Liver sampling: a vital window into HBV pathogenesis on the path to functional cure
Upkar S Gill1, Laura J Pallett2, Patrick T F Kennedy1, Mala K Maini2
Author affiliations
Department of Hepatology, Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Division of Infection and Immunity, UCL, London, UK
Correspondence to Dr Upkar S Gill, Department of Hepatology, Blizard Institute, Barts and the London School of Medicine and Dentistry, QMUL, London, UK; [email protected] and Professor Mala K Maini, Division of Infection and Immunity, UCL, London, WC1E 6JF, UK; [email protected]
Abstract
In order to optimally refine the multiple emerging drug targets for hepatitis B virus (HBV), it is vital to evaluate virological and immunological changes at the site of infection. Traditionally liver biopsy has been the mainstay of HBV disease assessment, but with the emergence of non-invasive markers of liver fibrosis, there has been a move away from tissue sampling. Here we argue that liver biopsy remains an important tool, not only for the clinical assessment of HBV but also for research progress and evaluation of novel agents. The importance of liver sampling has been underscored by recent findings of specialised subsets of tissue-resident immune subsets capable of efficient pathogen surveillance, compartmentalised in the liver and not sampled in the blood. Importantly, the assessment of virological parameters, such as cccDNA quantitation, also requires access to liver tissue. We discuss strategies to maximise information obtained from the site of infection and disease pathology. Fine needle aspirates of the liver may allow longitudinal sampling of the local virus/host landscape. The careful utilisation of liver tissue and aspirates in conjunction with blood will provide critical information in the assessment of new therapeutics for the functional cure of HBV.
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
http://dx.doi.org/10.1136/gutjnl-2017-314873
作者: StephenW 时间: 2018-3-9 12:17
肝脏采样：通向功能治愈途径的HBV发病机制的重要窗口
Upkar S Gill1，Laura J Pallett2，Patrick T F Kennedy1，Mala K Maini2