Departimento of Medicina Interna, Sapienza Università di Roma, Fondazione Andrea Cesalpino, Fondazione Cenci Bolognetti, Italy.
J Hepatol. 2010 Oct;53(4):752-61. doi: 10.1016/j.jhep.2010.06.003. Epub 2010 Jun 25.
This review covers the various aspects of the immune system that allows the relationship between the hepatitis-C virus, the host and chronic low-level inflammation, to be highly flexible and able to defend the host from persistent infections. This ambiguity mainly stems from the property of the immune system that can be both protective and harmful. Immunity cannot be fully protective without producing a certain degree of damage (acute hepatitis resulting in resolving HCV infection). In addition, the balance between protection and tissue damage is critical for the development of chronic HCV infection. The establishment of a state of chronic low-level inflammation is instrumental to limit liver immunopathology, to limit viral spread, and ultimately to ensure a long-lasting survival of the host. It is dictated by a fine equilibrium maintained by multiple immunologic mechanisms, including: sensory perception of innate immunity, virus-specific T and B cell functions, control of immune responses, and finally the balance between immunity and immunopathology that has principally evolved to favor the survival of the species.
本综述涵盖了免疫系统的各个方面，这些方面使得丙型肝炎病毒、宿主和慢性低水平炎症之间的关系具有高度的灵活性，并使宿主能够抵御持续性感染。这种模糊性主要源于免疫系统的特性，它既具有保护性，也具有危害性。如果没有产生一定程度的损伤（导致 HCV 感染消除的急性肝炎），免疫就不能完全起到保护作用。此外，保护和组织损伤之间的平衡对于慢性 HCV 感染的发展至关重要。慢性低水平炎症状态的建立有助于限制肝脏免疫病理学，限制病毒传播，最终确保宿主的长期存活。这是由多种免疫机制维持的精细平衡决定的，包括：先天免疫的感应、病毒特异性 T 细胞和 B 细胞功能、免疫反应的控制，以及最终在免疫和免疫病理学之间的平衡，这些主要是为了有利于物种的生存而进化的。
