Kondo Yasuteru, Ueno Yoshiyuki, Shimosegawa Tooru
Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-ku, Sendai City, Miyagi 980-8574, Japan.
Hepat Res Treat. 2011;2011:713216. doi: 10.1155/2011/713216. Epub 2011 Jun 14.
Patients with chronic hepatitis C (CHC) virus infection who have persistently normal alanine aminotransferase levels (PNALT) have mild inflammation and fibrosis in comparison to those with elevated ALT levels. The cellular immune responses to HCV are mainly responsible for viral clearance and the disease pathogenesis during infection. However, since the innate and adaptive immune systems are suppressed by various kinds of mechanisms in CHC patients, the immunopathogenesis of CHC patients with PNALT is still unclear. In this review, we summarize the representative reports about the immune suppression in CHC to better understand the immunopathogenesis of PNALT. Then, we summarize and speculate on the immunological aspects of PNALT including innate and adaptive immune systems and genetic polymorphisms of HLA and cytokines.
与丙氨酸氨基转移酶（ALT）水平升高的慢性丙型肝炎（CHC）病毒感染患者相比，ALT水平持续正常（PNALT）的CHC病毒感染患者炎症和纤维化程度较轻。对HCV的细胞免疫反应在感染期间主要负责病毒清除和疾病发病机制。然而，由于CHC患者的先天性和适应性免疫系统受到各种机制的抑制，PNALT的CHC患者的免疫发病机制仍不清楚。在本综述中，我们总结了关于CHC免疫抑制的代表性报告，以更好地理解PNALT的免疫发病机制。然后，我们总结并推测了PNALT的免疫学方面，包括先天性和适应性免疫系统以及HLA和细胞因子的基因多态性。
