Pathology of hepatitis C

Abstract: The basic morphological patterns of acute or chronic viral hepatitides are very similar, irrespective of the causative hepatitis viruses A, B, C, D or E. In addition, however, acute and chronic hepatitis C shows characteristic, although not pathognomonic histological changes. These consist of lymphoid aggregates in portal tracts, sometimes with germinal centers, damage of bile duct epithelium, and micro- or macrovesicular steatosis of hepatocytes. A combination of two of these three characteristic alterations is seen in over half of the patients with chronic hepatitis C and is helpful in the histological diagnosis of the disease.     

丙型肝炎病毒抗体化学发光免疫检测方法的建立及其临床应用简

目的：建立丙型肝炎病毒（rmv）抗体化学发光免疫检测方法,并分析其临床应用价值。方法：应用基因工程重组的HCV抗原包被微孔板,以辣根过氧化物酶标记的羊抗人IgG为二抗,并结合鲁米诺化学发光底物系统,建立HCV抗体化学发光免疫检测方法;应用HCV抗体诊断试剂国家参考品分析所建立方法的特异性、灵敏度、稳定性和精密性,并-9北京万泰公司的ELISA试剂盒同时检测临床血清样本350份,比较检测结果。结果：检测结果符合国家参考品质量标准。批内变异系数5．1％。6．6％,批间变异系数9-5％;试剂盒置37℃考核3d,其稳定性良好;与万泰公司的ELISA检测结果对照,阳性符合率分别为99．0％,阴性符合率分别为100％,总符合率为99．4％;Kappa值为0．986,一致性强度最强。结论：建立了特异、敏感和稳定的HCV抗体化学发光免疫检测方法,适用于HCV感染的批量筛查,具有较大的临床应用价值。     

Increased frequency of micronuclei in the lymphocytes of patients chronically infected with hepatitis B or hepatitis C virus

In this study, we analysed the frequency of micronuclei (MN), nucleoplasmic bridges (NPBs) and nuclear buds (NBUDs) and evaluated mutagen-induced sensitivity in the lymphocytes of patients chronically infected with hepatitis B virus (HBV) or hepatitis C virus (HCV). In total, 49 patients with chronic viral hepatitis (28 HBV-infected and 21 HCV-infected patients) and 33 healthy, non-infected blood donor controls were investigated. The frequencies (‰) of MN, NPBs and NBUDs in the controls were 4.41 ± 2.15, 1.15 ± 0.97 and 2.98 ± 1.31, respectively. The frequencies of MN and NPBs were significantly increased (p < 0.0001) in the patient group (7.01 ± 3.23 and 2.76 ± 2.08, respectively) compared with the control group. When considered separately, the HBV-infected patients (7.18 ± 3.57) and HCV-infected patients (3.27 ± 2.40) each had greater numbers of MN than did the controls (p < 0.0001). The HCV-infected patients displayed high numbers of NPBs (2.09 ± 1.33) and NBUDs (4.38 ± 3.28), but only the HBV-infected patients exhibited a significant difference (NPBs = 3.27 ± 2.40, p < 0.0001 and NBUDs = 4.71 ± 2.79, p = 0.03) in comparison with the controls. Similar results were obtained for males, but not for females, when all patients or the HBV-infected group was compared with the controls. The lymphocytes of the infected patients did not exhibit sensitivity to mutagen in comparison with the lymphocytes of the controls (p = 0.06). These results showed that the lymphocytes of patients who were chronically infected with HBV or HCV presented greater chromosomal instability.     

A personal account of the role of peptide research in drug discovery: the case of hepatitis C.

Although peptides themselves are not usually the end products of a drug discovery effort, peptide research often plays a key role in many aspects of this process. This will be illustrated by reviewing the experience of peptide research carried out at IRBM in the course of our study of hepatitis C virus (HCV). The target of our work is the NS3/4A protease, which is essential for maturation of the viral polyprotein. After a thorough examination of its substrate specificity we fine-tuned several substrate-derived peptides for enzymology studies, high-throughput screening and as fluorescent probes for secondary binding assays. In the course of these studies we made the key observation: that the protease is inhibited by its own cleavage products. Single analog and combinatorial optimization then derived potent peptide inhibitors. The crucial role of the NS4A cofactor was also addressed. NS4A is a small transmembrane protein, whose central domain is the minimal region sufficient for enzyme activation. Structural studies were performed with a peptide corresponding to the minimal activation domain, with a series of product inhibitors and with both. We found that NS3/4A is an induced fit enzyme, requiring both the cofactor and the substrate to acquire its bioactive conformation; this explained some puzzling results of 'serine-trap' type inhibitors. A more complete study on NS3 activation, however, requires the availability of the full-length NS4A protein. This was prepared by native chemical ligation, after sequence engineering to enhance its solubility; structural studies are in progress. Current work is focused on the P' region of the substrate, which, at variance with the P region, is not used for ground state binding to the enzyme and might give rise to inhibitors showing novel interactions with the enzyme.     

