HBV介导的肝星状细胞和天然免疫细胞的相互作用

肝脏非实质细胞在HBV相关的肝脏疾病中发挥着至关重要的作用,而肝星状细胞(HSC)的激活以及与肝内细胞之间的相互作用是导致肝纤维化的主要原因。主要介绍了HBV诱导的肝脏炎症以及天然免疫细胞与HSC的相互作用,简述了HBV作用下单核/巨噬细胞和自然杀伤细胞(NK细胞)对HSC的激活和杀伤作用以及HSC的肝脏免疫调节作用。     

Natural killer cells ameliorate liver fibrosis by killing activated stellate cells in NKG2D-dependent and tumor necrosis factor-related apoptosis-inducing ligand-dependent manners

BACKGROUND & AIMS: Viral hepatitis infection, which is a major cause of liver fibrosis, is associated with activation of innate immunity. However, the role of innate immunity in liver fibrosis remains obscure. METHODS: Liver fibrosis was induced either by feeding mice with the 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet or by injecting them with carbon tetrachloride. The Toll-like receptor 3 ligand, polyinosinic-polycytidylic acid, was used to activate innate immunity cells and mediators, including natural killer cells and interferon gamma. RESULTS: In the mouse model of DDC-induced liver fibrosis, natural killer cell activation by polyinosinic-polycytidylic acid induced cell death to activated hepatic stellate cells and attenuated the severity of liver fibrosis. Polyinosinic-polycytidylic acid treatment also ameliorated liver fibrosis induced by carbon tetrachloride. The observed protective effect of polyinosinic-polycytidylic acid on liver fibrosis was diminished through either depletion of natural killer cells or by disruption of the interferon gamma gene. Expression of retinoic acid early inducible 1, the NKG2D ligand, was undetectable on quiescent hepatic stellate cells, whereas high levels were found on activated hepatic stellate cells, which correlated with the resistance and susceptibility of quiescent hepatic stellate cells and activated hepatic stellate cells to natural killer cell lysis, respectively. Moreover, treatment with polyinosinic-polycytidylic acid or interferon gamma enhanced the cytotoxicity of natural killer cells against activated hepatic stellate cells and increased the expression of NKG2D and tumor necrosis factor-related apoptosis-inducing ligand on liver natural killer cells. Blocking NKG2D or tumor necrosis factor-related apoptosis-inducing ligand with neutralizing antibodies markedly diminished the cytotoxicity of polyinosinic-polycytidylic acid-activated natural killer cells against activated hepatic stellate cells. CONCLUSIONS: Our findings suggest that natural killer cells kill activated hepatic stellate cells via retinoic acid early inducible 1/NKG2D-dependent and tumor necrosis factor-related apoptosis-inducing ligand-dependent mechanisms, thereby ameliorating liver fibrosis.     

Activated natural killer T cells induce liver injury by Fas and tumor necrosis factor-alpha during alcohol consumption

BACKGROUND & AIMS: Chronic alcohol abuse induces liver injury and increases the severity of viral hepatitis, but the precise mechanisms responsible are not well understood. In particular, little is known about the role of natural killer T cells in alcohol-induced liver injury. Natural killer T cells are mediators of important regulator and effector functions making use of Fas and tumor necrosis factor (TNF)-alpha in apoptosis induction. This report analyzes the role of natural killer T cells, Fas, and TNF-alpha in a model of chronic alcohol consumption. METHODS: Mice fed alcohol by intragastric tube were assayed for serum alanine aminotransferase values, liver histology, and liver mononuclear cells before and after activation of natural killer T cells by ligand alpha-galactosylceramide. RESULTS: In alcohol-consuming animals, liver natural killer T cells increase, and further activation by alpha-galactosylceramide causes lethal liver injury. This is explained by alcohol-induced hepatocyte sensitization to cell-mediated lysis, which develops concomitant to increased cytolytic activity of natural killer T cells. Natural killer T cell-mediated apoptosis proceeds by the Fas pathway, and Fas is essential for alcohol-associated liver injury. TNF-alpha plays an additional role as a defect in TNF receptor-1 inhibits alcohol-associated liver injury. Alcohol-fed natural killer T cell-deficient Jalpha281(-/-) mice express a delay in alcohol-induced liver injury. CONCLUSIONS: Alcohol consumption induces an increase of natural killer T cells in the liver and a high sensitivity of hepatocytes to cell-mediated lysis. Stimulation of natural killer T cells during alcohol consumption induces serious liver injury by a mechanism that involves concomitant signals by Fas and tumor necrosis factor receptor-1 on alcohol-stressed hepatocytes.     

