丙型肝炎病毒感染性细胞模型的研究进展

丙型肝炎病毒（HCV）是造成慢性肝炎,肝硬化及肝癌的重要原因之一,目前全球约有1.7亿人感染HCV。然而缺乏有效的HCV感染模型,严重阻碍了对HCV致病机制的认识。最近几年以JFH1株和Huh-7细胞系为基础,通过对不同病毒株基因组的重组和细胞系的优化,进一步提高其感染能力,在HCV感染系统的建立上取得了突破性进展。我们简要综述近几年在HCV感染细胞模型方面取得的进展。     

诱导多能干细胞来源的肝细胞在HCV感染模型中的应用*

诱导多能干细胞(induced pluripotent stem cells,iPSCs)与胚胎干细胞(embryonic stem cells,ESCs)类似,是一类具有自我更新和无限增殖潜能的细胞, 并且能诱导分化为机体各胚层所有类型的细胞。因iPSCs来源于机体本身,规避了ESCs的免疫排斥和医学伦理等问题,具有极大的研究前景及应用潜能。大量研究表明,诱导多能干细胞分化的肝样细胞(iPS-derived hepatocyte-like cells,iHLCs)已广泛运用于HCV体内外感染模型的建立,并用于研究HCV的发病机制、宿主基因在HCV致病机制和筛选新型抗HCV药物及疫苗的研发。主要对iPSCs的来源、从不同策略诱导iPSCs成为功能性肝细胞的研究方法及其在HCV感染模型中的应用进行归纳总结。     

诱导多能干细胞来源的肝细胞在HCV感染模型中的应用*

诱导多能干细胞(induced pluripotent stem cells,iPSCs)与胚胎干细胞(embryonic stem cells,ESCs)类似,是一类具有自我更新和无限增殖潜能的细胞, 并且能诱导分化为机体各胚层所有类型的细胞。因iPSCs来源于机体本身,规避了ESCs的免疫排斥和医学伦理等问题,具有极大的研究前景及应用潜能。大量研究表明,诱导多能干细胞分化的肝样细胞(iPS-derived hepatocyte-like cells,iHLCs)已广泛运用于HCV体内外感染模型的建立,并用于研究HCV的发病机制、宿主基因在HCV致病机制和筛选新型抗HCV药物及疫苗的研发。主要对iPSCs的来源、从不同策略诱导iPSCs成为功能性肝细胞的研究方法及其在HCV感染模型中的应用进行归纳总结。     

丙型肝炎病毒感染实验动物模型的研究进展

丙型肝炎病毒（HCV）感染是导致人类慢性病毒性肝炎、肝硬化和肝癌的最主要病因之一。由于缺乏合适的HCV感染实验动物模型,使得针对HCV感染更为有效的疗法及疫苗的研发滞后。黑猩猩是HCV感染研究的最佳实验动物,但由于其来源有限、价格昂贵及临床症状等诸多问题,其应用受限,因此发展新的实验动物模型用于HCV感染相关的基础和应用研究迫在眉睫。近年来,以啮齿类等动物为替代模型取得了不少进展,应用转基因等实验技术使替代动物感染了HCV,并成功应用于多个学科领域的研究。本文分析了HCV自然感染的实验动物、自然感染和非自然感染的替代实验动物在致病机制研究、药物评价和疫苗研发应用中的优缺点及未来研究趋势。     

Transwell技术模拟人类免疫缺陷病毒感染黏膜及其他屏障系统的应用

近年来,由于Transwell小室能在体外模拟机体许多黏膜及生物屏障系统,如人生殖道黏膜、直肠组织黏膜以及血-脑屏障、血-视网膜屏障等,重现人类免疫缺陷病毒(HIV)感染机体的过程,对HIV感染机体的机制研究极为重要,因而被广泛应用.目前,尚无有效抗HIV疫苗问世,因此开发能阻断HIV性传播的药物是有效途径之一.应用Transwell技术深入研究HIV穿透黏膜及屏障系统感染机体的机制,也能为HIV防治药物的研发寻找新的作用靶点.本文就近年来Transwell技术在HIV感染黏膜及其他屏障系统中的应用作一综述.     

