Translational Hepatology Unit, Guadalajara University Hospital, E-19002 Guadalajara, Spain.
Department of Biology of Systems, University of Alcalá, E-28805 Alcalá de Henares, Spain.
Cells. 2021 Mar 3;10(3):538. doi: 10.3390/cells10030538.
Hepatitis C virus (HCV)-specific CD8 T cell response is essential in natural HCV infection control, but it becomes exhausted during persistent infection. Nowadays, chronic HCV infection can be resolved by direct acting anti-viral treatment, but there are still some non-responders that could benefit from CD8 T cell response restoration. To become fully reactive, T cell needs the complete release of T cell receptor (TCR) signalling but, during exhaustion this is blocked by the PD-1 effect on CD28 triggering. The T cell pool sensitive to PD-1 modulation is the progenitor subset but not the terminally differentiated effector population. Nevertheless, the blockade of PD-1/PD-L1 checkpoint cannot be always enough to restore this pool. This is due to the HCV ability to impair other co-stimulatory mechanisms and metabolic pathways and to induce a pro-apoptotic state besides the TCR signalling impairment. In this sense, gamma-chain receptor cytokines involved in memory generation and maintenance, such as low-level IL-2, IL-7, IL-15, and IL-21, might carry out a positive effect on metabolic reprogramming, apoptosis blockade and restoration of co-stimulatory signalling. This review sheds light on the role of combinatory immunotherapeutic strategies to restore a reactive anti-HCV T cell response based on the mixture of PD-1 blocking plus IL-2/IL-7/IL-15/IL-21 treatment.
丙型肝炎病毒(HCV)特异性 CD8 T 细胞反应是自然 HCV 感染控制的关键,但在持续感染过程中会衰竭。如今,慢性 HCV 感染可以通过直接作用抗病毒治疗来解决,但仍有一些无应答者可以从 CD8 T 细胞反应恢复中受益。为了完全反应,T 细胞需要完全释放 T 细胞受体(TCR)信号,但在衰竭过程中,这会被 PD-1 对 CD28 触发的作用阻断。对 PD-1 调节敏感的 T 细胞池是祖细胞亚群,但不是终末分化的效应细胞群。然而,阻断 PD-1/PD-L1 检查点并不总是足以恢复该池。这是由于 HCV 能够损害其他共刺激机制和代谢途径,并在 TCR 信号传导受损之外诱导促凋亡状态。在这种意义上,涉及记忆生成和维持的 γ 链受体细胞因子,如低水平的 IL-2、IL-7、IL-15 和 IL-21,可能对代谢重编程、凋亡阻断和共刺激信号的恢复产生积极影响。这篇综述阐明了基于 PD-1 阻断加 IL-2/IL-7/IL-15/IL-21 治疗混合的组合免疫治疗策略在恢复针对 HCV 的反应性 T 细胞反应中的作用。
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