肝脏自然杀伤细胞在慢性肝病中的作用

肝脏自然杀伤细胞（NK）是一种与外周血NK细胞不同的肝脏免疫细胞。近年来研究表明肝脏NK细胞在各种慢性肝脏疾病中起重要作用。包括对抑制病毒感染和肿瘤细胞生长,对抗肝纤维化均有益处,但同时其又刺激肝损伤和抑制肝再生（肝细胞增殖）。本文就肝脏NK细胞的特征、功能以及在各种常见慢性肝病中作用进展作一综述。     

Augmenter of liver regeneration (ALR) may promote liver regeneration by reducing natural killer (NK) cell activity in human liver diseases

Cytotoxicity of liver natural killer cells against regenerating hepatocytes has been reported as a possible mechanism of regeneration failure in fulminant hepatitis. An augmenter of liver regeneration (ALR) inhibits liver natural killer cell activity in rats. In this study, we measured hepatic expression of ALR mRNA, blood levels of ALR, and peripheral blood natural killer cell activity in patients with various types of acute liver disease to investigate the relationship between failure of liver regeneration and hepatic natural killer cells. Hepatic ALR mRNA expression was higher in liver disease patients than in non-liver disease controls, and a correlation was found between serum ALR values and hepatic levels of ALR mRNA. In acute liver injury, the serum ALR level also showed a negative correlation with NK activity. ALR was produced by and released from the liver at the time of hepatic injury. Our findings suggest that ALR may protect against failure of regeneration by inhibition of hepatic natural killer cell activity in acute liver injury. Received: December 7, 1998 / Accepted: August 27, 1999     

Immune suppression in chronic hepatitis B infection associated liver disease: A review

Hepatitis B virus(HBV) infection is one the leading risk factors for chronic hepatitis, liver fibrosis, cirrhosis and hepatocellular cancer(HCC), which are a major global health problem. A large number of clinical studies have shown that chronic HBV persistent infection causes the dysfunction of innate and adaptive immune response involving monocytes/macrophages, dendritic cells, natural killer(NK) cells, T cells. Among these immune cells, cell subsets with suppressive features have been recognized such as myeloid derived suppressive cells(MDSC),NK-reg, T-reg, which represent a critical regulatory system during liver fibrogenesis or tumourigenesis. However, the mechanisms that link HBVinduced immune dysfunction and HBV-related liver diseases are not understood.In this review we summarize the recent studies on innate and adaptive immune cell dysfunction in chronic HBV infection, liver fibrosis, cirrhosis, and HCC, and further discuss the potential mechanism of HBV-induced immunosuppressive cascade in HBV infection and consequences. It is hoped that this article will help ongoing research about the pathogenesis of HBV-related hepatic fibrosis and HBV-related HCC.     

