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Mambro A, Afshar A, Leone F, Dussault C, Stoové M, Savulescu J, Rich JD, Rowan DH, Sheehan J, Kronfli N. Reimbursing incarcerated individuals for participation in research: A scoping review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104283. [PMID: 38109837 DOI: 10.1016/j.drugpo.2023.104283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/18/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices. METHODS We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided. RESULTS A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9). CONCLUSIONS The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.
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Affiliation(s)
- Andrea Mambro
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Avideh Afshar
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Frederic Leone
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Camille Dussault
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark Stoové
- Burnet Institute, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Josiah D Rich
- Center for Health and Justice Transformation, The Miriam and Rhode Island Hospitals, Departments of Medicine and Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Daniel H Rowan
- Division of Infectious Disease, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | | | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada.
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2
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Norton NJ, Holder KA, Ings DP, Harnum DOA, Russell RS, Grant MD. Cellular Immune Responses to SARS-CoV-2 in Exposed Seronegative Individuals. Viruses 2023; 15:v15040996. [PMID: 37112977 PMCID: PMC10144856 DOI: 10.3390/v15040996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/30/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Some SARS-CoV-2-exposed individuals develop immunity without overt infection. We identified 11 individuals who were negative by nucleic acid testing during prolonged close contact and with no serological diagnosis of infection. As this could reflect natural immunity, cross-reactive immunity from previous coronavirus exposure, abortive infection due to de novo immune responses, or other factors, our objective was to characterize immunity against SARS-CoV-2 in these individuals. Blood was processed into plasma and peripheral blood mononuclear cells (PBMC) and screened for IgG, IgA, and IgM antibodies (Ab) against SARS-CoV-2 and common β-coronaviruses OC43 and HKU1. Receptor blocking activity and interferon-alpha (IFN-α) in plasma were also measured. Circulating T cells against SARS-CoV-2 were enumerated and CD4+ and CD8+ T cell responses discriminated after in vitro stimulation. Exposed uninfected individuals were seronegative against SARS-CoV-2 spike (S) and selectively reactive against OC43 nucleocapsid protein (N), suggesting common β-coronavirus exposure induced Ab cross-reactive against SARS-CoV-2 N. There was no evidence of protection from circulating angiotensin-converting enzyme (ACE2) or IFN-α. Six individuals had T cell responses against SARS-CoV-2, with four involving CD4+ and CD8+ T cells. We found no evidence of protection from SARS-CoV-2 through innate immunity or immunity induced by common β-coronaviruses. Cellular immune responses against SARS-CoV-2 were associated with time since exposure, suggesting that rapid cellular responses may contain SARS-CoV-2 infection below the thresholds required for a humoral response.
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Affiliation(s)
- Natasha J Norton
- Immunology and Infectious Diseases Program, Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL A1B 3V6, Canada
| | - Kayla A Holder
- Immunology and Infectious Diseases Program, Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL A1B 3V6, Canada
| | - Danielle P Ings
- Immunology and Infectious Diseases Program, Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL A1B 3V6, Canada
| | - Debbie O A Harnum
- Eastern Regional Health Authority, Department of Health and Community Services, St. John's, NL A1B 3V6, Canada
| | - Rodney S Russell
- Immunology and Infectious Diseases Program, Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL A1B 3V6, Canada
| | - Michael D Grant
- Immunology and Infectious Diseases Program, Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL A1B 3V6, Canada
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Moazen B, Saeedi Moghaddam S, Silbernagl MA, Lotfizadeh M, Bosworth RJ, Alammehrjerdi Z, Kinner SA, Wirtz AL, Bärnighausen TW, Stöver HJ, Dolan KA. Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates. Epidemiol Rev 2018; 40:58-69. [PMID: 29860343 DOI: 10.1093/epirev/mxy002] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
Prisoners engage in a range of risk behaviors that can lead to the transmission of viral infections, such as HIV, hepatitis B and hepatitis C. In this review, we summarize the epidemiologic literature from 2007 to 2017 on 4 key risk behaviors for human immunodeficiency virus and hepatitis C virus among prisoners globally: drug injection, sexual activity, tattooing, and piercing. Of 9,303 peer-reviewed and 4,150 gray literature publications, 140 and 14, respectively, met inclusion criteria covering 53 countries (28%). Regions with high levels of injection drug use were Asia Pacific (20.2%), Eastern Europe and Central Asia (17.3%), and Latin America and the Caribbean (11.3%), although the confidence interval for Latin America was high. Low levels of injection drug use in prison were found in African regions. The highest levels of sexual activity in prison were in Europe and North America (12.1%) and West and Central Africa (13.6%); low levels were reported from the Middle East and North African regions (1.5%). High levels of tattooing were reported from Europe and North America (14.7%), Asia Pacific (21.4%), and Latin America (45.4%). Prisons are burdened with a high prevalence of infectious diseases and risk behaviors for transmission of these diseases, and, commonly, a striking lack of evidence-based infection control measures, even when such measures are available in the surrounding community. Given that most prisoners return to these communities, failure to implement effective responses has repercussions not only prisoner health but also for public health.
