炎有关,但其在直接和/或间接肝损伤中的各自作用仍不清楚。为了研究肝损伤的这些因素,我们基于腺相关病毒基因治疗载体开发了一种新的CD8 + T细胞介导的肝炎实验模型。该载体用于将抗原递送至肝细胞,并过继转移对载体编码转基因特异的CD8 + T细胞以产生肝脏免疫病理学变化。在该实验模型中,CD8 + T细胞IFNγ作用于库普弗细胞,诱导TNFα分泌和肝损伤。IFNγ和TNFα在该损伤过程中均很重要,但TNFα作为库普弗细胞功能的自分泌放大器,而非肝细胞损伤的直接效应因子。
TNFα间接促进肝损伤,并非直接肝毒性剂。IFNγ也通过激活库普弗细胞间接导致肝损伤,同时通过诱导肝细胞主要组织相容性复合体I类直接促进肝炎。原则上,有可能通过开发靶向库普弗细胞的疗法来改善这种免疫病理间接机制,而不损害CD8 + T细胞介导的抗病毒免疫。这在慢性病毒性肝炎中具有巨大的治疗潜力。