Chronic ethanol consumption inhibits hepatic natural killer cell activity and accelerates murine cytomegalovirus-induced hepatitis

BACKGROUND: Chronic alcohol drinking accelerates the progression of liver disease in patients with hepatitis viral infection; however, the underlying mechanisms are not fully understood. METHODS: Here, we examined the effects of chronic ethanol feeding on hepatic natural killer (NK) cells and liver injury in 2 murine models of liver injury: injection of synthetic double-stranded RNA polyinosinic-polycytidylic acid (poly I:C), which mimics viral infection, and infection with murine cytomegalovirus (MCMV). Mice were fed the Lieber-DeCarli liquid diet containing 5% (vol/vol) ethanol for 8 weeks, resulting in a significant decrease in the percentage and total number of NK cells in the liver. RESULTS: In control, pair-fed mice, poly I:C injection induced NK cell accumulation in the liver and activated hepatic NK cell cytotoxicity, whereas such induction and activation were diminished in ethanol-fed mice. Treatment with poly I:C also induced expression of NKG2D, granzyme B, perforin, Fas L, TRAIL, and IFN-gamma on liver lymphocytes, which were delayed or reduced in ethanol-treated mice compared with pair-fed mice. In contrast, chronic ethanol feeding did not affect poly I:C-induced mild liver injury. Furthermore, MCMV infection activated hepatic NK cells and induced hepatic inflammation and injury. Chronic ethanol consumption inhibited hepatic NK cell activation during MCMV infection, but enhanced MCMV-induced liver injury, viral titer, and inflammation in the liver. CONCLUSIONS: Taken together, these findings suggest that chronic ethanol consumption decreases hepatic NK activity, thereby accelerating MCMV-induced hepatitis and liver injury.     

Negative regulation of liver regeneration by innate immunity (natural killer cells/interferon-gamma)

BACKGROUND AND AIMS: Hepatic lymphocytes are composed mainly of natural killer (NK) cells and NKT cells, which play key roles in innate immune responses against pathogens and tumors in the liver. This report analyzes the effects of activation of innate immunity by viral infection or the toll-like receptor 3 (TLR3) ligand on liver regeneration. METHODS: The partial hepatectomy (PHx) method was used as a model of liver regeneration. Murine cytomegalovirus (MCMV) infection and the TLR3 ligand polyinosinic-polycytidylic acid [poly(I:C)] were used to activate innate immunity. RESULTS: NK cells are activated after PHx, as evidenced by producing interferon (IFN)-gamma. Infection with MCMV or injection of poly(I:C) further activates NK cells to produce IFN-gamma and attenuates liver regeneration in the PHx model. Depletion of NK cells or disruption of either the IFN-gamma gene or the IFN-gamma receptor gene enhances liver regeneration and partially abolishes the negative effects of MCMV and polyI:C on liver regeneration, whereas NKT cells may only play a minor role in suppression of liver regeneration. Adoptive transfer of IFN-gamma +/+ NK cells, but not IFN-gamma -/- NK cells, restores the ability of polyI:C to attenuate liver regeneration in NK-depleted mice. Finally, administration of polyI:C or IFN-gamma enhances expression of several antiproliferative proteins, including STAT1, IRF-1, and p21cip1/waf1 in the livers of partially hepatectomized mice. CONCLUSIONS: Our findings suggest that viral infection and the TLR3 ligand negatively regulate liver regeneration via activation of innate immunity (NK/IFN-gamma), which may play an important role in the pathogenesis of viral hepatitis.     

The Natural Selection of Herpesviruses and Virus-Specific NK Cell Receptors

During the co-evolution of cytomegalovirus (CMV) and natural killer (NK) cells, each has evolved specific tactics in an attempt to prevail. CMV has evolved multiple immune evasion mechanisms to avoid detection by NK cells and other immune cells, leading to chronic infection. Meanwhile, the host has evolved virus-specific receptors to counter these evasion strategies. The natural selection of viral genes and host receptors allows us to observe a unique molecular example of “survival of the fittest”, as virus and immune cells try to out-maneuver one another or for the virus to achieve détente for optimal dissemination in the population.     

