Ohira Masahiro, Ishiyama Kohei, Tanaka Yuka, Doskali Marlen, Igarashi Yuka, Tashiro Hirotaka, Hiraga Nobuhiko, Imamura Michio, Sakamoto Naoya, Asahara Toshimasa, Chayama Kazuaki, Ohdan Hideki
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku,Hiroshima 734-8551, Japan.
J Clin Invest. 2009 Nov;119(11):3226-35. doi: 10.1172/JCI38374. Epub 2009 Oct 1.
After liver transplantation in HCV-infected patients, the virus load inevitably exceeds pre-transplantation levels. This phenomenon reflects suppression of the host-effector immune responses that control HCV replication by the immunosuppressive drugs used to prevent rejection of the transplanted liver. Here, we describe an adoptive immunotherapy approach, using lymphocytes extracted from liver allograft perfusate (termed herein liver allograft-derived lymphocytes), which includes an abundance of NK/NKT cells that mounted an anti-HCV response in HCV-infected liver transplantation recipients, despite the immunosuppressive environment. This therapy involved intravenously injecting patients 3 days after liver transplantation with liver allograft-derived lymphocytes treated with IL-2 and the CD3-specific mAb OKT3. During the first month after liver transplantation, the HCV RNA titers in the sera of recipients who received immunotherapy were markedly lower than those in the sera of recipients who did not receive immunotherapy. We further explored these observations in human hepatocyte-chimeric mice, in which mouse hepatocytes were replaced by human hepatocytes. These mice unfailingly developed HCV infections after inoculation with HCV-infected human serum. However, injection of human liver-derived lymphocytes treated with IL-2/OKT3 completely prevented HCV infection. Furthermore, an in vitro study using genomic HCV replicon-containing hepatic cells revealed that IFN-gamma-secreting cells played a pivotal role in such anti-HCV responses. Thus, our study presents what we believe to be a novel paradigm for the inhibition of HCV replication in HCV-infected liver transplantation recipients.
在丙型肝炎病毒(HCV)感染患者进行肝移植后,病毒载量不可避免地超过移植前水平。这种现象反映了用于预防移植肝排斥反应的免疫抑制药物对控制HCV复制的宿主效应免疫反应的抑制作用。在此,我们描述了一种过继性免疫治疗方法,即使用从肝移植灌注液中提取的淋巴细胞(本文称为肝移植来源淋巴细胞),其中包含大量NK/NKT细胞,尽管存在免疫抑制环境,但这些细胞在HCV感染的肝移植受者中引发了抗HCV反应。该治疗方法包括在肝移植后3天给患者静脉注射经白细胞介素-2(IL-2)和CD3特异性单克隆抗体OKT3处理的肝移植来源淋巴细胞。在肝移植后的第一个月,接受免疫治疗的受者血清中的HCV RNA滴度明显低于未接受免疫治疗的受者血清中的滴度。我们在人肝细胞嵌合小鼠中进一步探究了这些观察结果,在这些小鼠中,小鼠肝细胞被人肝细胞所取代。这些小鼠在接种HCV感染的人血清后必然会发生HCV感染。然而,注射经IL-2/OKT3处理的人肝来源淋巴细胞完全预防了HCV感染。此外,一项使用含基因组HCV复制子的肝细胞进行的体外研究表明,分泌γ干扰素的细胞在这种抗HCV反应中起关键作用。因此,我们的研究提出了一种我们认为是抑制HCV感染的肝移植受者中HCV复制的新范例。