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治疗性疫苗接种与免疫调节在慢性乙型肝炎治疗中的应用:土拨鼠的临床前研究

Therapeutic vaccination and immunomodulation in the treatment of chronic hepatitis B: preclinical studies in the woodchuck.

作者信息

Kosinska Anna D, Liu Jia, Lu Mengji, Roggendorf Michael

机构信息

Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Virchowstrasse 179, 45122, Essen, Germany.

出版信息

Med Microbiol Immunol. 2015 Feb;204(1):103-14. doi: 10.1007/s00430-014-0379-5. Epub 2014 Dec 23.

Abstract

Infection with hepatitis B virus (HBV) may lead to subclinical, acute or chronic hepatitis. In the prevaccination era, HBV infections were endemic due to frequent mother to child transmission in large regions of the world. However, there are still estimated 240 million chronic HBV carriers today and ca. 620,000 patients die per year due to HBV-related liver diseases. Recommended treatment of chronic hepatitis B with interferon-α and/or nucleos(t)ide analogues does not lead to satisfactory results. Induction of HBV-specific T cells by therapeutic vaccination or immunomodulation may be an innovative strategy to overcome virus persistence. Vaccination with commercially available HBV vaccines in patients with or without therapeutic reduction of viral load did not result in effective immune control of HBV infection, suggesting that combination of antiviral treatment with new formulations of therapeutic vaccines is needed. The woodchuck (Marmota monax) and its HBV-like woodchuck hepatitis virus are a useful preclinical animal model for developing new therapeutic approaches in chronic hepadnaviral infections. Several innovative approaches combining antiviral treatments using nucleos(t)ide analogues, with prime-boost vaccination using DNA vaccines, new hepadnaviral antigens or recombinant adenoviral vectors were tested in the woodchuck model. In this review, we summarize these encouraging results obtained with these therapeutic vaccines. In addition, we present potential innovations in immunostimulatory strategies by blocking the interaction of the inhibitory programmed death receptor 1 with its ligand in this animal model.

摘要

感染乙肝病毒(HBV)可能导致亚临床型、急性或慢性肝炎。在疫苗接种前的时代,由于世界上大片地区母婴传播频繁,HBV感染呈地方性流行。然而,如今估计仍有2.4亿慢性HBV携带者,每年约有62万患者死于HBV相关肝病。推荐使用α干扰素和/或核苷(酸)类似物治疗慢性乙型肝炎,但效果并不理想。通过治疗性疫苗接种或免疫调节诱导HBV特异性T细胞可能是克服病毒持续存在的一种创新策略。对病毒载量经治疗降低或未降低的患者接种市售HBV疫苗,均未有效控制HBV感染,这表明需要将抗病毒治疗与新型治疗性疫苗联合使用。土拨鼠(Marmota monax)及其类似HBV的土拨鼠肝炎病毒是开发慢性嗜肝DNA病毒感染新治疗方法的一种有用的临床前动物模型。在土拨鼠模型中测试了几种创新方法,即将使用核苷(酸)类似物的抗病毒治疗与使用DNA疫苗、新型嗜肝DNA病毒抗原或重组腺病毒载体的初免-加强接种相结合。在这篇综述中,我们总结了这些治疗性疫苗取得的令人鼓舞的结果。此外,我们还介绍了通过在该动物模型中阻断抑制性程序性死亡受体1与其配体的相互作用,在免疫刺激策略方面的潜在创新。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7195/4305085/e535538e40be/430_2014_379_Fig1_HTML.jpg

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