慢性乙型肝炎患者外周血NK细胞和T淋巴细胞计数变化及其临床意义

目的观察慢性乙型肝炎患者外周血NK细胞和T淋巴细胞数量的变化。方法在56例乙型肝炎肝衰竭、49例HBeAg阳性慢性乙型肝炎和41例乙型肝炎病毒携带者使用流式细胞仪检测外周血CD3+T细胞、CD3+CD4+T细胞、CD3+CD8+T细胞和NK(CD3-CD16+CD56+)细胞占淋巴细胞的比率(%)。结果肝衰竭患者CD3+T细胞和CD3-CD16+CD56+NK细胞计数比慢性乙型肝炎患者和乙型肝炎病毒携带者显著性降低(P0.05);慢性乙型肝炎患者CD3-CD16+CD56+NK细胞计数比乙型肝炎病毒携带者显著性升高(P0.05)。结论乙型肝炎肝衰竭患者外周血T细胞和NK细胞数量减少,而HBeAg阳性慢性乙型肝炎患者外周血T细胞数量增多。     

Interferon gamma-secreting HCV-specific CD8+ T cells in the liver of patients with chronic C hepatitis: relation to liver fibrosis--ANRS HC EP07 study

Little is known about the role of specific hepatitis C virus (HCV) CD8+ T cells in liver damage, especially for the progression of fibrosis, during the highly variable course of chronic C hepatitis. The aim of this study was to investigate the presence of HCV-specific CD8+ T cells in the liver of patients with chronic C hepatitis and to examine their clinical significance by relating the response to liver fibrosis and progression rate, serum viral load, serum aminotransferase levels, inflammatory activity and in situ characteristics of the intrahepatic infiltrate. Fifteen patients were prospectively included in the study. Intrahepatic lymphocytes were tested for interferon gamma (IFNg) production in response to HCV class I-restricted epitopic peptides using enzyme-linked immunospot analysis. Liver biopsy samples were evaluated for fibrosis, fibrosis progression rate, activity, and in situ number of CD8+ cytotoxic lymphocytes and apoptotic cells. An IFNg-specific CD8+ T-cell response was detected in the liver samples of 47% of patients which was significantly related to a lower stage of fibrosis (P = 0.02) and a lower progression rate of fibrosis (P = 0.01). It was neither related to the number of cytotoxic lymphocytes infiltrating the liver nor to hepatocyte apoptosis. In conclusion, our results indicate that the presence of HCV-specific IFNg-secreting T cells in the liver of patients with chronic C hepatitis is associated with low liver fibrosis and fibrosis progression rate, suggesting that these IFNg-secreting T cells might limit the progression of liver damage.     

Role of stress-induced NKG2D ligands in liver diseases

Cell death by apoptosis is a prominent feature in a variety of liver diseases. It is likely that apoptosis is the initial cellular response to hepatocyte and biliary injury, which then leads to the initiation of cellular and cytokine cascades culminating in hepatocyte death with subsequent fibrosis and cirrhosis. This sequence of events is of paramount clinical importance. Recently, soluble forms of the major histocompatibility complex class I-related chains A and closely related B (MIC A and B) were reported to be increased in patients with a variety of liver diseases. MIC A and B are cell surface glycoproteins that function as indicators for cellular stress and thus activate circulating cytotoxic natural killer (NK) cells. The interaction between MIC A and B with their cognate receptor natural killer group 2 member D (NKG2D) culminates in enhanced liver cell death, which is mediated in part by apoptotic mechanisms. The present overview focuses on the role of the stress-induced NKG2D ligands MIC A and B in diverse liver diseases. Critical insights into these complex relations may help to promote rationally based therapies in liver diseases. Importantly, we hope that this overview will help to stimulate further studies into mechanisms by which stress ligands mediate cell death and its sequale.     

Natural killer cell activation enhances immune pathology and promotes chronic infection by limiting CD8+ T-cell immunity

Infections with HIV, hepatitis B virus, and hepatitis C virus can turn into chronic infections, which currently affect more than 500 million patients worldwide. It is generally thought that virus-mediated T-cell exhaustion limits T-cell function, thus promoting chronic disease. Here we demonstrate that natural killer (NK) cells have a negative impact on the development of T-cell immunity by using the murine lymphocytic choriomeningitis virus. NK cell-deficient (Nfil3(-/-), E4BP4(-/-)) mice exhibited a higher virus-specific T-cell response. In addition, NK cell depletion caused enhanced T-cell immunity in WT mice, which led to rapid virus control and prevented chronic infection in lymphocytic choriomeningitis virus clone 13- and reduced viral load in DOCILE-infected animals. Further experiments showed that NKG2D triggered regulatory NK cell functions, which were mediated by perforin, and limited T-cell responses. Therefore, we identified an important role of regulatory NK cells in limiting T-cell immunity during virus infection.     

