Abstract

BackgroundChronic hepatitis C virus (HCV) infection results from weak or absent T cell responses. Pegylated-interferon-alpha (IFN-α) and ribavirin, the standard of care for chronic HCV, have numerous immune effects but are not potent T cell activators. A potent immune activator such as TLR9 agonist CpG oligodeoxynucleotide (CpG) may complement current treatment approaches.MethodsPeripheral blood mononuclear cells (PBMC) obtained from HCV chronic carriers who failed previous treatment and from healthy donors were incubated in vitro with the three main CpG classes (A, B or C), recombinant IFN-α-2b (IntronA) and/or ribavirin. Proliferation and cytokine secretion (IFN-α, IL-10 and IP-10) were evaluated.ResultsCpG induced proliferation and cytokine secretion in patterns expected for each CpG class with similar group means for HCV and healthy donors. IntronA and ribavirin, alone or together, had no detectable effects. IntronA and C-Class CpG together induced more IFN-α than CpG alone in most subjects. IFN-α secretion was proportional to the number of plasmacytoid dendritic cells in PBMC from healthy donors but not HCV donors in whom responses were highly heterogeneous.ConclusionThe strong immune stimulatory effect of CpG on PBMC isolated from treatment-failed HCV patients suggests possible utility alone or in combination with current HCV antiviral treatment.

Highlights

  • Chronic hepatitis C virus (HCV) infection results from weak or absent T cell responses

  • IL-10 has been proposed to promote the formation of regulatory T cells (Treg) in chronic HCV that inhibit the generation of desirable Th1 type T cell responses [23]

  • Cytokine secretion Healthy donor Peripheral blood mononuclear cells (PBMC) secreted the highest levels of IFN-α and IP-10 (Figure 1)

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Summary

Introduction

Chronic hepatitis C virus (HCV) infection results from weak or absent T cell responses. Pegylated-interferon-alpha (IFN-α) and ribavirin, the standard of care for chronic HCV, have numerous immune effects but are not potent T cell activators. Journal of Immune Based Therapies and Vaccines 2008, 6:3 http://www.jibtherapies.com/content/6/1/3 with self-resolving acute infection in comparison to those who go on to develop chronic disease [6,7,8,9]. These responses improve during therapy but remain much weaker than with self-resolving infection [10,11,12]. HCV treatments may benefit from more potent immune modulators used alone or in combination with current treatment regimes

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