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Affiliation(s)
- Babak Moazen
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.,Department of Community Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rebecca J Bosworth
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Zahra Alammehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Till W Bärnighausen
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Heino J Stöver
- Department of Health and Social Work, Institute of Addiction Research
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4
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Mohd Hanafiah K, Garcia ML, Barnes NC, Anderson DA. Detection of virus-specific polymeric immunoglobulin A in acute hepatitis A, C, E virus serum samples using novel chimeric secretory component. BMC Res Notes 2018; 11:688. [PMID: 30285838 PMCID: PMC6167832 DOI: 10.1186/s13104-018-3799-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/27/2018] [Indexed: 01/23/2023] Open
Abstract
Objective To conduct a proof-of-concept study on preferential binding of polymeric IgA (pIgA) using a novel recombinant rabbit/human chimeric secretory component (cSC) and preliminary assessment of the diagnostic potential of virus-specific pIgA in discriminating acute hepatitis A, E, and C (HAV, HEV, HCV) patients and uninfected controls using an indirect enzyme-linked immunoassay. Results cSC binds > 0.06 μg/ml of purified human and mouse pIgA with negligible cross-reactivity against IgM and IgA. Virus-specific pIgA was significantly higher in serum of acute HAV (n = 6) and HEV (n = 12) patients than uninfected samples (HEV: p < 0.001; HAV: p = 0.001), and had low correlation with virus-specific IgM (HEV r: − 0.25, 95% CI − 0.88 to 0.71, p = 0.636; HAV r: 0.05, 95% CI − 0.54 to 0.60, p: 0.885). Anti-HCV pIgA peaked early in HCV seroconversion panels (n = 14), and was undetectable after 4 weeks post-primary bleed, even in ongoing infections, while serum anti-HCV IgA, IgG and IgM persisted. Patients with early acute HCV infection had significantly higher levels of anti-HCV pIgA compared to those with chronic infections (p < 0.01). The use of novel cSC demonstrates the presence of virus-specific pIgA in sera of patients with acute HAV, HEV, and HCV infection, and posits its potential utility as a diagnostic biomarker that warrants further validation on larger sample populations.
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Affiliation(s)
- Khayriyyah Mohd Hanafiah
- Life Sciences, Macfarlane Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia. .,Department of Immunology, Monash University, 86 Commercial Road, Melbourne, VIC, 3004, Australia. .,School of Biological Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia.
| | - Mary L Garcia
- Life Sciences, Macfarlane Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Nadine C Barnes
- Life Sciences, Macfarlane Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - David A Anderson
- Life Sciences, Macfarlane Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.,Department of Microbiology and Immunology, University of Melbourne, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia
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5
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Ow MM, Hegazy D, Warshow UM, Cramp ME. Enhanced natural killer cell activity is found in exposed uninfected recipients of hepatitis C-contaminated blood. J Viral Hepat 2018; 25:245-253. [PMID: 29063663 DOI: 10.1111/jvh.12810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/04/2017] [Indexed: 12/17/2022]
Abstract
A minority of injecting drug users, termed exposed uninfected, are resistant to hepatitis C (HCV) infection despite repeated low-dose exposures. We identify for the first time a cohort of blood recipients who remained uninfected despite large-dose exposure to HCV-contaminated blood and characterize immune factors that may confer protection. Of 1340 blood recipients from the English Look Back database who were transfused HCV-contaminated blood, we identified 8 who remained uninfected. In these 8 exposed uninfecteds, we characterized their natural killer (NK) cell populations and HCV-specific T-cell responses. Findings were compared with 10 spontaneous resolvers of HCV infection, 10 patients with chronic HCV infection and 10 healthy controls. Exposed uninfecteds had significantly greater numbers of NK cells with the activating receptor NKp30+ on CD56bright and CD56dim subsets compared with other groups (P < .05). Following interleukin-2 activation, NK cells of exposed uninfecteds had enhanced cytotoxicity that positively correlated with NKp30 expression (P = .02). Differences in NKp80 and KIR2DL3 expression were also observed. HCV-specific T-cell responses were observed in some exposed uninfecteds but of low amplitude. Exposure without infection following transfusion of HCV-contaminated blood is a very rare phenomenon and suggests a high level of resistance to infection. Enhanced NK cell activation and killing, with weak HCV-specific T-cell responses, were observed many years after exposure in uninfected recipients and may contribute to protection from HCV acquisition, although additional protective factors are being sought in this important cohort.