KCTD9在暴发性肝炎小鼠中的作用机制初探

目的 初步探讨KCTD9在暴发性肝炎模型小鼠中的作用机制.方法 78只BALB/cJ小鼠(其中雄性6只)随机分为暴发性肝炎对照组和暴发性肝炎模型组,每组39只(每组雄性3只);75只C3H/HeJ雌性小鼠分为慢性肝炎对照组(36只)和慢性肝炎模型组(39只).模型组每只小鼠腹腔注射MHV-3(100 PFU).暴发性肝炎对照组和模型组48 h试验点以1只雄性小鼠供取睾丸,2只雌性小鼠供取肝脾等组织标本和分离肝细胞,10只雌性小鼠为1个单位取肝组织供分离肝脾淋巴细胞;慢性肝炎对照组和模型组48 h时以1只小鼠供取肝脾组织,1只小鼠供分离肝细胞,10只为1个单位供分离肝脾淋巴细胞,重复3次,剩下3只小鼠在建模15d时处死,仅供取肝脾组织.磁珠分选肝脾单个核细胞,采用免疫组织化学、实时定量PCR技术检测KCTD9在暴发性肝炎、慢性肝炎模型动物中的表达差异,各组间比较用t检验或方差分析.结果 与对照组比较,KCTD9 mRNA在暴发性肝炎模型组小鼠肝CD8+T细胞、CD4+T细胞、自然杀伤细胞(NK)细胞中分别上调8.8倍、59.4倍、577.1倍,t值分别为-5.393、-3.706和-4.714,P值均＜0.05,差异有统计学意义;在脾CD4+T细胞、CD8+T细胞中,KCTD9 mRNA表达水平分别下调了43％和69％,t值分别为2.906、10.98,P值均＜ 0.05,差异有统计学意义.与对照组比较,在慢性肝炎模型组小鼠肝NK细胞和CD4+T细胞中KCTD9 mRNA分别下调71％、51％,t值分别为3.827、5.746,P值均＜0.05,差异有统计学意义.KCTD9蛋白在暴发性肝炎模型组小鼠肝细胞中呈弱阳性表达,坏死灶周围及组织中炎症浸润细胞中呈强阳性表达;脾中阳性细胞仍散在分布,与对照组比较,脾白髓中细胞数量减少达71％.结论 KCTD9在MHV-3诱导的暴发性肝炎模型小鼠肝脏高表达,可能参与疾病发生和发展过程.     

NK细胞与丙型肝炎

自然杀伤细胞（NK细胞）无需抗原预先致敏,即可直接杀伤某些肿瘤细胞和病毒感染细胞,是人类抗感染免疫及抗肿瘤、清除异己细胞的第一道天然防线。HCV感染的患者NK细胞数量和功能降低可能是造成疾病慢性化的重要原因。本文就NK细胞与丙型肝炎的关系作一综述。     

