Different clinical behaviors of acute hepatitis C virus infection are associated with different vigor of the anti-viral cell-mediated immune response
Different clinical behaviors of acute hepatitis C virus infection are associated with different vigor of the anti-viral cell-mediated immune response
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DOI：
10.1172/jci118842
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发表时间：
1996-08-01
影响因子：
15.9
通讯作者：
Ferrari, C
中科院分区：
文献类型：
--
作者：
Missale, G;Bertoni, R;Ferrari, C
抗病毒 T 细胞反应被认为在丙型肝炎病毒感染的发病机制中发挥着核心作用，由于 > 50% 的 HCV 感染发生慢性演变，因此对疾病早期临床阶段的 T 细胞反应进行序贯分析可能有助于确定与恢复或慢性病毒持续性相关的 T 细胞反应特征。为此，对 21 名急性丙型肝炎病毒感染受试者进行了平均 44 周的连续随访，12 名患者将转氨酶值标准化，在整个随访期间保持正常；除两名患者外，所有患者均清除了血清中的丙型肝炎病毒 RNA，其余 9 名患者表现出持续的病毒血症和转氨酶升高。对核心、E1、E2、NS3、NS4和NS5重组抗原和合成肽的外周血T细胞增殖反应的分析显示，转氨酶水平正常化的患者对除E1之外的所有丙型肝炎病毒抗原的反应明显比未正常化的患者更强烈且更频繁地检测到。通过对T细胞反应的连续评估，两组患者之间的差异在急性感染的早期阶段就已经可检测到，并且在整个随访过程中都保持不变。结果表明，感染早期阶段 T 细胞反应的活力可能是疾病消退和感染控制的关键决定因素。
The anti-viral T cell response is believed to play a central role in the pathogenesis of hepatitis C virus infection, Since chronic evolution occurs in > 50% of HCV infections, the sequential analysis of the T cell response from the early clinical stages of disease may contribute to define the features of the T cell response associated with recovery or chronic viral persistence, For this purpose, 21 subjects with acute hepatitis C virus infection were sequentially followed for an average time of 44 wk, Twelve patients normalized transaminase values that remained normal throughout the follow-up period; all but two cleared hepatitis C virus-RNA from serum, The remaining nine patients showed persistent viremia and elevated transaminases. Analysis of the peripheral blood T cell proliferative response to core, E1, E2, NS3, NS4, and NS5 recombinant antigens and synthetic peptides showed that responses to all hepatitis C virus antigens, except El, were significantly more vigorous and more frequently detectable in patients who hormalized transaminase levels than in those who did not, By sequential evaluation of the T cell response, a difference between the two groups of patients was already detectable at the very early stages of acute infection and then maintained throughout the follow-up period, The results suggest that the vigor of the T cell response during the early stages of infection may be a critical determinant of disease resolution and control of infection.