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PLoS One. 2017;12(6):e0179094.

Immunological dynamics associated with rapid virological response during the early phase of type I interferon therapy in patients with chronic hepatitis C.

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제1저자 이재원 · 교신저자 김원, 조남혁

소속 (5)
  1. Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea.
  2. Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea.
  4. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
  5. Institute of Endemic Disease, Seoul National University Medical Research Center and Bundang Hospital, Seoul, Republic of Korea.

Abstract

Type I interferons (IFNs) play an important role in antiviral immunity as well as immunopathogenesis of diverse chronic viral infections. However, the precise mechanisms regulating the multifaceted effects of type I IFNs on the immune system and pathological inflammation still remain unclear. In order to assess the immunological dynamics associated with rapid viral clearance in chronic hepatitis C patients during the acute phase of type I IFN therapy, we analyzed multiple parameters of virological and immunological responses in a cohort of 59 Korean hepatitis C patients who received pegylated IFN-α and ribavirin (IFN/RBV). Most of the Korean patients had favorable alleles in the IFN-λ loci for responsiveness to IFN/RBV (i.e., C/C in rs12979860, T/T in rs8099917, and TT/TT in rs368234815). Rapid virological response (RVR) was determined mainly by the hepatitis C virus genotype. Among the cytokines analyzed, higher plasma levels of IL-17A and FGF were observed in non-RVR patients infected with viral genotype 1 and IP-10 was consistently elevated in RVR group infected with genotype 2 during the early phase of antiviral therapy. In addition, these three cytokines were correlated each other, suggesting a functional linkage of the cytokines in antiviral responses during IFN/RBV therapy. A low baseline frequencies of regulatory T cells and γδ T cells, but high level of group 2 innate lymphoid cells, in peripheral bloods were also significantly associated with the RVR group, implicating a potential role of the cellular immunity during the early phase of IFN/RBV therapy. Therefore, the immunological programs established by chronic hepatitis C and rapid disruption of the delicate balance by exogenous type I IFN might be associated with the subsequent virological outcomes in chronic hepatitis C patients.

Figures

Fig 1
Fig 1 Differential expression of cytokines in the plasma of chronic hepatitis C patients infected with different viral genotypes. The levels of IL-17A, IP-10, FGF, and VEGF in patients’ plasma were examined. The plasma concentrations of four cytokines that were differentially expressed in RVR (R) and non-RVR (NR) patients infected with genotype 1 or genotype 2/6 are presented. The data points (RVR with genotype 1: n = 12, non-RVR with genotype 1: n = 32, RVR with genotype 2: n = 34, non-RVR with genotype 2/6: n = 8) were derived from patients’ samples before and one week after type I IFN therapy. Horizontal bars represent the mean values. **, p < 0.01; ***, p < 0.001.
Fig 2
Fig 2 Correlation of IL-17A, IP-10, and FGF levels in patients’ plasma. The plasma levels of IL-17A were correlated with FGF or IP-10 levels in either a positive or negative way (left two panels). The correlations among the three cytokines are also presented in 3D plot (right panel). The data points (n = 66) derived from patients with RVR (blue dots) and non-RVR (red dots) before and one week after type I IFN therapy are indicated.
Fig 3
Fig 3 Correlation of plasma IL-17A levels with Th17 cells in peripheral blood. The ratio of IL-17A+ CD4 T cells (Th17) per CD4 T cells was positively correlated with plasma IL-17A levels. The data points (n = 39) derived from patients with RVR (blue dots) and non-RVR (red dots) before and one week after type I IFN therapy are indicated (left panel). The proportions (%) of IL-17A+ CD4 T cells (Th17) among peripheral CD4 T cells in patients with RVR (R) and non-RVR (NR) infected with viral genotype 1 or genotype 2 (middle panel) before (W0) and one week (W1) after type I IFN therapy (right panel) are also analyzed. Horizontal bars represent the mean values.
Fig 4
Fig 4 Relative frequencies of Th17 and TReg cells in peripheral blood of chronic hepatitis C patients. The proportions (%) of CD4+CD25+FoxP3+ T cells (TReg) among peripheral CD4 T cells in patients with RVR (R) and non-RVR (NR) before (W0) and one week (W1) after type I IFN therapy are presented (upper panel). TReg: Th17 ratio was also presented in the lower panel. Horizontal bars represent the mean values. *, p < 0.05; **, p < 0.01; ***, p < 0.001. ns, not significant.
Fig 5
Fig 5 Relative frequencies of innate immune cells in peripheral blood of chronic hepatitis C patients. The proportions (%) of γδ T cells, IL-17A+ γδT cells, and group 2 and group 3 innate lymphoid cells (ILC2 and ILC3) in PBMCs of patients with RVR (R) and non-RVR (NR) before (W0) and one week (W1) after type I IFN therapy are presented. Horizontal bars represent the mean values. *, p < 0.05; **, p < 0.01; ***, p < 0.001.

그림 출처: PubMed Central 공개 논문 (PMC5470700)

Conflict of interest statement

Competing Interests:The authors have declared that no competing interests exist.

그 밖의 정보
출판 형태
Journal Article
저널
PloS one · eISSN 1932-6203
전자 출판
2017-06-14
MeSH
Aged · Antiviral Agents / administration & dosage / pharmacology · Drug Therapy, Combination · Female · Gene Expression Regulation / drug effects · Genotype · Hepacivirus / genetics / physiology · Hepatitis C, Chronic / drug therapy / immunology / virology · Humans · Interferon Type I / administration & dosage / pharmacology · Interleukins / genetics · Male · Middle Aged · Prospective Studies · Republic of Korea · Ribavirin / administration & dosage / pharmacology · Treatment Outcome · Viral Load
Substances
Antiviral Agents · Interferon Type I · Interleukins · Ribavirin
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