肝脏采样：通向功能治愈途径的HBV发病机制的重要窗口

StephenW

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

StephenW

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

作者从属关系

    伦敦英国伦敦玛丽皇后大学伦敦医学与牙科学院布莱克斯研究所Barts和伦敦医学院免疫生物学中心，免疫生物学中心
    感染与免疫部，英国伦敦大学学院，伦敦

    对应于英国伦敦QMUL伦敦医学和牙科学院Bluck Institute，Barts和肝脏病学系Upkar S Gill博士; [email protected]和英国WC1E 6JF伦敦大学学院感染与免疫系Mala K Maini教授; [email protected]

抽象

为了优化改进乙型肝炎病毒（HBV）的多种新兴药物靶点，评估感染部位的病毒学和免疫学变化至关重要。传统上，肝活检一直是HBV疾病评估的主要依据，但随着肝纤维化非侵入性标记物的出现，人们开始摆脱组织取样。在这里，我们认为肝脏活检仍然是一个重要的工具，不仅用于HBV的临床评估，而且还用于研究进展和新药的评估。近年来发现的肝脏采样的重要性已经得到了强化，这些特定的子集能够进行有效的病原体监测，在肝脏中进行分区并且不在血液中进行采样。重要的是，评估病毒学参数，如cccDNA定量，也需要访问肝组织。我们讨论最大化从感染部位和疾病病理学获得的信息的策略。肝脏的细针抽吸可以允许纵向采样本地病毒/宿主景观。肝脏组织的细致利用和血液的抽吸将为评估HBV治疗的新疗法提供重要信息。

这是根据知识共享署名（CC BY 4.0）许可条款分发的开放存取文章，允许其他人分发，混合，修改和构建此作品，商业用途，前提是原始作品被正确引用。请参阅：http://creativecommons.org/licenses/by/4.0/

http://dx.doi.org/10.1136/gutjnl-2017-314873

StephenW

http://gut.bmj.com/content/67/4/767?etoc