Platelets mediate cytotoxic T lymphocyte-induced liver damage

Impairment of liver regeneration correlates with activated hepatic NKT cells in HBV transgenic mice

A fraction of HBV carriers have a risk to develop liver cancer. Because liver possesses a strong regeneration capability, surgical resection of cancerous liver or transplantation with healthy liver is an alternate choice for HBV-caused hepatocarcinoma therapy. How HBV infection affects the regeneration of hepatectomized or transplanted liver remains elusive. We report that partial hepatectomy (PHx)-induced liver regeneration was reduced in HBV transgenic (HBV-tg) mice, a model of human HBV infection. PHx markedly triggered natural killer T (NKT) cell accumulation in the hepatectomized livers of HBV-tg mice, simultaneously with enhanced interferon gamma (IFN-gamma) production and CD69 expression on hepatic NKT cells at the early stage of liver regeneration. The impairment of liver regeneration in HBV-tg mice was largely ameliorated by NKT cell depletion, but not by natural killer (NK) cell depletion. Blockage of CD1d-NKT cell interaction considerably alleviated NKT cell activation and their inhibitory effect on regenerating hepatocytes. Neutralization of IFN-gamma enhanced bromodeoxyuridine incorporation in HBV-tg mice after PHx, and IFN-gamma mainly induced hepatocyte cell cycle arrest. Adoptive transfer of NKT cells from regenerating HBV-tg liver, but not from normal mice, could inhibit liver regeneration in recipient mice.

CONCLUSION

Activated NKT cells negatively regulate liver regeneration of HBV-tg mice in the PHx model.

HBV pathogenesis in animal models: recent advances on the role of platelets

Hepatitis B virus (HBV) causes acute and chronic necroinflammatory liver diseases and hepatocellular carcinoma (HCC). HBV replicates noncytopathically in the hepatocyte, and most of the liver injury associated with this infection reflects the immune response. While the innate immune response may not contribute significantly to the pathogenesis of liver disease or viral clearance, the adaptive immune response, particularly the cytotoxic T lymphocyte (CTL) response, contributes to both. Recent observations also reveal that antigen-nonspecific inflammatory cells enhance CTL-induced liver pathology and, more surprisingly, that platelets facilitate the intrahepatic accumulation of CTLs, suggesting that the host response to HBV infection is a highly complex but coordinated process. The notion that platelets contribute to liver disease and viral clearance by promoting the recruitment of virus-specific CTLs into the liver is a new concept in viral pathogenesis, which may prove useful to implement treatments of chronic HBV infection in man.

Treatment with HMGB1 inhibitors diminishes CTL-induced liver disease in HBV transgenic mice

Using hepatitis B virus (HBV) transgenic mice as recipients of virus-specific cytotoxic T lymphocytes (CTLs), we recently showed that polymorphonuclear neutrophils (PMNs) and the matrix-degrading metalloproteinases (MMPs) they produce are necessary for the intrahepatic recruitment of antigen nonspecific mononuclear cells that amplify the liver damage initiated by the CTLs. We now report that the high-mobility group box 1 protein (HMGB1) is also involved in this process. Transfer of CTLs in HBV transgenic mice induces the translocation of HMGB1 from the nucleus to the cytoplasm of hepatocytes surrounding CTL-containing necroinflammatory liver foci, without significant net synthesis of HMGB1. Treatment of CTL-injected HBV transgenic mice with either recombinant Box-A or glycyrrhizin, two functional inhibitors of extracellular HMGB1, significantly decreases the intrahepatic recruitment of PMNs and all other inflammatory cells, in the face of intact homing of virus-specific CTLs into the liver. The inhibition of PMN chemoattraction explains the mode of action of glycyrrhizin, which has long been used in Japan for the treatment of hepatitis, and suggests that new and more potent inhibitors of HMGB1 may be useful for the treatment of patients chronically infected with HBV.

Platelet-lymphocyte conjugation differs between lymphocyte subpopulations

BACKGROUND

Platelets can bind to, and thereby influence, lymphocyte function.

OBJECTIVE

The propensities of different lymphocyte subpopulations to form platelet-lymphocyte conjugates/aggregates (P-Lym) was investigated using four-color whole blood flow cytometry.