Hepatitis C in India

Hepatitis C is an emerging infection in India and an important pathogen causing liver disease in India. The high risk of chronicity of this blood-borne infection and its association with hepatocellular carcinoma underscores its public health importance. Blood transfusion and unsafe therapeutic interventions by infected needles are two preventable modalities of spread of hepatitis C infection. In addition, risk factor modification by reducing the number of intravenous drug users will help curtail the prevalence of this infection. This review summarizes the extent, nature and implications of this relatively new pathogen in causing disease in India.     

The decline in antibodies to hepatitis C virus during antiviral therapy

The goal of the study was to analyze B-cell response to hepatitis C virus during antiviral therapy among responders and non-responders. The content of antibodies to individual structural and non-structural HCV proteins was investigated during two years in three groups of patients: initial responders, non-responders and a reference group (without therapy). Treated patients in all groups exhibited the decrease in antibodies to analyzed HCV proteins, but with different patterns. The first statistically significant differences in the decline of the virus-specific antibodies between initial responders and non-responders were observed within the first three months after the beginning of therapy. Some treated patients demonstrated the decrease in antibody levels to HCV proteins after the end of therapy.     

Osteopontin gene polymorphisms as predictors for the efficacy of interferon therapy in chronic hepatitis C Egyptian patients with genotype 4

This study aimed to determine the relationship between osteopontin gene polymorphisms and its protein level and the efficacy of interferon‐based therapies in Hepatitis C virus (HCV) patients. Hundreds HCV patients genotype 4, treated with pegylated interferon alfa‐2b plus ribavirin and 60 healthy subjects were enrolled. All individuals were subjected to clinical and laboratory parameters, including hepatitis markers and HCV quantitation by real‐time polymerase chain reaction. Single nucleotide polymorphisms (SNPs) of osteopontin (OPN) gene (nucleotide ?155, ?443 and ?1748) were analysed by direct sequencing in addition to estimation of serum level of OPN. SNP at ?443 (C/C versus C/T, T/T) was found to represent predictors for treatment response by univariate logistic regression analysis. OPN serum level was independent predictors for treatment response by both univariate and multivariate logistic regression analysis. SNP at nucleotide ?443 and serum OPN protein levels could be used as useful markers to predict the efficacy of treatment. Copyright © 2013 John Wiley & Sons, Ltd.     

The natural course of chronic hepatitis C

Abstract: In 1988, investigators from the Chiron Company (USA) detected the non-A, non-B agent and named it hepatitis C virus (HCV). An anti-HCV antibody assay (ELISA) and subsequently confirmation tests (immunoblot and polymerase chain reaction) were developed. HCV exposure results in a chronic infection in a majority of cases. This chronic infection is associated with slowly progressive chronic liver disease. Chronic HCV infection is, like HBV, also associated with the development of hepatocellular carcinoma. Most HCV carriers are infected by parenteral routes. Intravenous drug users have the highest risk of becoming infected. Intrafamiliar spread is seen in certain parts of the world but sexual and perinatal transmission does not play an important role in spreading the infection. Antiviral therapy (alpha-interferon) in patients with chronic hepatitis C will normalize liver function tests in about 25% of the cases.     

慢性乙型肝炎患者肝组织和外周血白细胞中钠离子依赖性维生素C转运体的表达

用免疫组化和Western blot技术检测SVCT1和SVCT2蛋白在慢性乙型肝炎患者及正常人外周血白细胞中的表达.免疫组化结果显示：在慢性乙型肝炎患者肝组织中SVCT1和SVCT2蛋白的阳性表达率和阳性表达强度显著低于正常肝组织（P〈0.01）;Western-blot检测显示,慢性乙型肝炎患者外周血白细胞中SVCT1表达缺失,SVCT2蛋白表达强度为0.481&#177;0.056,均显著低于正常人（分别为0.325&#177;0.085和0.971&#177;0.140）（P〈0.01）.提示慢性乙型肝炎患者体内肝细胞和外周血白细胞存在SVCT1和SVCT2蛋白表达低下或缺失;SVCT1和SVCT2蛋白表达低下或缺失可能是乙型肝炎病毒易感性的主要原因之一.     

