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Foka P, Dimitriadis A, Karamichali E, Kyratzopoulou E, Giannimaras D, Koskinas J, Varaklioti A, Mamalaki A, Georgopoulou U. Alterations in the iron homeostasis network: A driving force for macrophage-mediated hepatitis C virus persistency. Virulence 2016; 7:679-90. [PMID: 27058404 PMCID: PMC4991317 DOI: 10.1080/21505594.2016.1175700] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/09/2016] [Accepted: 04/01/2016] [Indexed: 02/06/2023] Open
Abstract
Mechanisms that favor Hepatitis C virus (HCV) persistence over clearance are unclear, but involve defective innate immunity. Chronic infection is characterized by hepatic iron overload, hyperferraemia and hyperferittinaemia. Hepcidin modulates iron egress via ferroportin and its storage in ferritin. Chronic HCV patients have decreased hepcidin, while HCV replication is modified by HAMP silencing. We aimed to investigate interactions between HCV and hepcidin, during acute and chronic disease, and putative alterations in cellular iron homeostasis that enhance HCV propagation and promote viral persistence. Thus, we used HCV JFH-1-infected co-cultures of Huh7.5 hepatoma and THP-1 macrophage cells, HCV patients' sera and Huh7 hepcidin-expressing cells transfected with HCV replicons. Hepcidin levels were elevated in acutely infected patients, but correlated with viral load in chronic patients. HAMP expression was up-regulated early in HCV infection in vitro, with corresponding changes in ferritin and FPN. Hepcidin overexpression enhanced both viral translation and replication. In HCV-infected co-cultures, we observed increased hepcidin, reduced hepatoma ferritin and a concurrent rise in macrophaghic ferritin over time. Altered iron levels complemented amplified replication in hepatoma cells and one replication round in macrophages. Iron-loading of macrophages led to enhancement of hepatic HCV replication through reversed ferritin "flow." Viral transmissibility from infected macrophages to naïve hepatoma cells was induced by iron. We propose that HCV control over iron occurs both by intracellular iron sequestration, through hepcidin, and intercellular iron mobilisation via ferritin, as means toward enhanced replication. Persistence could be achieved through HCV-induced changes in macrophagic iron that enhances viral replication in these cells.
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Affiliation(s)
- Pelagia Foka
- Molecular Virology Laboratory, Hellenic Pasteur Institute, Athens, Greece
- Molecular Biology and Immunobiotechnology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Alexios Dimitriadis
- Molecular Biology and Immunobiotechnology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Eirini Karamichali
- Molecular Virology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Eleni Kyratzopoulou
- Molecular Biology and Immunobiotechnology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Dionyssios Giannimaras
- Molecular Biology and Immunobiotechnology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - John Koskinas
- Second Department of Internal Medicine, Medical School of Athens, Hippokration Hospital, Athens, Greece
| | - Agoritsa Varaklioti
- Blood Center and National Center for Congenital Bleeding Disorders, Laiko General Hospital, Athens, Greece
| | - Avgi Mamalaki
- Molecular Biology and Immunobiotechnology Laboratory, Hellenic Pasteur Institute, Athens, Greece
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Contini P, Negrini S, Bodini G, Trucchi C, Ubezio G, Strada P, Savarino V, Ghio M. Granulocytes and monocytes apheresis induces upregulation of TGFβ 1 in patients with active ulcerative colitis: A possible involvement of soluble HLA-I. J Clin Apher 2016; 32:49-55. [PMID: 27080173 DOI: 10.1002/jca.21466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/22/2016] [Accepted: 03/28/2016] [Indexed: 12/20/2022]
Abstract