RESULTS

P-Lym constituted approximately 3% of circulating lymphocytes. Platelet conjugation was most common among large (monocyte-sized) lymphocytes. Platelet activation by ADP slightly increased platelet-T-cell conjugation, mainly to T-cytolytic (Tc) cells, but markedly elevated platelet-natural killer (NK)-cell conjugation. T-cell activation by phytohemagglutinin increased heterotypic conjugation among both T-helper (TH) and Tc cells, whilst NK-cell activation by interleukin-2 affected platelet-NK-cell aggregation little. Neither platelet activation nor lipopolysaccharides-induced B-cell activation enhanced platelet-B-cell aggregation. Activation-dependent heterotypic conjugation was mainly found among large cells, with increased percentages of conjugated cells and more platelets bound per lymphocyte. P-Lym formation initiated by platelet activation was abolished by P-selectin blockade, and tended to be reduced by inhibition of GPIIb/IIIa, CD11b, or CD40L. P-Lym formation initiated by lymphocyte activation was partially inhibited by each of these blocking agents, but more markedly inhibited when the blocking agents were combined.

CONCLUSIONS

Platelets selectively bind to larger and activated lymphocytes. T-lymphocyte activation enhances platelet-T-cell aggregation. Platelet activation enhances platelet-Tc aggregation slightly and platelet-NK-cell aggregation markedly, while cellular activation affects platelet-B-cell aggregation little. P-selectin ligation is essential, but GPIIb/IIIa, CD40L, and CD11b also contribute to the heterotypic conjugation.

Cerebral malaria: role of microparticles and platelets in alterations of the blood-brain barrier

Brain lesions of cerebral malaria (CM) are characterised by a sequestration of Plasmodium falciparum-parasitised red blood cells (PRBC), leucocytes and platelets within brain microvessels, by an excessive release of pro-inflammatory cytokines as well as by disruption of the blood-brain barrier (BBB). We evaluated the possibility that PRBC and platelets interact and induce functional alterations in brain endothelium. Using an in vitro model of endothelial lesion, we showed that platelets can act as bridges between PRBC and endothelial cells (EC) allowing the binding of PRBC to endothelium devoid of cytoadherence receptors. Furthermore, platelets potentiated the cytotoxicity of PRBC for brain EC by inducing an alteration of the integrity of their monolayer and increasing their apoptosis. These findings provide insights into the mechanisms by which platelets can be deleterious to the brain endothelium during CM. Another aspect of inflammatory and infectious diseases is that they often lead to activation of vascular and blood cells. Such activation results in an enhanced vesiculation, i.e. the release of circulating microparticles (MP). We thus explored plasma levels of endothelial MP in Malawian children with malaria. Plasma MP numbers were markedly increased on admission only in patients with severe malaria complicated with coma. Using the experimental mouse model of CM, we evaluated the pathogenic implications of MP using genetically deficient mice in which the capacity to vesiculate is impaired. Such mice, lacking the ABCA-1 gene, upon infection by Plasmodium berghei ANKA, showed complete resistance to CM. When purified from infected susceptible animals, MP were able to reduce normal plasma clotting time and to significantly enhance tumour necrosis factor release from naïve macrophages. Altogether these data provide a novel insight into the pathogenic mechanisms leading to the neurological syndrome. The finding that ABCA-1 gene deletion confers complete protection against cerebral pathology, linked to an impaired MP production, provides new potential targets for therapeutic amelioration of severe malaria.

Pathogenetic and antiviral immune responses against hepatitis B virus

Hepatitis B virus (HBV) is a noncytopathic virus that causes liver disease of variable duration and severity. It is widely assumed that during HBV infection the host immune response is responsible for both hepatocellular damage and viral clearance. Whereas there is considerable evidence that the innate immune response does not play a significant role in these processes, the adaptive immune response, particularly virus-specific cytotoxic T lymphocytes (CTLs), seems to contribute to nearly all of the liver injury associated with HBV infection. By killing infected cells and producing antiviral cytokines capable of purging HBV from viable hepatocytes, CTLs are also thought to eliminate the virus. Although liver damage is initiated and mediated by the CTLs, antigen-nonspecific inflammatory cells can worsen CTL-induced immunopathology and platelets may facilitate the accumulation of CTLs in the liver. The mechanisms responsible for disease pathogenesis and viral clearance during HBV infection are the subject of this review.

The emerging role of platelets in adaptive immunity

Platelets' foremost role in survival is hemostasis. However, a significant quantity of research has demonstrated that platelets are an integral part of inflammation and can also be potent effector cells of the innate immune response. CD154, a molecule of vital importance to adaptive immune responses, is expressed by activated platelets and has been implicated in platelet-mediated modulation of innate immunity and inflammatory disease states. Recent studies in mice extend the role of platelet CD154 to the adaptive immune response demonstrating that platelets can enhance antigen presentation, improve CD8 T cell responses, and play a critical function in normal T-dependent humoral immunity. The latter studies suggest that the current paradigm for the B cell germinal center response should be modified to include a role for platelets.