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Affiliation(s)
- M M Ow
- Department of Medicine, University of Auckland, Auckland, New Zealand.,Hepatology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - D Hegazy
- Hepatology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - U M Warshow
- Hepatology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - M E Cramp
- Hepatology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.,Southwest Liver Unit, Derriford Hospital, Plymouth Hospitals NHS Trust, Plymouth, UK
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6
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Thöns C, Senff T, Hydes TJ, Manser AR, Heinemann FM, Heinold A, Heilmann M, Kim AY, Uhrberg M, Scherbaum N, Lauer GM, Khakoo SI, Timm J. HLA-Bw4 80(T) and multiple HLA-Bw4 copies combined with KIR3DL1 associate with spontaneous clearance of HCV infection in people who inject drugs. J Hepatol 2017; 67:462-470. [PMID: 28412292 DOI: 10.1016/j.jhep.2017.03.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/16/2017] [Accepted: 03/31/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Natural killer (NK) cell function is regulated by inhibitory and activating receptors including killer cell immunoglobulin-like receptors (KIRs). Here, we analyzed the impact of different KIR/KIR-ligand genotypes on the outcome of hepatitis C virus (HCV) infection in people who inject drugs (PWID). METHODS KIR/KIR-ligand genotypes associated with spontaneous clearance of HCV infection were identified in a cohort of PWID from Germany (n=266) and further validated in a second anti-HCV positive cohort of PWID recruited in North America (n=342). NK cells of PWID and healthy donors were functionally characterized according to their KIR/KIR-ligand genotype by flow cytometry. RESULTS Multivariate logistic regression analysis revealed that KIR3DL1/HLA-Bw4 80(T) was associated with spontaneous clearance of HCV infection in PWID, which was confirmed in the PWID cohort from North America. Compared with PWID with detectable HCV RNA, the frequency of individuals with multiple HLA-Bw4 alleles was significantly higher in anti-HCV positive PWID with resolved HCV infection (29.7% vs. 15.2%; p=0.0229) and in anti-HCV seronegative PWID (39.2%; p=0.0006). KIR3DL1+ NK cells from HLA-Bw4 80(T)-positive PWID showed superior functionality compared to HLA-Bw4 80(I)-positive PWID. This differential impact was not observed in healthy donors; however, the HLA-Bw4 copy number strongly correlated with the functionality of KIR3DL1+ NK cells. CONCLUSIONS HLA-Bw4-80(T) and multiple HLA-Bw4 copies in combination with KIR3DL1 are associated with protection against chronic hepatitis C in PWID by distinct mechanisms. Better licensing of KIR3DL1+ NK cells in the presence of multiple HLA-Bw4 copies is beneficial prior to seroconversion whereas HLA-Bw4 80(T) may be beneficial during acute hepatitis C. Lay summary: Natural killer (NK) cells are part of the innate immune system and are regulated by a complex network of activating and inhibiting receptors. The regulating receptor-ligand pairs of an individual are genetically determined. Here, we identified a particular set of ligand and receptor genes that are associated with better functionality of NK cells and better outcome upon exposure to HCV in a high-risk group.
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Affiliation(s)
- Christine Thöns
- Institute for Virology, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Tina Senff
- Institute for Virology, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Theresa J Hydes
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK
| | - Angela R Manser
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Andreas Heinold
- Institute for Transfusion Medicine, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Martin Heilmann
- Department for Addiction Medicine and Addictive Behavior, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Arthur Y Kim
- Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Markus Uhrberg
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Norbert Scherbaum
- Department for Addiction Medicine and Addictive Behavior, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Georg M Lauer
- Gastrointestinal Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Salim I Khakoo
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK
| | - Jörg Timm
- Institute for Virology, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany.
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7
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Scavenger receptor class B member 1 (SCARB1) variants modulate hepatitis C virus replication cycle and viral load. J Hepatol 2017; 67:237-245. [PMID: 28363797 DOI: 10.1016/j.jhep.2017.03.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/24/2017] [Accepted: 03/14/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS There are numerous coding and non-coding variants in the SCARB1 gene that encodes scavenger receptor class B member 1 (SR-BI), a key receptor for both high density lipoproteins and hepatitis C virus (HCV). Many have been linked to clinical phenotypes, yet their impact on the HCV replication cycle is incompletely understood. The aim of this study was to analyze the impact of these variants on the molecular biology and clinical course of HCV. METHODS We analyzed key coding non-synonymous as well as non-coding SCARB1 variants using virological in vitro and human genetics approaches. RESULTS Non-synonymous variants: S112F and T175A have greatly reduced HCV receptor function. When present on the cell surface, these variants are impaired in their ability to interact with HCV E2. Non-coding variants: The G allele in rs3782287 is associated with decreased viral load. Haplotype analysis confirmed these findings and identified haplotype rs3782287 A/rs5888 C as a risk allele associated with increased viral load. We also detected a trend towards lower hepatic SR-BI expression in individuals with the rs3782287 GG genotype associated with low viral load suggesting a potential underlying mechanism. CONCLUSION Coding and non-coding genetic SCARB1 variants modulate the HCV replication cycle and possibly clinical features of hepatitis C. These findings underscore the relevance of SR-BI as an HCV receptor and contribute to our understanding of inter-individual variation in HCV infection. LAY SUMMARY The cell surface receptor SR-BI (scavenger receptor class B member 1), is essential for hepatitis C virus (HCV) entry into hepatocytes. Variations in the gene coding this receptor influence infectivity and viral load. We analyzed these variations to gain a better understanding of inter-individual differences over the course of HCV infection.
