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Grubczak K, Grzeszczuk A, Groth M, Hryniewicz A, Kretowska-Grunwald A, Flisiak R, Moniuszko M. Effects of Pegylated Interferon Alpha and Ribavirin (pegIFN-α/RBV) Therapeutic Approach on Regulatory T Cells in HCV-Monoinfected and HCV/HIV-Coinfected Patients. Viruses 2021; 13:v13081448. [PMID: 34452314 PMCID: PMC8402834 DOI: 10.3390/v13081448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/10/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
Approximately 25% of HIV-infected patients are co-infected with HCV. Notably, the burden of HCV infection (e.g., viral persistence, viral load, or HCV-related liver symptoms) is more pronounced in the presence of HIV co-infection. However, to date, the underlying immune mechanisms accounting for accelerated disease progression in HIV/HCV-coinfected individuals have not been described in sufficient detail. We hypothesized that regulatory T cells (Treg) bearing potent immunosuppressive capacities could not only play a substantial role in the pathogenesis of HCV/HIV coinfection but also modulate the response to the standard anti-viral therapy. MATERIALS AND METHODS To this end, we studied alterations in frequencies of Treg cells in correlation with other Treg-related and virus-related parameters in both HCV and HCV/HIV-infected patients subjected to standard pegIFN-α/RBV therapy. RESULTS Notably, we found that pegIFN-α/RBV therapy significantly increased levels of Treg cells in HCV-infected but not in HIV/HCV-coinfected individuals. Furthermore, HIV/HCV-coinfection was demonstrated to inhibit expansion of regulatory T cells during anti-viral treatment; thus, it might probably be responsible for viral persistence and HCV-related liver damage. CONCLUSIONS Therapy with pegIFN-α/RBV demonstrated a significant effect on regulatory T cells in the course of HIV and/or HCV infection indicating a crucial role in the anti-viral immune response.
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Affiliation(s)
- Kamil Grubczak
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
- Correspondence: (K.G.); (M.M.); Tel./Fax: +48-85-748-59-72 (K.G. & M.M.)
| | - Anna Grzeszczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-540 Bialystok, Poland;
| | - Monika Groth
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Anna Hryniewicz
- Department of Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Anna Kretowska-Grunwald
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland;
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
- Correspondence: (K.G.); (M.M.); Tel./Fax: +48-85-748-59-72 (K.G. & M.M.)
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Cairoli V, De Matteo E, Rios D, Lezama C, Galoppo M, Casciato P, Mullen E, Giadans C, Bertot G, Preciado MV, Valva P. Hepatic lymphocytes involved in the pathogenesis of pediatric and adult non-alcoholic fatty liver disease. Sci Rep 2021; 11:5129. [PMID: 33664397 PMCID: PMC7933421 DOI: 10.1038/s41598-021-84674-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/19/2021] [Indexed: 02/06/2023] Open
Abstract
The immune response is critical in NAFLD pathogenesis, but the liver infiltrate's composition and the role of each T cell population is still up for debate. To characterize liver pathogenesis in pediatric and adult cases, frequency and localization of immune cell populations [Cytotoxic T Lymphocytes (CD8+), T helper Lymphocytes (CD4+), Regulatory T lymphocytes (Foxp3+) and Th17 (IL-17A+)] were evaluated. In portal/periportal (P/P) tracts, both age groups displayed a similar proportion of CD8+ and CD4+ lymphocytes. However, comparable Foxp3+ and IL-17A+ cell frequencies were observed in pediatric cases, meanwhile, in adults Foxp3+ was higher than IL-17A+ cells. Interestingly, IL-17A+ lymphocytes seemed to be nearly exclusive of P/P area in both age groups. In intralobular areas, both pediatric and adult cases showed CD8+ lymphocytes predominance with lower frequencies of CD4+ lymphocytes followed by Foxp3+ . Severe inflammation was associated with higher intralobular Foxp3+ lymphocytes (p = 0.026) in children, and lower P/P Foxp3+ and higher IL-17A+ lymphocytes in adults. All cases with fibrosis ≥ 2 displayed P/P low Foxp3+ and high IL-17A+ lymphocyte counts. Pediatric cases with worse steatosis showed high P/P CD4+ (p = 0.023) and intralobular CD8+ (p = 0.027) and CD4+ cells (p = 0.012). In NAFLD cases, the lymphocyte liver infiltrate composition differs between histological areas. Treg and Th17 balance seems to condition damage progression, denoting their important role in pathogenesis.
