Di Scala Marianna, Otano Itziar, Gil-Fariña Irene, Vanrell Lucia, Hommel Mirja, Olagüe Cristina, Vales Africa, Galarraga Miguel, Guembe Laura, Ortiz de Solorzano Carlos, Ghosh Indrajit, Maini Mala K, Prieto Jesús, González-Aseguinolaza Gloria
Gene Therapy and Regulation of Gene Expression Program, Center for Applied Medical Research (CIMA), Pamplona, Spain Instituto de Investigación Sanitaria de Navarra (IdisNA), Pamplona, Spain.
Division of Infection and Immunity, University College London, London, United Kingdom.
J Virol. 2016 Sep 12;90(19):8563-74. doi: 10.1128/JVI.01030-16. Print 2016 Oct 1.
In chronic hepatitis B (CHB), failure to control hepatitis B virus (HBV) is associated with T cell dysfunction. HBV transgenic mice mirror many features of the human disease, including T cell unresponsiveness, and thus represent an appropriate model in which to test novel therapeutic strategies. To date, the tolerant state of CD8(+) T cells in these animals could be altered only by strong immunogens or by immunization with HBV antigen-pulsed dendritic cells; however, the effectors induced were unable to suppress viral gene expression or replication. Because of the known stimulatory properties of alpha interferon (IFN-α) and interleukin-15 (IL-15), this study explored the therapeutic potential of liver-directed gene transfer of these cytokines in a murine model of CHB using adeno-associated virus (AAV) delivery. This combination not only resulted in a reduction in the viral load in the liver and the induction of an antibody response but also gave rise to functional and specific CD8(+) immunity. Furthermore, when splenic and intrahepatic lymphocytes from IFN-α- and IL-15-treated animals were transferred to new HBV carriers, partial antiviral immunity was achieved. In contrast to previous observations made using either cytokine alone, markedly attenuated PD-L1 induction in hepatic tissue was observed upon coadministration. An initial study with CHB patient samples also gave promising results. Hence, we demonstrated synergy between two stimulating cytokines, IL-15 and IFN-α, which, given together, constitute a potent approach to significantly enhance the CD8(+) T cell response in a state of immune hyporesponsiveness. Such an approach may be useful for treating chronic viral infections and neoplastic conditions.
With 350 million people affected worldwide and 600,000 annual deaths due to HBV-induced liver cirrhosis and/or hepatocellular carcinoma, chronic hepatitis B (CHB) is a major health problem. However, current treatment options are costly and not very effective and/or need to be administered for life. The unprecedented efficacy of the strategy described in our paper may offer an alternative and is relevant for a broad spectrum of readers because of its clear translational importance to other chronic viral infections in which a hyporesponsive antigen-specific T cell repertoire prevents clearance of the pathogen.
在慢性乙型肝炎(CHB)中,无法控制乙型肝炎病毒(HBV)与T细胞功能障碍有关。HBV转基因小鼠反映了人类疾病的许多特征,包括T细胞无反应性,因此是测试新型治疗策略的合适模型。迄今为止,这些动物中CD8(+) T细胞的耐受状态只能通过强免疫原或用HBV抗原脉冲的树突状细胞免疫来改变;然而,诱导的效应细胞无法抑制病毒基因表达或复制。由于已知α干扰素(IFN-α)和白细胞介素-15(IL-15)的刺激特性,本研究利用腺相关病毒(AAV)递送,探索了在CHB小鼠模型中肝脏定向基因转移这些细胞因子的治疗潜力。这种联合不仅导致肝脏中病毒载量的降低和抗体反应的诱导,还产生了功能性和特异性的CD8(+)免疫。此外,当将来自IFN-α和IL-15处理动物的脾细胞和肝内淋巴细胞转移到新的HBV携带者时,实现了部分抗病毒免疫。与之前单独使用任何一种细胞因子的观察结果相反,联合给药时在肝组织中观察到PD-L1诱导明显减弱。对CHB患者样本的初步研究也给出了有希望的结果。因此,我们证明了两种刺激细胞因子IL-15和IFN-α之间的协同作用,它们共同构成了一种有效方法,可在免疫低反应状态下显著增强CD8(+) T细胞反应。这种方法可能对治疗慢性病毒感染和肿瘤性疾病有用。
慢性乙型肝炎(CHB)是一个主要的健康问题,全球有3.5亿人受其影响,每年有60万人死于HBV引起的肝硬化和/或肝细胞癌。然而,目前的治疗选择成本高昂且效果不佳和/或需要终身给药。我们论文中描述的策略具有前所未有的疗效,可能提供一种替代方案,并且由于其对其他慢性病毒感染具有明确的转化重要性,对广泛的读者群体都有意义,在这些慢性病毒感染中,低反应性的抗原特异性T细胞库阻止了病原体的清除。