Granulocyte and monocyte apheresis has been used in different immune-mediated disorders, mainly inflammatory bowel diseases. The removal of activated leukocytes and several additional immunomodulatory mechanisms have been so far suggested to explain the anti-inflammatory effects of the treatment. Recent data indicate that, during centrifugation based apheresis, sHLA-I adsorbed to plastic circuits is able to induce TGFβ1 production in activated leukocytes. On these bases, the present study was aimed at analyzing if this model could be applied to a noncentrifugation based apheresis, such as granulocyte and monocyte apheresis. Ten patients with ulcerative colitis were enrolled. Every patient received 5 weekly apheresis treatments. Cellulose acetate beads removed from the column post-GMA were stained by fluorescent anticlass I mAb and examined by fluorescent microscope. Moreover, sFasL plasma concentration, TGFβ1 plasma levels, and the percentage of TGFβ1 positive neutrophils were evaluated before and immediately after each single apheresis. Immunofluorescent images revealed a homogeneous layer of a sHLA-I adsorbed to the surface of the beads recovered following the procedure. sFasL plasma concentration progressively increased both following the procedures and during inter-procedure periods. Consistently, also TGFβ1 plasma levels and the percentage of TGFβ1 positive neutrophils increased during the procedures with a meaningful relationship with sFasL plasma levels. Taken together, these findings suggest that the immunosuppressive effects attributed to granulocyte and monocyte apheresis might depend, at least in part, on the sensitivity of activated leucocytes to the bioactivity of sHLA-I molecules. J. Clin. Apheresis 32:49-55, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Paola Contini
- Department of Internal Medicine, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Simone Negrini
- Department of Internal Medicine, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Giorgia Bodini
- Department of Internal Medicine, Gastroenterology Unit I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Cecilia Trucchi
- Department of Health Sciences, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Gianluca Ubezio
- Immunohematology and Transfusion Centre, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Paolo Strada
- Immunohematology and Transfusion Centre, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Vincenzo Savarino
- Department of Internal Medicine, Gastroenterology Unit I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Massimo Ghio
- Department of Internal Medicine, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
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Ibáñez-Samaniego L, Catalina MV, Rincón D, Lo Iacono O, Fernández A, Clemente G, Bañares R, Vaquero J, Salcedo M. Liver Support With Albumin Dialysis Reduces Hepatitis C Virus Viremia and Facilitates Antiviral Treatment of Severe Hepatitis C Virus Recurrence After Liver Transplantation. Ther Apher Dial 2016; 20:189-96. [PMID: 26929255 DOI: 10.1111/1744-9987.12381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/11/2015] [Accepted: 10/09/2015] [Indexed: 11/29/2022]
Abstract
Patients with severe hepatitis C virus (HCV) recurrence after liver transplantation (LT) present an ominous prognosis, rarely achieving sustained virological response (SVR). Dialysis procedures may transiently decrease the HCV viral load, but the effect of albumin dialysis is currently unknown. Here, we evaluated the impact of albumin dialysis using the Molecular Adsorbent Recirculating System (MARS) used as a co-adjuvant antiviral treatment for severe HCV recurrence after LT. Thirteen patients (11 males, median age 48 years) with fibrosing cholestatic hepatitis or METAVIR fibrosis score ≥ F3 with severe portal hypertension underwent three consecutive MARS sessions. Antiviral therapy was initiated in 11 patients within 24 h after the MARS sessions. A contemporary cohort of seven patients who did not follow the MARS protocol is shown for comparison. MARS treatment resulted in consistent decreases of viral load from 7.59 log10 IU/mL [6.15-8.90] to 6.79 log10 IU/mL [5.18-7.84] (P = 0.003) as well as in decreases of serum bilirubin, gamma-glutamyl transpeptidase, alanine aminotransferase and aspartate aminotransferase (all P < 0.05). The overall rate of SVR was 0% in the Control group and 54.6% in patients initiating antiviral therapy within 24 h after MARS. Survival at 1 and 3 years was, respectively, 93% and 70% in patients undergoing MARS, compared with 29% and 14% in the Control group (P = 0.001). No major adverse events related to MARS treatment were observed. In conclusion, the use of MARS may facilitate the achievement of SVR and improve the prognosis of patients with severe HCV-recurrence after LT by reducing viral load and improving liver function prior to antiviral therapy.