Human oncogenic viruses: Hepatitis B and hepatitis C viruses and their role in hepatocarcinogenesis

Chronic infections caused by hepatitis B virus (HBV) and/or hepatitis C virus (HCV) are the main risk factors for the development of hepatocellular carcinoma (HCC) in humans. Both viruses cause a wide spectrum of clinical manifestations ranging from healthy carrier state to acute and chronic hepatitis, liver cirrhosis, and HCC. HBV and HCV belong to different viral families (Hepadnoviridae and Flaviviridae, respectively); they are characterized by different genetic structures. Clinical manifestations of these viral infections result from the interaction between these viruses and host hepatocytes (i.e. between viral and cell genomes). Proteins encoded by both viruses play an important role in processes responsible for immortalization and transformation of these cells. Chronic inflammation determined by host immune response to the viral infection, hepatocyte death and their compensatory proliferation, as well as modulation of expression of some regulatory proteins of the cell (growth factors, cytokines, etc.) are the processes that play the major role in liver cancer induced by HBV and HCV.     

丙型肝炎病毒受体研究进展

丙型肝炎病毒(HCV)入侵宿主细胞是在多种受体联合介导下才能完成的复杂过程.我们针对已报道的HCV 可能的细胞受体 CD81、低密度脂蛋白受体、B 族Ⅰ型清道夫受体、紧密连接蛋白家族、表皮生长子受体、酪氨酸激酶 EphA2受体、NPC1L1受体展开介绍,为今后研究和探索新型 HCV 疫苗和药物奠定基础.     

丙型肝炎病毒诊断参考品的研究进展

体外诊断试剂的参考品是由逐一反复论证的一套样品所组成,用于全面控制试剂质量,它对于试剂应达到的各种指标提出了全面要求。目前国际上常用的丙型肝炎诊断试剂参考品为抗HCV抗体血清参考品和核酸检测参考品,我们简要综述了丙型肝炎病毒诊断试剂参考品的研制及发展。     

慢性丙型肝炎患者中丙型肝炎病毒准种变异研究进展

丙型肝炎病毒（HCV）具有较高的变异性,通常以准种的形式分布在感染者的体内,病毒容易逃离机体的免疫监控,因而无法被有效地清除,导致机体很难控制其感染的发展,故易转变成慢性肝炎。HCV准种变异在宿主体内的持续存在对病毒感染的控制、抗病毒药物和疫苗的发展都是一个巨大的挑战。,我们重点阐述近年来关于HCV准种变异及其与慢性丙型肝炎患者的机体免疫、疾病进展、治疗效果之间关系的研究进展。     

用国产重组抗原研制丙肝病毒抗体检测试剂

用克隆表达的丙型肝炎病毒核心蛋白及非结构 3区蛋白、非结构 4区蛋白和非结构 5区蛋白作为抗原 ,研制装配了第三代丙肝病毒抗体检测试剂。用该试剂检测国家第三代丙肝病毒抗体检测试剂标准血清 ,40份阴性血清全部符合 ,40份阳性血清出现 1份假阴性。分析探讨了各种影响试剂质量的因素     

Hepatitis C virus (HCV) genotyping by annealing reverse transcription-PCR products with genotype-specific capture probes

The genotype of the hepatitis C virus (HCV) strain infecting a given patient is an important predictive factor for the clinical outcome of chronic liver disease and its response to anti-viral therapeutic agents. We herein sought to develop a new easy, sensitive and accurate HCV genotyping method using annealing genotype-specific capture probes (AGSCP) in an automation-friendly 96-well plate format. The validation of our new AGSCP was performed using the Standard HCV Genotype Panel. We then used both our AGSCP and the commercially available INNO-LiPA assay to analyze the HCV genotypes from 111 Korean patients. Discordant results were analyzed by direct sequencing. AGSCP successfully genotyped the standard panel. The genotypes of 111 patient samples were also obtained successfully by AGSCP and INNO-LiPA. We observed a high concordance rate (93 matched samples, 83.8%) between the two assays. Sequencing analysis of the 18 discordant results revealed that the AGSCP had correctly identified 12 samples, whereas the INNO-LiPA had correctly identified only 6. These results collectively indicate that AGSCP assay is a convenient and sensitive method for large-scale genotyping, and it may be a promising tool for the determination of HCV and other genotypes in clinical settings.     