丙型肝炎病毒基因突变与免疫逃逸

免疫逃逸（Immune evasion）是指病原体逃避机体免疫监控的现象。在宿主和病毒的长期共同进化过程中,病毒形成了各种逃选机制以逃避宿主的免疫监控,其中病毒基因变异是最主要机制。丙型肝炎病毒（Hepatitis C virus,HCV）在感染个体中表现出极高的基因异质性,能有效地逃逸机体免疫识剐和破坏宿主免疫应答的能力,HCV还可侵袭免疫细胞来抑制机体的免疫功能,而建立HCV持续性感染。了解HCV病毒突变与免疫逃逸机制将会为预防和控制丙型肝炎提供依据。     

在小鼠模型中抗闭锁蛋白单克隆抗体完全阻止了丙型肝炎病毒的感染

丙型肝炎病毒(HCV)进入宿主细胞的过程分多步完成。过程中需要多种宿主因子,闭锁蛋白(OCLN)作为紧密连接蛋白被包括在内,并且体外细胞培养系统业已表明其在HCV感染过程中不可或缺。然而,由于缺乏能够识别完整OCLN细胞外环状结构域并抵御HCV感染的连接子,研究者们尚不清楚OCLN是否能够作为HCV治疗手段中有效且安全的目标物。通过使用基因免疫法和独特细胞差异化筛选技术,研究者成功制备了四种大鼠抗OCLN单克隆抗体(mAb)。     

丙型肝炎病毒感染的体外培养细胞的抗原表达

建立丙型肝炎病毒（HCV）体外感染细胞模型,观察其感染细胞的HCV抗原表达,用抗HCV抗体和HCVRNA阳性及阴性血清感染MOLT-4细胞,制备细胞片进行免疫酶染色。结果显示HCV感染MOLT-4细胞4天和阴性对照HCV抗原均为阴性;感染后7天胞浆内可见HCV抗原阳性免疫反应产物;15天阳性细胞达到高峰,43天仍可见少量阳性细胞。结果表明HCV体外感染MOLT-4细胞胞浆内观察到HCV抗原表达。     

HCV感染过程中的相关免疫反应

丙型肝炎病毒(Hepatitis C Virus,HCV)是慢性丙型病毒性肝炎的主要病因,也是引发肝硬化和肝癌的主要诱因。在HCV感染过程中,伴随着干扰素信号通路的激活和干扰素刺激基因(IFN-stimulated gene,ISG)的持续表达,且有HCV独特的免疫逃逸和免疫细胞的功能损伤。现就HCV感染过程中机体的固有免疫反应和适应性免疫反应的研究进展作一综述。     

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。     

Hepatitis C Virus (HCV) Infection May Elicit Neutralizing Antibodies Targeting Epitopes Conserved in All Viral Genotypes

Anti-hepatitis C virus (HCV) cross-neutralizing human monoclonal antibodies, directed against conserved epitopes on surface E2 glycoprotein, are central tools for understanding virus-host interplay, and for planning strategies for prevention and treatment of this infection. Recently, we developed a research aimed at identifying these antibody specificities. The characteristics of one of these antibodies (Fab e20) were addressed in this study. Firstly, using immunofluorescence and FACS analysis of cells expressing envelope HCV glycoproteins, Fab e20 was able to recognize all HCV genotypes. Secondly, competition assays with a panel of mouse and rat monoclonals, and alanine scanning mutagenesis analyses located the e20 epitope within the CD81 binding site, documenting that three highly conserved HCV/E2 residues (W529, G530 and D535) are critical for e20 binding. Finally, a strong neutralizing activity against HCV pseudoparticles (HCVpp) incorporating envelope glycoproteins of genotypes 1a, 1b, 2a, 2b and 4, and against the cell culture-grown (HCVcc) JFH1 strain, was observed. The data highlight that neutralizing antibodies against HCV epitopes present in all HCV genotypes are elicited during natural infection. Their availability may open new avenues to the understanding of HCV persistence and to the development of strategies for the immune control of this infection.     

Hepatitis C virus and Epstein-Barr virus: dual infection or atypical antibody response

Positive serological reactions against hepatitis C virus (HCV) appeared in the course of Epstein-Barr virus (EBV) infectious mononucleosis. In 429 consecutive patients with high levels of transaminases, 28 patients with EBV primary infection were found. The presence of anti-HCV antibodies and HCV RNA was studied in these subjects. In seven patients anti-HCV antibodies (C33 and C22c RIBA bands) were detected, but all were polymerase chain reaction (PCR) negative. These results may have been due solely to a HCV infection or were an atypical response to HCV in the course of infectious mononucleosis.     

A Hepatitis C Virus (HCV) Vaccine Comprising Envelope Glycoproteins gpE1/gpE2 Derived from a Single Isolate Elicits Broad Cross-Genotype Neutralizing Antibodies in Humans

Although a cure for HCV is on the near horizon, emerging drug cocktails will be expensive, associated with side-effects and resistance making a global vaccine an urgent priority given the estimated high incidence of infection around the world. Due to the highly heterogeneous nature of HCV, an effective HCV vaccine which could elicit broadly cross-neutralizing antibodies has represented a major challenge. In this study, we tested for the presence of cross-neutralizing antibodies in human volunteers who were immunized with recombinant glycoproteins gpE1/gpE2 derived from a single HCV strain (HCV1 of genotype 1a). Cross neutralization was tested in Huh-7.5 human hepatoma cell cultures using infectious recombinant HCV (HCVcc) expressing structural proteins of heterologous HCV strains from all known major genotypes, 1–7. Vaccination induced significant neutralizing antibodies against heterologous HCV genotype 1a virus which represents the most common genotype in North America. Of the 16 vaccinees tested, 3 were selected on the basis of strong 1a virus neutralization for testing of broad cross-neutralizing responses. At least 1 vaccinee was shown to elicit broad cross-neutralization against all HCV genotypes. Although observed in only a minority of vaccinees, our results prove the key concept that a vaccine derived from a single strain of HCV can elicit broad cross-neutralizing antibodies against all known major genotypes of HCV and provide considerable encouragement for the further development of a human vaccine against this common, global pathogen.     

