Suresh Manasa, Menne Stephan
Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC 20057, United States.
World J Gastrointest Oncol. 2021 Jun 15;13(6):509-535. doi: 10.4251/wjgo.v13.i6.509.
This review describes woodchucks chronically infected with the woodchuck hepatitis virus (WHV) as an animal model for hepatocarcinogenesis and treatment of primary liver cancer or hepatocellular carcinoma (HCC) induced by the hepatitis B virus (HBV). Since laboratory animal models susceptible to HBV infection are limited, woodchucks experimentally infected with WHV, a hepatitis virus closely related to HBV, are increasingly used to enhance our understanding of virus-host interactions, immune response, and liver disease progression. A correlation of severe liver pathogenesis with high-level viral replication and deficient antiviral immunity has been established, which are present during chronic infection after WHV inoculation of neonatal woodchucks for modeling vertical HBV transmission in humans. HCC in chronic carrier woodchucks develops 17 to 36 mo after neonatal WHV infection and involves liver tumors that are comparable in size, morphology, and molecular gene signature to those of HBV-infected patients. Accordingly, woodchucks with WHV-induced liver tumors have been used for the improvement of imaging and ablation techniques of human HCC. In addition, drug efficacy studies in woodchucks with chronic WHV infection have revealed that prolonged treatment with nucleos(t)ide analogs, alone or in combination with other compounds, minimizes the risk of liver disease progression to HCC. More recently, woodchucks have been utilized in the delineation of mechanisms involved in innate and adaptive immune responses against WHV during acute, self-limited and chronic infections. Therapeutic interventions based on modulating the deficient host antiviral immunity have been explored in woodchucks for inducing functional cure in HBV-infected patients and for reducing or even delaying associated liver disease sequelae, including the onset of HCC. Therefore, woodchucks with chronic WHV infection constitute a well-characterized, fully immunocompetent animal model for HBV-induced liver cancer and for preclinical evaluation of the safety and efficacy of new modalities, which are based on chemo, gene, and immune therapy, for the prevention and treatment of HCC in patients for which current treatment options are dismal.
本综述将慢性感染土拨鼠肝炎病毒(WHV)的土拨鼠描述为肝癌发生以及治疗由乙型肝炎病毒(HBV)引起的原发性肝癌或肝细胞癌(HCC)的动物模型。由于易感染HBV的实验动物模型有限,越来越多地使用经实验感染与HBV密切相关的肝炎病毒WHV的土拨鼠,以增进我们对病毒-宿主相互作用、免疫反应和肝病进展的理解。已证实严重的肝脏病变与高水平病毒复制和抗病毒免疫缺陷相关,这些情况在新生土拨鼠接种WHV以模拟人类HBV垂直传播后的慢性感染期间出现。慢性携带病毒的土拨鼠在新生期感染WHV后17至36个月会发生HCC,所涉及的肝肿瘤在大小、形态和分子基因特征方面与HBV感染患者的肿瘤相似。因此,患有WHV诱导性肝肿瘤的土拨鼠已被用于改进人类HCC的成像和消融技术。此外,对慢性感染WHV的土拨鼠进行的药物疗效研究表明,单独或与其他化合物联合使用核苷酸类似物进行长期治疗,可将肝病进展为HCC的风险降至最低。最近,土拨鼠已被用于阐明急性、自限性和慢性感染期间针对WHV的固有免疫和适应性免疫反应所涉及的机制。在土拨鼠中探索了基于调节宿主抗病毒免疫缺陷的治疗干预措施,以诱导HBV感染患者实现功能性治愈,并减少甚至延缓相关肝病后遗症,包括HCC的发生。因此,慢性感染WHV的土拨鼠构成了一个特征明确、具有完全免疫能力的动物模型,可用于HBV诱导的肝癌研究,以及基于化学疗法、基因疗法和免疫疗法的新方法预防和治疗HCC的安全性和有效性的临床前评估,而目前针对这些患者的治疗选择效果不佳。