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Ghosh S, Nandi M, Pal S, Mukhopadhyay D, Chakraborty BC, Khatun M, Bhowmick D, Mondal RK, Das S, Das K, Ghosh R, Banerjee S, Santra A, Chatterjee M, Chowdhury A, Datta S. Natural killer cells contribute to hepatic injury and help in viral persistence during progression of hepatitis B e-antigen-negative chronic hepatitis B virus infection. Clin Microbiol Infect 2016; 22:733.e9-733.e19. [PMID: 27208430 DOI: 10.1016/j.cmi.2016.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/05/2016] [Accepted: 05/09/2016] [Indexed: 12/13/2022]
Abstract
Hepatitis B e-antigen negative (e(-)) chronic HBV infection (CHI) encompasses a heterogeneous clinical spectrum ranging from inactive carrier (IC) state to e(-) chronic hepatitis B (CHB), cirrhosis and hepatic decompensation. In the backdrop of dysfunctional virus-specific T cells, natural killer (NK) cells are emerging as innate effectors in CHI. We characterized CD3(-) CD56(+) NK cells in clinically well-defined, treatment-naive e(-) patients in IC, e(-)CHB or decompensated liver cirrhosis (LC) phase to appraise their role in disease progression. The NK cell frequencies increased progressively with disease severity (IC 8.2%, e(-)CHB 13.2% and LC 14.4%). Higher proportion of NK cells from LC/e(-)CHB expressed CD69, NKp46, NKp44, TRAIL and perforin, the last two being prominent features of CD56(bright) and CD56(dim) NK subsets, respectively. The frequencies of CD3(-) CD56(+) NK cells together with TRAIL(+) CD56(bright) and Perforin(+) CD56(dim) NK cells correlated positively with serum alanine transaminase levels in e(-)CHB/LC. K562 cell-stimulated NK cells from e(-)CHB/LC exhibited significantly greater degranulation but diminished interferon-γ production than IC. Further, Perforin(+) NK cell frequency inversely correlated with autologous CD4(+) T-cell count in e(-) patients and ligands of NK receptors were over-expressed in CD4(+) T cells from e(-)CHB/LC relative to IC. Co-culture of sorted CD56(dim) NK cells and CD4(+) T cells from e(-)CHB showed enhanced CD4(+) T-cell apoptosis, which was reduced by perforin inhibitor, concanamycin A, suggesting a possible perforin-dependent NK cell-mediated CD4(+) T-cell depletion. Moreover, greater incidence of perforin-expressing NK cells and decline in CD4(+) T cells were noticed intrahepatically in e(-)CHB than IC. Collectively, NK cells contribute to the progression of e(-)CHI by enhanced TRAIL- and perforin-dependent cytolytic activity and by restraining anti-viral immunity through reduced interferon-γ secretion and perforin-mediated CD4(+) T-cell lysis.
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Affiliation(s)
- S Ghosh
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - M Nandi
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - S Pal
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - D Mukhopadhyay
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - B C Chakraborty
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - M Khatun
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - D Bhowmick
- CU-BD Centre of Excellence for Nanobiotechnology, Centre for Research in Nanoscience and Nanotechnology, University of Calcutta, India
| | - R K Mondal
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - S Das
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - K Das
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - R Ghosh
- Division of Gastrointestinal and Liver Pathology, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - S Banerjee
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - A Santra
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - M Chatterjee
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - A Chowdhury
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - S Datta
- Department of Hepatology and Centre for Liver Research, School of Digestive & Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India.
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