Role of anti-cyclic citrullinated peptide antibodies in discriminating patients with rheumatoid arthritis from patients with chronic hepatitis C infection-associated polyarticular involvement

This study was performed to assess the utility of anti-cyclic citrullinated peptide (anti-CCP) antibodies in distinguishing between patients with rheumatoid arthritis (RA) and patients with polyarticular involvement associated with chronic hepatitis C virus (HCV) infection. Serum anti-CCP antibodies and rheumatoid factor (RF) were evaluated in 30 patients with RA, 8 patients with chronic HCV infection and associated articular involvement and 31 patients with chronic HCV infection without any joint involvement. In addition, we retrospectively analysed sera collected at the time of first visit in 10 patients originally presenting with symmetric polyarthritis and HCV and subsequently developing well-established RA. Anti-CCP antibodies and RF were detected by commercial second-generation anti-CCP2 enzyme-linked immunosorbent assay and immunonephelometry respectively. Anti-CCP antibodies were detected in 23 of 30 (76.6%) patients with RA but not in patients with chronic HCV infection irrespective of the presence of articular involvement. Conversely, RF was detected in 27 of 30 (90%) patients with RA, 3 of 8 (37.5%) patients with HCV-related arthropathy and 3 of 31 (9.7%) patients with HCV infection without joint involvement. Finally, anti-CCP antibodies were retrospectively detected in 6 of 10 (60%) patients with RA and HCV. This indicates that anti-CCP antibodies can be useful in discriminating patients with RA from patients with HCV-associated arthropathy.     

Expression and purification of E2/NS1 protein of hepatitis C virus and detection of anti-E2/NS1 antibodies in chronic liver disease patients

Glycoproteins on the surface of viral particles present the main target of neutralizing antibodies. The structural proteins of most Flaviviruses are known to elicit neutralizing antibodies and, thus, to help in both the natural resolution of the infection and the protection from challenge with homologous hepatitis C virus (HCV). Because such antigens are associated with the viral clearance in both humans and chimpanzees, we aimed to express the E2/NS1 protein of HCV and to study the role of anti-E2/NS1 antibodies in the natural resolution of HCV infection. The prevalence of anti-E2/NS1 antibodies to recombinant E2/NS1 protein was seen by Western blot in chronic liver disease patients (15 chronic hepatitis and 12 cirrhotic patients), who were positive for anti-HCV and negative for HBV infection. The study also included 2 negative controls (positive for HBV infection and negative for anti-HCV antibodies) and 2 healthy controls (negative for both HBV and HCV infection). Anti-E2/NS1 was present in 20% of the chronic hepatitis and 16% of the cirrhosis patients. None of the controls were positive for anti-E2/NS1 antibodies. Serum samples positive for anti-E2/NS1 antibodies were also positive for HCV RNA by RT/PCR. Accordingly, the presence of anti-E2/NS1 may have very little or no role in the natural resolution of HCV infection.     

Cellular immune responses associated with occult hepatitis C virus infection of the liver

Occult hepatitis C virus (HCV) infection is a type of recently identified chronic infection that is evidenced only by detection of HCV RNA in liver; patients consistently test negative for antibodies to HCV and HCV RNA in serum. Using ex vivo and in vitro measures of T-cell responses, we have identified functional virus-specific memory CD4(+) and CD8(+) T cells in the peripheral blood of patients with occult HCV infection. The features of the virus-specific T cells were consistent with immune surveillance functions, supporting previous exposure to HCV. In addition, the magnitudes of CD4(+) and CD8(+) T-cell responses were in parallel and correlated inversely with the extent of liver HCV infection. The detection of HCV-specific T cells in individuals in whom HCV RNA can persist in the liver despite the absence of viremia and antibodies indicates that HCV replication is prolonged in the face of virus-specific CD4(+) and CD8(+) T-cell responses. These findings demonstrate that HCV-specific cellular immune responses are markers not only of previous exposure to and recovery from HCV but also of ongoing occult HCV infection.     