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8
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Keoshkerian E, Hunter M, Cameron B, Nguyen N, Sugden P, Bull R, Zekry A, Maher L, Seddiki N, Zaunders J, Kelleher A, Lloyd AR. Hepatitis C-specific effector and regulatory CD4 T-cell responses are associated with the outcomes of primary infection. J Viral Hepat 2016; 23:985-993. [PMID: 27558465 DOI: 10.1111/jvh.12576] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 06/29/2016] [Indexed: 12/31/2022]
Abstract
Clearance of primary hepatitis C virus (HCV) infection has been associated with strong and broadly targeted cellular immune responses. This study aimed to characterize HCV-specific CD4+ effector and regulatory T-cell numbers and cytokine production during primary infection. Antigen-specific CD4+ T-cell responses were investigated in a longitudinal cohort of subjects from pre-infection to postoutcome, including subjects who cleared [n=12] or became chronically infected [n=17]. A cross-sectional cohort with previously cleared, or chronic infection [n=15 for each], was also studied. Peripheral blood mononuclear cells were incubated with HCV antigens and surface stained for T-effector (CD4+CD25high CD134+CD39-) and T-regulatory (CD4+CD25high CD134+CD39+) markers, and culture supernatants assayed for cytokine production. Contrary to expectations, the breadth and magnitude of the HCV-specific CD4+ T-cell responses were higher in subjects who became chronically infected. Subjects who cleared the virus had HCV-specific CD4+ T-cell responses dominated by effector T cells and produced higher levels of IFN-γ, in contrast to HCV-specific CD4+ T-cell responses dominated by regulatory T cells and more IL-10 production in those who became chronically infected. Better understanding of the role of antigen-specific CD4+ T-cell responses in primary HCV will further define pathogenesis and help guide development of a preventative vaccine.
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Affiliation(s)
- E Keoshkerian
- UNSW Australia, Kirby Institute (Viral Immunology Systems Program, VISP) and School of Medical Sciences (SOMS), Kensington, NSW, Australia
| | - M Hunter
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - B Cameron
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - N Nguyen
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - P Sugden
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - R Bull
- UNSW Australia, Kirby Institute (Viral Immunology Systems Program, VISP) and School of Medical Sciences (SOMS), Kensington, NSW, Australia
| | - A Zekry
- UNSW Australia, St George and Sutherland Clinical School, Sydney, NSW, Australia
| | - L Maher
- UNSW Australia, Kirby Institute (Viral Hepatitis Epidemiology and Prevention Program VHEPP), Kensington, NSW, Australia
| | - N Seddiki
- The Vaccine Research Institute (VRI), INSERM, Créteil, France
| | - J Zaunders
- UNSW Australia, Kirby Institute (Immunovirology and Pathogenesis Program, IVPP), Kensington, NSW, Australia
| | - A Kelleher
- UNSW Australia, Kirby Institute (Immunovirology and Pathogenesis Program, IVPP), Kensington, NSW, Australia
| | - A R Lloyd
- UNSW Australia, Kirby Institute (Viral Immunology Systems Program, VISP) and School of Medical Sciences (SOMS), Kensington, NSW, Australia
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9
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Swann RE, Mandalou P, Robinson MW, Ow MM, Foung SKH, McLauchlan J, Patel AH, Cramp ME. Anti-envelope antibody responses in individuals at high risk of hepatitis C virus who resist infection. J Viral Hepat 2016; 23:873-880. [PMID: 27405885 PMCID: PMC5244678 DOI: 10.1111/jvh.12568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 02/05/2016] [Accepted: 05/17/2016] [Indexed: 12/12/2022]
Abstract
Injection drug users uninfected by hepatitis C virus (HCV) despite likely repeated exposure through high-risk behaviour are well documented. Factors preventing infection in these individuals are incompletely understood. Here, we looked for anti-HCV-envelope antibody responses in a cohort of repeatedly exposed but uninfected subjects. Forty-two hepatitis C diagnostic antibody- and RNA-negative injection drug users at high risk of exposure were studied and findings compared to healthy controls and cases with chronic HCV infection. Purified IgGs from sera were tested by ELISA for binding to genotype 1a and 3a envelope glycoproteins E1E2 with further testing for IgG and IgM reactivity against soluble E2. Virus-neutralizing activity was assessed using an HCV pseudoparticle system. Uninfected subjects demonstrated significantly greater IgG and IgM reactivities to envelope glycoproteins than healthy controls with IgG from 6 individuals additionally showing significant neutralization. This study is the first to describe humoral immunological responses targeting the HCV envelope, important for viral neutralization, in exposed uninfected individuals. A subset of these cases also had evidence of viral neutralization via anti-envelope antibodies. In addition to confirming viral exposure, the presence of specific anti-envelope antibodies may be a factor that helps these individuals resist HCV infection.