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Affiliation(s)
- Victoria Cairoli
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children's Hospital, Gallo 1330, C1425EFD, Buenos Aires, CABA, Argentina
| | - Elena De Matteo
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children's Hospital, Gallo 1330, C1425EFD, Buenos Aires, CABA, Argentina
| | - Daniela Rios
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children's Hospital, Gallo 1330, C1425EFD, Buenos Aires, CABA, Argentina
| | - Carol Lezama
- Liver Unit, Ricardo Gutiérrez Children's Hospital, C1425EFD, Buenos Aires, CABA, Argentina
| | - Marcela Galoppo
- Liver Unit, Ricardo Gutiérrez Children's Hospital, C1425EFD, Buenos Aires, CABA, Argentina
| | - Paola Casciato
- Liver Unit, Italian's Hospital of Buenos Aires, C1199ABH, Buenos Aires, CABA, Argentina
| | - Eduardo Mullen
- Pathology Division, Italian's Hospital of Buenos Aires, C1199ABH, Buenos Aires, CABA, Argentina
| | - Cecilia Giadans
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children's Hospital, Gallo 1330, C1425EFD, Buenos Aires, CABA, Argentina
| | - Gustavo Bertot
- H.A. Barceló Foundation-Medicine University, C1425EFD, Buenos Aires, CABA, Argentina
| | - María Victoria Preciado
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children's Hospital, Gallo 1330, C1425EFD, Buenos Aires, CABA, Argentina
| | - Pamela Valva
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children's Hospital, Gallo 1330, C1425EFD, Buenos Aires, CABA, Argentina.
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3
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Keating SM, Dodge JL, Norris PJ, Heitman J, Gange SJ, French AL, Glesby MJ, Edlin BR, Latham PS, Villacres MC, Greenblatt RM, Peters MG. The effect of HIV infection and HCV viremia on inflammatory mediators and hepatic injury-The Women's Interagency HIV Study. PLoS One 2017; 12:e0181004. [PMID: 28902848 PMCID: PMC5597129 DOI: 10.1371/journal.pone.0181004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/22/2017] [Indexed: 12/21/2022] Open
Abstract
Hepatitis C virus infection induces inflammation and while it is believed that HIV co-infection enhances this response, HIV control may reduce inflammation and liver fibrosis in resolved or viremic HCV infection. Measurement of systemic biomarkers in co-infection could help define the mechanism of inflammation on fibrosis and determine if HIV control reduces liver pathology. A nested case-control study was performed to explore the relationship of systemic biomarkers of inflammation with liver fibrosis in HCV viremic and/or seropositive women with and without HIV infection. Serum cytokines, chemokines, growth factors and cell adhesion molecules were measured in HIV uninfected (HIV-, n = 18), ART-treated HIV-controlled (ARTc, n = 20), uncontrolled on anti-retroviral therapy (ARTuc, n = 21) and elite HIV controllers (Elite, n = 20). All were HCV seroreactive and had either resolved (HCV RNA-; <50IU/mL) or had chronic HCV infection (HCV RNA+). In HCV and HIV groups, aspartate aminotransferase to platelet ratio (APRI) was measured and compared to serum cytokines, chemokines, growth factors and cell adhesion molecules. APRI correlated with sVCAM, sICAM, IL-10, and IP-10 levels and inversely correlated with EGF, IL-17, TGF-α and MMP-9 levels. Collectively, all HCV RNA+ subjects had higher sVCAM, sICAM and IP-10 compared to HCV RNA-. In the ART-treated HCV RNA+ groups, TNF-α, GRO, IP-10, MCP-1 and MDC were higher than HIV-, Elite or both. In ARTuc, FGF-2, MPO, soluble E-selectin, MMP-9, IL-17, GM-CSF and TGF-α are lower than HIV-, Elite or both. Differential expression of soluble markers may reveal mechanisms of pathogenesis or possibly reduction of fibrosis in HCV/HIV co-infection.
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Affiliation(s)
- Sheila M. Keating
- Blood Systems Research Institute, San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California San Francisco, California, United States of America
- * E-mail:
| | - Jennifer L. Dodge
- Department of Surgery, UCSF, San Francisco, California, United States of America
| | - Philip J. Norris
- Blood Systems Research Institute, San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California San Francisco, California, United States of America
- Department of Medicine, UCSF, San Francisco, California, United States of America
| | - John Heitman
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Stephen J. Gange
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Audrey L. French
- CORE Center, Stroger Hospital of Cook County, Chicago, Illinois, United States of America
| | - Marshall J. Glesby
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medical College, New York, New York, United States of America
| | - Brian R. Edlin
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medical College, New York, New York, United States of America
- Department of Medicine, SUNY Downstate, Brooklyn, New York, United States of America
| | - Patricia S. Latham
- Department of Pathology and Medicine, George Washington University Medical Center, Washington DC, United States of America
| | - Maria C. Villacres
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Ruth M. Greenblatt
- Department of Pharmacology, UCSF, San Francisco, California, United States of America
| | - Marion G. Peters
- Department of Medicine, UCSF, San Francisco, California, United States of America
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Sarsekeyeva N, Kosherova B. Evaluation of immunological indices in HIV-infected patients with chronic hepatitis C in Kazakhstan. Int J Gen Med 2016; 9:147-53. [PMID: 27284263 PMCID: PMC4883804 DOI: 10.2147/ijgm.s101303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate immunological indices in HIV-infected patients with chronic hepatitis C (CHC) who are injecting drug users. Materials and methods The study examined 38 patients coinfected with HIV and CHC who were injecting drug users and 36 patients with HIV/CHC who were not injecting drug users. In the study of immune status, the relative and absolute numbers of CD3+, CD4+, CD8+, CD16+, and CD20+ cells were determined by means of flow cytofluorometry of “FACSCount” using monoclonal antibodies of the company Becton Dickinson. The level of circulating immune complexes in blood serum was determined by means of precipitation in polyethylene glycol solution. Results It was found that T-cell immunodeficiency was developing in patients coinfected with HIV and CHC. T-cell immunodeficiency was characterized by a decrease in the number of T-helpers, mainly for injecting drug users. At the same time, patients coinfected with HIV and CHC experienced markedly elevated levels of circulating immune complexes, mainly among injecting drug users. The evaluation of immunogram indices in injecting drug users coinfected with HIV and CHC, depending on the stage of HIV infection, revealed a greater degree of immune-suppression of T-helper cells in clinical stage III. Conclusion Our comprehensive immunological study of patients coinfected with HIV and CHC revealed a pronounced dysfunction of the immune system. The comparison of the immune system indices in patients with HIV/CHC showed a more pronounced T-cell suppression in injecting drug users than in patients with HIV/CHC but who were not injecting drug users.