Hepatitis C virus (HCV)-induced immunoglobulin hypermutation reduces the affinity and neutralizing activities of antibodies against HCV envelope protein

Hepatitis C virus (HCV) often causes persistent infection despite the presence of neutralizing antibodies against the virus in the sera of hepatitis C patients. HCV infects both hepatocytes and B cells through the binding of its envelope glycoprotein E2 to CD81, the putative viral receptor. Previously, we have shown that E2-CD81 interaction induces hypermutation of heavy-chain immunoglobulin (V(H)) in B cells. We hypothesize that if HCV infects antibody-producing B cells, the resultant hypermutation of V(H) may lower the affinity and specificity of the HCV-specific antibodies, enabling HCV to escape from immune surveillance. To test this hypothesis, we infected human hybridoma clones producing either neutralizing or non-neutralizing anti-E2 or anti-E1 antibodies with a lymphotropic HCV (SB strain). All of the hybridoma clones, except for a neutralizing antibody-producing hybridoma, could be infected with HCV and support virus replication for at least 8 weeks after infection. The V(H) sequences in the infected hybridomas had a significantly higher mutation frequency than those in the uninfected hybridomas, with mutations concentrating in complementarity-determining region 3. These mutations lowered the antibody affinity against the targeting protein and also lowered the virus-neutralizing activity of anti-E2 antibodies. Furthermore, antibody-mediated complement-dependent cytotoxicity with the antibodies secreted from the HCV-infected hybridomas was impaired. These results suggest that HCV infection could cause some anti-HCV-antibody-producing hybridoma B cells to make less-protective antibodies.     

Antibodies against HBV, HCV and HAV detected by using microparticle enzyme immunoassay in hepatitis outpatients

The presence of the hepatitis B surface antigen (HBsAg), of the antibodies against HBc, HCV and HAV was determined in outpatients in the period September 2005 - December 2006. The serum samples were analyzed by using Enzyme Immunoassay microparticles (Abbott AxSYM System). At least one test was positive in 238 patients (15.4%) of the total of 1547 patients. Of the 238 positive subjects, in 130 positive subjects (54.6%) the existence of HBV infection could be ascertained based on the presence of HBsAg or of the antibodies against HBc or of their association; 83 patients (34.9%) presented antibodies against HCV and in other 12 patients the antibodies against HCV were associated with HBsAg or with antibodies against HBc, suggesting the coexistence of HCV and HBV infection. The antibodies against HCV and the associations between HCV and HBV were mostly detected in subjects with the diagnosis of cirrhosis, liver failure or chronic hepatitis. Of the 13 (5.46%) patients with antibodies against HAV, 6 patients presented the associations: in 2 cases antibodies anti-HAV with positive HBsAg, in 1 case antibodies anti-HAV and anti-HBc with positive HBsAg, in 2 cases antibodies anti-HAV and anti-HBc and in 1 case antibodies anti-HAV and anti-HCV.     

Functional Analysis of Claudin-6 and Claudin-9 as Entry Factors for Hepatitis C Virus Infection of Human Hepatocytes by Using Monoclonal Antibodies

The relevance of claudin-6 and claudin-9 in hepatitis C virus (HCV) entry remains elusive. We produced claudin-6- or claudin-9-specific monoclonal antibodies that inhibit HCV entry into nonhepatic cells expressing exogenous claudin-6 or claudin-9. These antibodies had no effect on HCV infection of hepatoma cells or primary hepatocytes. Thus, although claudin-6 and claudin-9 can serve as entry factors in cell lines, HCV infection into human hepatocytes is not dependent on claudin-6 and claudin-9.     

Persistent infection by HCV and EBV in peripheral blood mononuclear cells and risk of non-Hodgkin's lymphoma

Hepatitis C virus (HCV) and Epstein–Barr virus (EBV) have been repeatedly associated with risk of non-Hodgkin's lymphoma (NHL) in studies focusing on serological evidence of infection. We investigated NHL risk in association with detection of HCV-RNA or EBV-DNA in the peripheral blood mononuclear cells (PBMC). The study involved 91 NHL cases and 182 controls nested in the Italian branch of the EPIC (European Prospective Investigation of Cancer and nutrition) cohort, which obtained blood samples from 47,749 healthy volunteers between 1993 and 1998 in 5 Italian cities. NHL cases were identified until June 2005 through linkage with records of the Cancer, Mortality, and Hospital Discharge Registries. For all study subjects, we performed viral genome analyses on DNA and RNA extracted from buffy-coats and analysed EBV and HCV antibodies. The odds ratios (ORs) of NHL were 1.2 (95% confidence intervals: 0.4–3.8; 5 exposed cases) for PBMC HCV infection and 1.2 (0.7–2.3; 24 exposed cases) for PBMC EBV infection. Similar OR estimates were found for detection of EBV and HCV antibodies. These null results, although based on a relatively small sample size, suggest that persistent EBV and HCV infection in the PBMC is not a stronger predictor of NHL risk than serological evidence of infection.