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Affiliation(s)
- R. E. Swann
- MRC – University of Glasgow Centre for Virus ResearchUniversity of GlasgowGlasgowUK
| | - P. Mandalou
- Hepatology Research GroupPlymouth University Peninsula Schools of Medicine and DentistryPlymouthUK,South West Liver UnitDerriford HospitalPlymouthUK
| | - M. W. Robinson
- MRC – University of Glasgow Centre for Virus ResearchUniversity of GlasgowGlasgowUK,School of Biochemistry and ImmunologyTrinity College DublinDublinIreland
| | - M. M. Ow
- Hepatology Research GroupPlymouth University Peninsula Schools of Medicine and DentistryPlymouthUK,South West Liver UnitDerriford HospitalPlymouthUK
| | - S. K. H. Foung
- Department of PathologyStanford University School of MedicineStanfordCAUSA
| | - J. McLauchlan
- MRC – University of Glasgow Centre for Virus ResearchUniversity of GlasgowGlasgowUK
| | - A. H. Patel
- MRC – University of Glasgow Centre for Virus ResearchUniversity of GlasgowGlasgowUK
| | - M. E. Cramp
- Hepatology Research GroupPlymouth University Peninsula Schools of Medicine and DentistryPlymouthUK,South West Liver UnitDerriford HospitalPlymouthUK
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10
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Söderberg-Nauclér C, Fornara O, Rahbar A. Cytomegalovirus driven immunosenescence-An immune phenotype with or without clinical impact? Mech Ageing Dev 2016; 158:3-13. [PMID: 27318107 DOI: 10.1016/j.mad.2016.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 11/30/2022]
Abstract
The continuous emerging increase in life span has led to vulnerability to a number of different diseases in the elderly. Some of these risks may be attributed to specific changes in the immune system referred to as immunoscenescence. This term aims to describe decreased immune functions among elderly individuals, and is characterized to be harmful age-associated changes in the immune system that lead to its gradual immune dysfunction. An impaired function of the immune system may increase susceptibility to various diseases in the elderly population such as infections, cardiovascular diseases and cancer. Although it is unclear how this immune phenotype develops, emerging evidence suggest that it may reflect an exhaustion of the immune system, possibly caused by one or several chronic infections. The main candidate is human cytomegalovirus (CMV), which can induce immune dysfunctions observed in immunoscenescence. Although the immune system is currently considered to be exhausted in CMV positive elderly individuals, it is not known whether such dysfunction of the immune system is a main reason for increased susceptibility to other diseases, or if direct effects of the virus in disease pathogenesis reflect the increased vulnerability to them. These aspects will be discussed in this review.
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Affiliation(s)
- Cecilia Söderberg-Nauclér
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden.
| | - Olesja Fornara
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden
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11
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Rahbar A, Peredo I, Solberg NW, Taher C, Dzabic M, Xu X, Skarman P, Fornara O, Tammik C, Yaiw K, Wilhelmi V, Assinger A, Stragliotto G, Söderberg-Naucler C. Discordant humoral and cellular immune responses to Cytomegalovirus (CMV) in glioblastoma patients whose tumors are positive for CMV. Oncoimmunology 2015; 4:e982391. [PMID: 25949880 DOI: 10.4161/2162402x.2014.982391] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 10/28/2014] [Indexed: 01/22/2023] Open
Abstract
Background. Glioblastoma (GBM) is the most common malignant brain tumor in adults and is nearly always fatal. Emerging evidence suggests that human Cytomegalovirus (HCMV) is present in 90-100% of GBMs and that add-on antiviral treatment for HCMV show promise to improve survival. Methods. In a randomized, placebo-controlled trial of valganciclovir in 42 GBM patients, blood samples were collected for analyses of HCMV DNA, RNA, reactivity against HCMV peptides, IgG, and IgM at baseline and at 3, 12, and 24 weeks of treatment. Results. All 42 tumors were positive for HCMV protein. All patients examined had at least one blood sample positive for HCMV DNA, 63% were HCMV RNA positive, and 21% were IgM positive. However, 29% of GBM patients were IgG negative for HCMV. Five of these samples were positive in an enzyme-linked immunosorbent assay (ELISA) that used antigens derived from a clinical isolate. Blood T cells from 11 of 13 (85%) HCMV IgG-negative GBM patients reacted against HCMV peptides. Valganciclovir did not affect IgG titers, DNA, or RNA levels of the HCMV immediate early (HCMV IE) gene in blood. Conclusion. In GBM patients, HCMV activity is higher than in healthy controls and serology is a poor test to define previous or active HCMV infection in these patients.