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Affiliation(s)
- Nazgul Sarsekeyeva
- Department of Infectious Diseases and Dermatovenerology, Karaganda State Medical University, Karaganda, Kazakhstan; Karaganda Regional Center for the AIDS Prevention and Control, Karaganda, Kazakhstan
| | - Bakhyt Kosherova
- Rectorate of Karaganda State Medical University, Karaganda, Kazakhstan
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Shmagel NG, Shmagel KV, Saidakova EV, Korolevskaya LB, Chereshnev VA. Discordant response of CD4(+) T cells to antiretroviral therapy in HIV-infected patients coinfected with hepatitis C virus is accompanied by increased liver damage. DOKL BIOCHEM BIOPHYS 2016; 465:358-60. [PMID: 26728724 DOI: 10.1134/s1607672915060034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Indexed: 11/22/2022]
Abstract
A study of HIV-infected patients coinfected with hepatitis C virus and receiving antiretroviral therapy (ART) but not treated with interferon was performed. Patients were divided into two groups-with standard and inefficient recovery of CD4(+) T cells. It was found that patients with discordant response of CD4(+) T cells to ART showed heavier destructive processes in the liver than the successfully recovered subjects. They had increased levels of ALT and AST. In these patients, the risk of development of liver cirrhosis is greater.
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Affiliation(s)
- N G Shmagel
- Perm State University, Perm, Russia.,Perm Regional Center for Protection against AIDS and Infectious Diseases, Perm, Russia
| | - K V Shmagel
- Perm State University, Perm, Russia. .,Institute of Ecology and Genetics of Microorganisms, Ural Branch, Russian Academy of Sciences, ul. Goleva 13, Perm, 614081, Russia.
| | - E V Saidakova
- Perm State University, Perm, Russia.,Institute of Ecology and Genetics of Microorganisms, Ural Branch, Russian Academy of Sciences, ul. Goleva 13, Perm, 614081, Russia
| | - L B Korolevskaya
- Perm State University, Perm, Russia.,Institute of Ecology and Genetics of Microorganisms, Ural Branch, Russian Academy of Sciences, ul. Goleva 13, Perm, 614081, Russia
| | - V A Chereshnev
- Perm State University, Perm, Russia.,Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences, ul. Pervomaiskaya 91, Yekaterinburg, 620041, Russia.,Yeltsin Ural Federal University, Yekaterinburg, Russia
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Hirashima N, Iwase H, Shimada M, Imamura J, Sugiura W, Yokomaku Y, Watanabe T. An Hepatitis C Virus (HCV)/HIV Co-Infected Patient who Developed Severe Hepatitis during Chronic HCV Infection: Sustained Viral Response with Simeprevir Plus Peginterferon-Alpha and Ribavirin. Intern Med 2015; 54:2173-7. [PMID: 26328642 DOI: 10.2169/internalmedicine.54.4344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe the case of a 42-year-old man who developed severe hepatitis caused by hepatitis C virus (HCV) infection at 14 years after the start of human immunodeficiency virus (HIV) treatment. Surprisingly, the levels of alanine aminotransferase (ALT) fluctuated, reaching a peak higher than 1,000 IU/L during chronic HCV infection, and the hepatic histology showed advanced liver fibrosis at 3 years after the primary HCV infection. He was treated with simeprevir, peginterferon-alpha, and ribavirin with a sustained viral response. We conclude that HCV/HIV co-infected patients need to commence anti-HCV therapy when the levels of ALT fluctuate severely under successful HIV control.
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Affiliation(s)
- Noboru Hirashima
- Department of Gastroenterology, National Hospital Organization Nagoya Medical Center, Japan
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