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丙型肝炎病毒特异性 T 细胞衍生的转化生长因子-β与缓慢的肝纤维化有关。

Hepatitis C virus-specific T-cell-derived transforming growth factor beta is associated with slow hepatic fibrogenesis.

机构信息

Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA 02215, USA.

出版信息

Hepatology. 2012 Dec;56(6):2094-105. doi: 10.1002/hep.25951.

Abstract

UNLABELLED

Hepatitis C virus (HCV)-specific immune effector responses can cause liver damage in chronic infection. Hepatic stellate cells (HSC) are the main effectors of liver fibrosis. TGFβ, produced by HCV-specific CD8(+) T cells, is a key regulatory cytokine modulating HCV-specific effector T cells. Here we studied TGFβ as well as other factors produced by HCV-specific intrahepatic lymphocytes (IHL) and peripheral blood cells in hepatic inflammation and fibrogenesis. This was a cross-sectional study of two well-defined groups of HCV-infected subjects with slow (≤ 0.1 Metavir units/year, n = 13) or rapid (n = 6) liver fibrosis progression. HCV-specific T-cell responses were studied using interferon-gamma (IFNγ)-ELISpot ±monoclonal antibodies (mAbs) blocking regulatory cytokines, along with multiplex, enzyme-linked immunosorbent assay (ELISA) and multiparameter fluorescence-activated cell sorting (FACS). The effects of IHL stimulated with HCV-core peptides on HSC expression of profibrotic and fibrolytic genes were determined. Blocking regulatory cytokines significantly raised detection of HCV-specific effector (IFNγ) responses only in slow fibrosis progressors, both in the periphery (P = 0.003) and liver (P = 0.01). Regulatory cytokine blockade revealed HCV-specific IFNγ responses strongly correlated with HCV-specific TGFβ, measured before blockade (R = 0.84, P = 0.0003), with only a trend to correlation with HCV-specific IL-10. HCV-specific TGFβ was produced by CD8 and CD4 T cells. HCV-specific TGFβ, not interleukin (IL)-10, inversely correlated with liver inflammation (R = -0.63, P = 0.008) and, unexpectedly, fibrosis (R = -0.46, P = 0.05). In addition, supernatants from HCV-stimulated IHL of slow progressors specifically increased fibrolytic gene expression in HSC and treatment with anti-TGFβ mAb abrogated such expression.

CONCLUSION

Although TGFβ is considered a major profibrogenic cytokine, local production of TGFβ by HCV-specific T cells appeared to have a protective role in HCV-infected liver, together with other T-cell-derived factors, ameliorating HCV liver disease progression.

摘要

未标注

丙型肝炎病毒(HCV)特异性免疫效应反应可导致慢性感染中的肝损伤。肝星状细胞(HSC)是肝纤维化的主要效应细胞。HCV 特异性 CD8+T 细胞产生的 TGFβ是调节 HCV 特异性效应 T 细胞的关键调节细胞因子。在这里,我们研究了 TGFβ以及由 HCV 特异性肝内淋巴细胞(IHL)和外周血细胞产生的其他因子在肝炎症和纤维化中的作用。这是一项对两组明确的 HCV 感染患者的横断面研究,其纤维化进展速度较慢(≤0.1 Metavir 单位/年,n=13)或较快(n=6)。使用干扰素-γ(IFNγ)-ELISpot±单克隆抗体(mAb)阻断调节细胞因子,以及多重、酶联免疫吸附测定(ELISA)和多参数荧光激活细胞分选(FACS)研究了 HCV 特异性 T 细胞反应。测定了用 HCV 核心肽刺激的 IHL 对 HSC 表达纤维生成和纤维溶解基因的影响。仅在纤维化进展较慢的患者中,阻断调节细胞因子可显著提高 HCV 特异性效应(IFNγ)反应的检测率,无论是在外周(P=0.003)还是在肝脏(P=0.01)。调节细胞因子阻断揭示 HCV 特异性 IFNγ 反应与 HCV 特异性 TGFβ强烈相关,在阻断之前进行测量(R=0.84,P=0.0003),仅呈与 HCV 特异性 IL-10 相关的趋势。HCV 特异性 TGFβ由 CD8 和 CD4 T 细胞产生。HCV 特异性 TGFβ,而非白细胞介素(IL)-10,与肝炎症(R=-0.63,P=0.008),出人意料地与纤维化(R=-0.46,P=0.05)呈负相关。此外,来自纤维化进展较慢的患者的 HCV 刺激的 IHL 的上清液特异性增加了 HSC 的纤维溶解基因表达,并且用抗 TGFβ mAb 治疗消除了这种表达。

结论

尽管 TGFβ被认为是主要的促纤维化细胞因子,但 HCV 特异性 T 细胞的局部产生似乎在 HCV 感染的肝脏中具有保护作用,与其他 T 细胞衍生的因子一起,改善 HCV 肝病的进展。

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