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Key Words
- ELISA, enzyme-linked immunosorbent assay
- FACS, flow cytometry analyses
- FITC, fluorescein isothiocyanate
- GBM, glioblastoma
- HCMV IE, human Cytomegalovirus-immediate early
- HCMV, human Cytomegalovirus
- HIV, human immunodeficiency virus
- HSV, herpes simplex virus
- PBMC, Peripheral blood mononuclear cells
- PBS, Phosphate buffered saline
- PCR, polymerase chain reaction
- SEB, staphylococcal snterotoxin B
- VIGAS study, Efficacy and Safety of Valcyte® as an Add-on Therapy in Patients with Malignant Glioblastoma and cytomegalovirus infection
- Valcyte
- cytomegalovirus
- glioblastoma
- peptides stimulation
- serology
- valganciclovir
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Affiliation(s)
- Afsar Rahbar
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Inti Peredo
- Departments of Neurosurgery; Karolinska University Hospital ; Stockholm, Sweden
| | - Nina Wolmer Solberg
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Chato Taher
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Mensur Dzabic
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Xinling Xu
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Petra Skarman
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Olesja Fornara
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Charlotte Tammik
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Koon Yaiw
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Vanessa Wilhelmi
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Alice Assinger
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | | | - Cecilia Söderberg-Naucler
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
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12
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Martinez D, Palmer C, Simar D, Cameron BA, Nguyen N, Aggarwal V, Lloyd AR, Zekry A. Characterisation of the cytokine milieu associated with the up-regulation of IL-6 and suppressor of cytokine 3 in chronic hepatitis C treatment non-responders. Liver Int 2015; 35:463-72. [PMID: 24461080 DOI: 10.1111/liv.12473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 01/16/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS In chronic hepatitis C virus infection (CHC), expression of suppressor of cytokine signalling-3 (SOCS3) has been shown to be associated with obesity and non-response to antiviral therapy. In this study, we aimed to determine the effect of SOCS3 induction on the cytokine response in patients receiving Pegylated interferon (PegIFN) and ribavirin (RBV) therapy. METHODS Peripheral blood mononuclear cells (PBMC) collected at baseline and at 12 weeks from CHC patients receiving PegIFN/RBV therapy were examined for mRNA and protein SOCS3 expression. Immunological assays were employed to examine cytokine production. RESULTS There was increased expression of SOCS3 in PBMC of non-responders at week 12 of therapy, when compared to treatment responders (P = 0.0001). The expression of SOCS3 correlated with body mass index (BMI) (r = 0.54; P = 0.01). Patients with low SOCS3 expression at week 12 of therapy had lower HCV-specific IFN-γ production in enzyme-linked immunosorbent spot (ELISpot) assays (P = 0.01), and reduced ex-vivo production of the anti-HCV effector cytokines interleukin (IL)-2 and tumour necrosis factor (TNF)-α(P = 0.01 and P = 0.04 respectively). Analysis of serum cytokine levels revealed higher levels of IL-6 at week 12 in the high SOCS3 expression group (P = 0.02) while IL-6 levels correlated with SOCS3 expression in the entire cohort (P = 0.04). Ex-vivo studies confirmed that IL-6 induced SOCS3, and neutralisation of IL-6 reduced levels of SOCS3. CONCLUSION In subjects with increased BMI and non-response to antiviral therapy, the IL-6/SOCS3 axis appears to play a crucial role in altering the anti-HCV-cytokine response associated with antiviral therapy.
