CNRS UMR 8161, Institut de Biologie de Lille, 1 rue du Professeur Calmette, Lille 59021, France.
Expert Opin Biol Ther. 2010 Nov;10(11):1563-72. doi: 10.1517/14712598.2010.529125. Epub 2010 Oct 11.
Hepatic cirrhosis is a frequent consequence of chronic hepatitis infection (HBV and HCV) or alcohol abuse and the most common cause of hepatocellular carcinoma (HCC). Currently, liver transplantation remains the only effective therapeutic approach for cirrhosis-related HCC patients. The evolution of the pathology strongly depends on immunological mechanisms.
Despite the presence of specific T cells, viral chronic infection and continuous tumor growth suggest a failure of immune control. It appears that direct suppression of antiviral or antitumor effector cells by regulatory T cells plays a pivotal role in the impairment of immune response. Several types of regulatory T cells have been described, natural regulatory T cells (nTreg) and induced-type 1 regulatory T cells (Tr1) being the best characterized.
Currently, there is no evidence for a direct implication of regulatory T cells in the evolution of hepatitis, especially concerning chronic infection, cirrhosis late stage and HCC progress. However, recent studies show that regulatory T cells are implicated in the modulation of HBV- and HCV-associated immune response, thus, promoting HCC progress.
Therefore, nTreg and Tr1 cells seem to play an important role in the control of immune response leading to chronic hepatitis infection and progression of the pathology to cirrhosis and HCC.
肝硬化是慢性肝炎感染(HBV 和 HCV)或酗酒的常见后果,也是肝细胞癌(HCC)的最常见原因。目前,肝移植仍然是肝硬化相关 HCC 患者唯一有效的治疗方法。病理学的演变强烈依赖于免疫机制。
尽管存在特异性 T 细胞,但病毒慢性感染和持续肿瘤生长表明免疫控制失败。似乎调节性 T 细胞对抗病毒或抗肿瘤效应细胞的直接抑制在免疫反应的损害中起着关键作用。已经描述了几种类型的调节性 T 细胞,天然调节性 T 细胞(nTreg)和诱导型 1 调节性 T 细胞(Tr1)是最具特征的。
目前,尚无证据表明调节性 T 细胞直接参与肝炎的演变,特别是慢性感染、肝硬化晚期和 HCC 进展。然而,最近的研究表明,调节性 T 细胞参与调节 HBV 和 HCV 相关的免疫反应,从而促进 HCC 的进展。
因此,nTreg 和 Tr1 细胞似乎在控制免疫反应中发挥重要作用,导致慢性肝炎感染以及病理学向肝硬化和 HCC 的进展。