J Autoimmun. 2018 Dec;95:58-68. doi: 10.1016/j.jaut.2018.10.021. Epub 2018 Oct 26.
Viral hepatitis, inflammation, and cancer: A lesson for autoimmunity.
Piconese S1, Cammarata I2, Barnaba V3.
Author information
1
Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Italy; Istituto Pasteur Italia - Fondazione Cenci Bolognetti, Rome, Italy.
2
Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Italy.
3
Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Italy; Istituto Pasteur Italia - Fondazione Cenci Bolognetti, Rome, Italy; Center for Life Nano Science, Istituto Italiano di Tecnologia, Rome, Italy. Electronic address: [email protected].
Abstract
In the present review, we analyzed the various overlapping and non-mutually exclusive mechanisms that intersect and form complex and highly flexible immunological networks allowing the defense against liver infections and tumors. Liver immunity results from the combination of the skills of systemic and local immune system(s) to sense and recognize pathogen or tumor antigens, to sensitize a wide range of innate and adaptive immune cells, and to clear the "invaders", through the establishment of a transient liver immunopathology state undergoing resolution/control of infections or tumors, and memory development. Then, a special emphasis is placed on discussing about the capacity of the immune system(s) to develop a state of chronic low-level immunopathology adapting through the intervention of simultaneous immunoregulatory mechanisms, when the liver is infected by highly mutable viruses (e.g., hepatitis B or C viruses [HBV or HCV]) capable to escape from the immune recognition. The establishment of chronic inflammation represents an advantage for the species survival, because it guarantees the long-term survival of human hosts despite the virus persistence. However, chronic inflammation, in the long run, can evolve towards severe consequences (decompensated cirrhosis and hepatocellular carcinoma) in some individuals, finding requiring the impelling need of discovering new therapeutic anti-viral and immunostimulatory agents addressed, in combination, to fight especially HBV that, in contrast to HCV, lacks antivirals capable to eradicate the virus. Finally, we discussed the concept proposing that the divergent immunoregulatory mechanisms that develop in persisting infections or tumors, on the one hand, and autoimmunity, on the other hand, are the mirror image of each other, whose understanding is also relevant for preparing novel immunotherapeutic approaches in autoimmune diseases.
KEYWORDS:
1
意大利罗马Sapienza大学Dipartimento di Medicina InternaeSpecialitàMediche; Istituto Pasteur Italia - Fondazione Cenci Bolognetti，罗马，意大利。
2
Dipartimento di Medicina InternaeSpecialitàMediche，Sapienza University of Rome，Italy。
3
意大利罗马Sapienza大学Dipartimento di Medicina InternaeSpecialitàMediche; Istituto Pasteur Italia - Fondazione Cenci Bolognetti，罗马，意大利;生命纳米科学中心，Istituto Italiano di Tecnologia，罗马，意大利。电子地址：[email protected]。