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Affiliation(s)
- Danica Martinez
- School of Medical Sciences, Inflammation and Infection Research Centre (IIRC), Sydney, New South Wales, Australia
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13
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Sugden PB, Cameron B, Mina M, Lloyd AR. Protection against hepatitis C infection via NK cells in highly-exposed uninfected injecting drug users. J Hepatol 2014; 61:738-45. [PMID: 24845613 DOI: 10.1016/j.jhep.2014.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 04/17/2014] [Accepted: 05/06/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS HCV seroprevalence surveys in longstanding injecting drug users (IDUs) reveal a small minority who remain seronegative, with some exhibiting HCV-specific cellular immunity. This study aimed to characterise this immunity, assess associations with risk behaviours and protection against infection. METHODS A nested case-control series from a prospective cohort of seronegative IDUs was selected with incident cases (IN; n = 28) matched by demographics and risk behaviour to exposed uninfected (EU) subjects (n = 28). Samples were assayed for natural killer (NK) cell phenotypes and function, HCV-specific IFNγ in ELISpot, and HCV-specific CD4 T effector responses. IL28B and HLA-C/KIR2DL3 genotypes were tested. RESULTS Numbers of activated (CD69(+)) NK cells in the mature CD56(dim)CD16(+) subset, and cytotoxic (NKp30(+)) cells in the CD56(bright)CD16(+) subset were higher in the EU subjects (p = 0.040, p = 0.038 respectively). EU subjects had higher frequencies of interferon gamma (IFNγ) producing NK cells, and lower frequencies of CD107a expression (p = 0.003, p = 0.015 respectively). By contrast, the frequency, magnitude, and breadth of HCV-specific CD4 and CD8 T cell responses did not differ, nor did IL28B, HLA-C, or KIR2DL3 allele frequencies. CONCLUSIONS Sustained NK cell activation contributes to protection against HCV infection. HCV-specific cellular immunity is prevalent in EU subjects but does not appear to be protective.
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MESH Headings
- Adult
- Antigens, CD/immunology
- Antigens, Differentiation, T-Lymphocyte/immunology
- Drug Users/psychology
- Female
- Gene Expression Profiling
- Hepatitis C/etiology
- Hepatitis C/genetics
- Hepatitis C/immunology
- Hepatitis C/prevention & control
- Humans
- Interferons
- Interleukins/genetics
- Interleukins/immunology
- Killer Cells, Natural/immunology
- Lectins, C-Type/immunology
- Lymphocyte Activation/immunology
- Male
- Natural Cytotoxicity Triggering Receptor 3/immunology
- Receptors, KIR2DL3/genetics
- Receptors, KIR2DL3/immunology
- Risk-Taking
- Substance Abuse, Intravenous/complications
- Substance Abuse, Intravenous/genetics
- Substance Abuse, Intravenous/immunology
- Substance Abuse, Intravenous/psychology
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Affiliation(s)
- Peter B Sugden
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Barbara Cameron
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia.
| | - Michael Mina
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Andrew R Lloyd
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
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14
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Thoens C, Berger C, Trippler M, Siemann H, Lutterbeck M, Broering R, Schlaak J, Heinemann FM, Heinold A, Nattermann J, Scherbaum N, Alter G, Timm J. KIR2DL3⁺NKG2A⁻ natural killer cells are associated with protection from productive hepatitis C virus infection in people who inject drugs. J Hepatol 2014; 61:475-81. [PMID: 24780303 DOI: 10.1016/j.jhep.2014.04.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 03/18/2014] [Accepted: 04/11/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Despite continuous high-risk behavior, a subgroup among people who inject drugs (PWID) remains seronegative for hepatitis C virus (HCV) suggesting that a state of "natural resistance" to HCV Infection may exist. Homozygosity for KIR2DL3 and its ligand HLA-C1 group alleles has been associated with control of HCV infection, however, the mechanism mediating this protective effect remained unclear. METHODS Peripheral NK cells from PWID (n=104) were phenotypically and functionally characterized by multicolor flow cytometry. Expression levels of the NK cell receptor ligands were analysed in liver biopsies and primary human hepatocytes. RESULTS HCV seronegative PWID (n=34) had increased levels of KIR2DL3(+)NKG2A(-) NK cells compared to healthy controls (n=10; p<0.001) and PWID with chronic (n=38; p<0.001) or resolved infection (n=37; p<0.001). There was an inverse correlation between the frequency of KIR2DL3(+) and NKG2A(+) NK cells (r=-0.53; p<0.0001). Importantly, expression of HLA-E, the ligand for NKG2A, was significantly upregulated in liver biopsies of HCV infected patients (n=51) compared to HBV infected patients (n=22; p<0.01) and correlated with HCV viral load (r=0.32; p<0.0029). In functional analyses KIR2DL3(-)NKG2A(+) NK cells but not KIR2DL3(+)NKG2A(-) NK cells were significantly inhibited by HLA-E ligation. Accordingly, interferon gamma secretion of NK cells from PWID with chronic infection but not from HCV seronegative PWID was significantly suppressed in the presence of HLA-E. CONCLUSIONS KIR2DL3(+)NKG2A(-) NK cells are not sensitive to HLA-E-mediated inhibition and may thereby control early HCV infection prior to seroconversion and result in an apparent state of "natural resistance" to HCV in PWID.