用核酸免疫技术制备抗丙肝病毒C区单克隆抗体

用丙肝病毒Ｃ＋Ｅ１区真核表达质粒ｐｃＤＮＡ－ＨＣＶ／Ｃ＋Ｅ１按４００ｕｇ／只剂量免疫ＢＡＬＢ／Ｃ小鼠,１４周后同一剂量再加强免疫一次。加强免疫后２周,在５０％ＰＥＧ１４５０介导下将脾细胞与ＳＰ２／０小鼠骨髓瘤细胞（５１）融合。实验结果融合率达５４．３％（３１３／５７６）。阳性率为５．４％（１７”３１３）。克隆化后得到６株稳定分泌抗丙肝病毒Ｃ区单克隆抗体杂交瘤细胞株。这６株杂交瘤均产生ＩｇＭ抗体,接种ＢＡＬＢ／Ｃ小鼠后产生腹水的效价为１６４－１３２０（ＥＬＩＳＡ）。     

Chimpanzees in hepatitis C virus research: 1998–2007

Background  Chimpanzees have been widely used in hepatitis C virus (HCV) research, but their endangered status and high financial and ethical costs have prompted a closer review.
Methods  One hundred and nine articles published in 1998–2007 were analyzed for the number of chimpanzees involved, experimental procedures, objectives and other relevant issues.
Results  The articles described the use of 852 chimpanzees, but accounting for likely multiple uses, the number of individual chimpanzees involved here is estimated to be approximately 500. Most articles addressed immunology and inoculation studies. A significant portion of studies lasted for several months or years. Approximately one half of the individual chimpanzees were each used in 2–10 studies.
Conclusions  Significant financial and scientific resources have been expended in these chimpanzee HCV studies. Discussion addresses troublesome questions presented by some of the reviewed articles, including statistical validity, repeatability, and biological relevance of this model. These concerns merit attention as future approaches to HCV research and research priorities are considered.     

γ/δ T细胞与丙型肝炎病毒、乙型肝炎病毒感染

病毒性肝炎的发病机制迄今尚未完全明确,诸多证据表明,乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)所致肝炎可能是肝脏细胞免疫防御反应病毒入侵的结果。γ/δT细胞是新近认识的一个T细胞亚群,是机体抵抗外来病原微生物入侵的重要天然免疫细胞之一。近年研究发现,肝内富含γ/δT细胞,而病毒性肝炎肝内γ/δT细胞数量显著增高。目前有关γ/δT细胞与肝炎病毒感染的研究主要集中在HCV感染领域,即γ/δT细胞通过分泌多种细胞因子抑制体内HCV的复制。目前,有关γ/δT细胞与HBV感染的报道甚为少见。慢性HBV感染体内可能导致γ/δT细胞免疫学功能异常,这可能是导致体内病毒性乙型肝炎慢性化的主要原因之一。     

Hepatitis C virus NS5B RNA replicase specifically binds ribosomes

Hepatitis C virus (HCV) non-structural protein 5B (NS5B) is an RNA replicase. We expressed full-length NS5B (591 amino acid residues) in Escherichia coli as a fusion protein with maltose binding protein (MBP-NS5B). MBP-NS5B was recovered in the soluble fraction after centrifugation at 40,000 x g and affinity-purified with amylose resin. The purified MBP-NS5B had a high-level of poly (A), oligo (U)-dependent UMP incorporation with a Km of 2 microM for UTP. Surprisingly, the enzymatically active MBP-NS5B was sedimented by ultracentrifugation at 160,000 x g. The pellet contained 16S and 23S ribosomal RNAs, suggesting that ribosomes were associated with MBP-NS5B. Ribosomes and MBP-NS5B were subsequently co-purified on amylose resin. Deletion study revealed that either the N-terminal (amino acid residues 1-107) or the C-terminal (amino acid residues 498-591) region of NS5B were sufficient for this association with ribosomes. We further found that NS5B also bound with human ribosomes. Our results implicate a novel mechanism of coupling between replication and translation of the viral genome in the life cycle of HCV.     

我国西部1a型丙肝病毒结构区的cDNA克隆和序列分析

克隆我国西部丙型肝炎病毒全部结构区基因,为探讨HCV的变异和致癌作用,研制丙肝疫苗作准各。从1名西安市丙肝感染血液中,用Trizol试剂裂解HCV病毒颗粒,用糖原与RNA共沉淀提取HCVRNA,用AMV逆转录酶和随机引物逆转录为eDNA,用RT-PCR方法扩增目的片段并转化到pGEM-T质粒,得到pGEM-T-HCVc、pGEM-T-HCVel和pGEM-T-HCVe2克隆。将以上3个克隆用特定的酶降解,用连结酶进行连接,构建了HCV结构区的完整克隆。将克隆好的质粒pGEM-T-HCVjg从两端双向测广手,得到完整的HCV结构基因eDNA核苷酸序列,总长度为2238bp,与已发表的HCV序列长度一致,未发现缺失或移码突变,序列中间亦未发现转录终止子。本序列与HCVla、lb序列核苷酸的同源性分别为91．8％、84．5％;氨基酸的同源性分别为94.2％、86．3％;应为HCVla亚型。以上结果说明我国西部地区存在HCVla亚型,所克隆HCV结构区eDNA克隆可以用于基因工程表达。