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Affiliation(s)
- Luis Ibáñez-Samaniego
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - María-Vega Catalina
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Diego Rincón
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Oreste Lo Iacono
- Servicio de Gastroenterología, Hospital del Tajo, Aranjuez, Madrid, Spain
| | - Ainhoa Fernández
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Gerardo Clemente
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Bañares
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Javier Vaquero
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Magdalena Salcedo
- Unidad de Hepatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
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Namba T, Shiba R, Yamamoto T, Hirai Y, Moriwaki T, Matsuda J, Kadoya H, Takeji M, Yamada Y, Yoshihara H, Yamauchi A. Successful treatment of HCV-related cryoglobulinemic glomerulonephritis with double-filtration plasmapheresis and interferon combination therapy. Clin Exp Nephrol 2010; 14:372-6. [PMID: 20467773 DOI: 10.1007/s10157-010-0282-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 03/15/2010] [Indexed: 12/13/2022]
Abstract
A 67-year-old, hepatitis C virus (HCV)-positive woman was admitted to our hospital because of proteinuria and leg edema. Laboratory examination showed decreased serum albumin and complement activity and positive cryoglobulin. The HCV RNA genotype was 1b with high viral load. Kidney biopsy showed membranoproliferative glomerulonephritis (MPGN) with capillary deposition of C3, IgM, and IgG, indicating HCV-associated glomerulonephritis. In addition to interferon (IFN) therapy, double-filtration plasmapheresis (DFPP) was performed to reduce HCV RNA blood levels in the early stage of IFN therapy. This treatment greatly reduced the viral load and induced clinical remission of MPGN, suggesting that DFPP plus IFN combination therapy may represent a potentially effective modality for refractory-type HCV-associated glomerulonephritis.
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Fujiwara K, Kaneko S, Kakumu S, Sata M, Hige S, Tomita E, Mochida S. Double filtration plasmapheresis and interferon combination therapy for chronic hepatitis C patients with genotype 1 and high viral load. Hepatol Res 2007; 37:701-10. [PMID: 17573947 DOI: 10.1111/j.1872-034x.2007.00117.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
AIM The efficacy and safety of double filtration plasmapheresis (DFPP) plus interferon (IFN) combination therapy were compared with those of IFN therapy alone in 193 chronic hepatitis C patients having a high hepatitis C virus ribonucleic acid load of difficult-to-treat genotype 1b. METHODS All patients received either interferon alpha-2b (IFN-alpha-2b) monotherapy or combination therapies with ribavirin and IFN-alpha-2b or pegylated interferon alpha-2b (PEG-IFN-alpha-2b). Each patient individually decided whether to receive concomitant DFPP. DFPP was immediately followed by IFN treatment, and up to five sessions were given during the first week. RESULTS Sixty patients decided to receive DFPP. In the DFPP plus PEG-IFN-alpha-2b therapy group (n = 30), viral load reduction at 4 weeks after the start of treatment was greater than innon-DFPP (n = 74) (2.47 vs 1.52, log, P = 0.010), and the sustained virus response was also higher (77.8% vs 50.0%), even in cases of re-treated patients (relapsers or non-responders to previous IFN therapies). Adverse events, mild and transient, were observed in 38.3% of all DFPP-treated patients. CONCLUSION DFPP plus IFN combination therapy produced a great reduction of viral load during the early stage of treatment and achieved a high sustained virus response, suggesting that this combination therapy may be a new modality for chronic hepatitis C patients at difficult-to-treat states.
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Sawada K, Ohnishi K, Kusaka T, Matoba Y, Fukunaga K. Dramatic response to granulocytapheresis in a Crohn's disease case complicated by hepatitis C virus. Dig Dis Sci 2005; 50:1533-4. [PMID: 16110849 DOI: 10.1007/s10620-005-2875-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Koji Sawada
- Department of Gastroenterology, Fujimoto Hospital of Medicine, 3-15-27 Konda Habikino, Osaka 583-0857, Japan.
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