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Affiliation(s)
- Christine Thoens
- Institute of Virology, University of Duisburg-Essen, University Hospital, Essen, Germany
| | | | - Martin Trippler
- Department for Gastroenterology and Hepatology, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Holger Siemann
- Addiction Research Group, Department of Psychiatry and Psychotherapy, Rhine State Hospital, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - Melanie Lutterbeck
- Department for Gastroenterology and Hepatology, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Ruth Broering
- Department for Gastroenterology and Hepatology, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Jörg Schlaak
- Department for Gastroenterology and Hepatology, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Andreas Heinold
- Institute for Transfusion Medicine, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Jacob Nattermann
- Department of Internal Medicine, University of Bonn, Bonn, Germany
| | - Norbert Scherbaum
- Addiction Research Group, Department of Psychiatry and Psychotherapy, Rhine State Hospital, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - Galit Alter
- The Ragon Institute of MGH, MIT and Harvard, Boston, USA
| | - Joerg Timm
- Institute of Virology, University of Duisburg-Essen, University Hospital, Essen, Germany.
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15
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Flynn JK, Sacks-Davis R, Higgs P, Aitken C, Moneer S, Suppiah V, Tracy L, Ffrench R, Bowden S, Drummer H, George J, Bharadwaj M, Hellard M. Detection of HCV-Specific IFN-γ Responses in HCV Antibody and HCV RNA Negative Injecting Drug Users. HEPATITIS MONTHLY 2014; 14:e14678. [PMID: 24497881 PMCID: PMC3909641 DOI: 10.5812/hepatmon.14678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/13/2013] [Accepted: 11/21/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Detectable HCV-specific cellular immune responses in HCV antibody and RNA negative people who inject drugs (PWID) raise the question of whether some are resistant to HCV infection. Immune responses from people who have been exposed to hepatitis C virus (HCV) and remain anti-HCV negative are of interest for HCV vaccine development; however, limited research addresses this area. OBJECTIVES In a cohort of HCV antibody and RNA negative PWID, we assessed whether the presence of HCV-specific IFN-γ responses or genetic associations provide any evidence of protection from HCV infection. PATIENTS AND METHODS One hundred and ninety-eight participants were examined longitudinally for clinical, behavioral, social, environmental and genetic characteristics (IFNL3 genotype [formally IL-28B] and HLA type). Sixty-one of the 198 participants were HCV antibody and RNA negative, with 53 able to be examined longitudinally for HCV-specific IFN-γ ELISpot T cell responses. RESULTS Ten of the 53 HCV antibody and RNA negative participants had detectable HCV-specific IFN-γ responses at baseline (18%). The magnitude of IFN-γ responses averaged 131 +/- 96 SFC/106 PBMC and the breadth was mean 1 +/- 1 pool positive. The specificity of responses were mainly directed to E2, NS4b and NS5b. Participants with (10) and without (43) HCV-specific IFN-γ responses did not differ in behavioral, clinical or genetic characteristics (P > 0.05). There was a larger proportion sharing needles (with 70%, without 49%, P = 0.320) and a higher incidence of HCV (with 35.1 per 100 py, 95% CI 14.6, 84.4, without 16.0 per 100 py, 95% CI 7.2, 35.6, P = 0.212) in those with IFN-γ responses, although not statistically significant. Half the participants with baseline IFN-γ responses became HCV RNA positive (5/10), with one of these participants spontaneously clearing HCV. The spontaneous clearer had high magnitude and broad Th1 responses, favorable IFNL3 genotype and favorable HLA types. CONCLUSIONS This study demonstrated the detection of HCV-specific IFN-γ responses in HCV antibody and RNA negative individuals, with a tendency for HCV-specific IFN-γ responses to be associated with HCV exposure. The potential role of HCV-specific IFN-γ responses in those who remained HCV RNA negative is of value for the development of novel HCV therapeutics.
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Affiliation(s)
- Jacqueline K Flynn
- Centre for Biomedicine, Burnet Institute, Melbourne, Australia
- Department of Infectious Diseases, Monash University, Melbourne, Australia
- Corresponding Author: Jacqueline K Flynn, Centre for Biomedicine, Burnet Institute, 3001 Victoria, G.P.O. Box: 2284, Melbourne, Australia. Tel: +61-392822109, Fax: +61-392822100, E-mail:
| | - Rachel Sacks-Davis
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Melbourne, Australia
| | - Campbell Aitken
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sarah Moneer
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia
| | - Vijay Suppiah
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Sydney, Australia
- School of Pharmacy, University of South Australia, Adelaide, Australia
| | - Lilly Tracy
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia
| | - Rosemary Ffrench
- Centre for Biomedicine, Burnet Institute, Melbourne, Australia
- Department of Immunology, Monash University, Melbourne, Australia
| | - Scott Bowden
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia
| | - Heidi Drummer
- Centre for Biomedicine, Burnet Institute, Melbourne, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia
- Department of Microbiology, Monash University, Clayton, Australia
| | - Jacob George
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Mandvi Bharadwaj
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia
| | - Margaret Hellard
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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