丙型肝炎病毒与宿主:相互持久的斗争在宿主免疫中留下不可磨灭的痕迹。
Hepatitis C Virus and the Host: A Mutual Endurance Leaving Indelible Scars in the Host's Immunity.
机构信息
Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
出版信息
Int J Mol Sci. 2023 Dec 23;25(1):268. doi: 10.3390/ijms25010268.
Hepatitis C virus (HCV) has spread worldwide, and it is responsible for potentially severe chronic liver disease and primary liver cancer. Chronic infection remains for life if not spontaneously eliminated and viral persistence profoundly impairs the efficiency of the host's immunity. Attempts have been made to develop an effective vaccine, but efficacy trials have met with failure. The availability of highly efficacious direct-acting antivirals (DAA) has created hope for the progressive elimination of chronic HCV infections; however, this approach requires a monumental global effort. HCV elicits a prompt innate immune response in the host, characterized by a robust production of interferon-α (IFN-α), although interference in IFN-α signaling by HCV proteins may curb this effect. The late appearance of largely ineffective neutralizing antibodies and the progressive exhaustion of T cells, particularly CD8 T cells, result in the inability to eradicate the virus in most infected patients. Moreover, an HCV cure resulting from DAA treatment does not completely restore the normal immunologic homeostasis. Here, we discuss the main immunological features of immune responses to HCV and the epigenetic scars that chronic viral persistence leaves behind.
丙型肝炎病毒(HCV)已在全球范围内传播,可导致潜在的严重慢性肝脏疾病和原发性肝癌。如果不能自发清除,慢性感染将持续终生,病毒持续存在会严重损害宿主免疫的效率。人们曾尝试开发有效的疫苗,但疗效试验均以失败告终。高效直接作用抗病毒药物(DAA)的出现为逐步消除慢性 HCV 感染带来了希望;然而,这需要全球范围内的巨大努力。HCV 在宿主中引发迅速的先天免疫反应,其特征是干扰素-α(IFN-α)的大量产生,尽管 HCV 蛋白对 IFN-α信号的干扰可能会抑制这种作用。大量无效中和抗体的迟发出现以及 T 细胞(尤其是 CD8 T 细胞)的逐渐耗竭,导致大多数感染患者无法清除病毒。此外,DAA 治疗后清除 HCV 并不能完全恢复正常的免疫稳态。在这里,我们讨论了针对 HCV 的免疫反应的主要免疫学特征,以及慢性病毒持续存在所留下的表观遗传痕迹。