Involvement of natural killer cells in PolyI:C-induced liver injury

BACKGROUND/AIMS: The roles of T cells, natural killer T cells (NKT) and macrophages in autoimmune hepatitis have been well documented. However, the roles of natural killer (NK) cells in liver injury remain obscure. Here we examined the effect of Polyinosinic: polycytidylic acid (PolyI:C)-activated NK cells on liver injury. METHODS: Mice were intraperitoneally injected with PolyI:C at a dose of 20mug/g body wt. The percentage and absolute number of NK cells in the liver were analyzed with flow cytometry. Serum alanine transaminase (ALT) and aspartate aminotransferase (AST) assay and H-E staining were used to evaluate the liver injury. RESULTS: Following PolyI:C injection, NK cells accumulation and activation occurred in the liver. Meanwhile, slight elevation of ALT/AST in the serum, mild inflammation and focal necrosis in the liver were also observed. Depletion of NK cells markedly attenuated PolyI:C-induced liver injury. Neutralization of endogenous Interleukin-12 produced by Kupffer cells abrogated the accumulation of NK cells in the liver and subsequent liver injury. The liver injury was also alleviated by neutralization of vascular cell adhesive molecule-1. CONCLUSIONS: These findings suggest that PolyI:C preferentially recruits and activates hepatic NK cells, which may be responsible for the mild hepatitis.     

Regulatory natural killer cells in murine liver and their immunosuppressive capacity

Background: Abundant amounts of natural killer (NK) cells are present in the liver, most of which are endowed with direct cytotoxic and inflammatory cytokine production capacities. However, the control of compromised immunity in the liver may be accomplished by a population of regulatory NK cells possessing suppressive or tolerogenic functions. Aims: To identify and characterize regulatory NK cells in murine liver. Methods: NK cells were isolated from the liver of C57BL/6 mice by magnetic‐activated cells sorting (MACS). NK cells were stimulated with different agents and those cells that produced interleukin (IL)‐10 were detected by flow cytometry and isolated by MACS. IL‐10‐producing NK cells were regarded as regulatory NK cells and the functional capacities of liver‐derived regulatory NK cells were assessed in vitro. Results: The frequencies of regulatory NK cells in the liver were 4.1 ± 0.3% of hepatic NK cells and 0.45 ± 0.02% of liver nonparenchymal cells. Regulatory NK cells produced abundant amounts of IL‐10 in culture. These cells also suppressed the proliferative capacities of T cells and B cells in vitro. However, another population of NK cells that did not produce IL‐10 (immunogenic NK cells) could not suppress lymphocyte proliferation. Conclusions: The presence of regulatory NK cells in the liver and their immunosuppressive capacities endowed these cells with the critical function of maintaining homeostasis under normal conditions. Exaggerated or impaired functions of these cells may also contribute to different pathological processes.     

肝脏自然杀伤细胞在小鼠急性肝衰竭中的作用

目的 探讨肝脏自然杀伤(NK)细胞在3型鼠肝炎病毒(MHV-3)诱导的小鼠急性肝衰竭中的作用.方法 取6～8周龄雌性Balb/cJ小鼠,腹腔注射100 pfu MHV-3,采用流式细胞术检测感染MHV-3 0、24、48、70 h后的Balb/cJ小鼠肝脏、脾脏、外周血和骨髓中NK细胞的百分率及肝脏NK细胞表面活化分子CD69表达的百分率.细胞内细胞因子染色法检测肝脏NK细胞分泌干扰素γ的水平.非放射性细胞毒试验检测肝脏NK细胞的杀伤活性. 结果Balb/cJ小鼠感染MHV-3后,肝脏NK细胞的比例显著升高,在感染48 h后达到峰值(43.9%±2.3%),约为感染前的4倍,随后仍维持在较高水平至小鼠死亡;外周血NK细胞比例同样明显升高,在感染48 h后达到峰值(18.0%±5.4%),但随后显著同落,至70 h仅为1.3%±0.6%,脾脏和骨髓NK细胞比例均先明显减少后又有所上升.肝脏NK细胞在MHV-3感染48 h后其表面活化分子CD69表达明显上调,杀伤活性显著增强,同时分泌干扰素Y的水平也显著增加. 结论 Balb/cJ小鼠感染MHV-3后,来自骨髓和脾脏的NK细胞在肝脏迅速大量募集和活化,且杀伤活性显著增强,分泌干扰素Y水平也显著增加,表明肝脏NK细胞在MHV-3导致的急性肝衰竭中可能发挥着关键作用.