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Increased Proinflammatory Cytokine Production by Chronic Hepatitis B Patients With Mutant Hepatitis B Virus: Plausible Mechanisms Underlying Severe Liver Diseases in These Patients
Ruksana Raihan 1 , Sheikh Mohammad Fazle Akbar 2 3 , Mamun Al Mahtab 4 , Md Sakirul Islam Khan 5 , Shahina Tabassum 6 , Kok Keng Tee 7 8 , Rosmawati Binti Mohamed 1
Affiliations
Affiliations
1
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
2
Department of Pathology, Ehime University Proteo-Science Center, Ehime University Graduate School of Medicine, Toon City, Japan.
3
Miyakawa Memorial Research Foundation, Tokyo, Japan.
4
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
5
Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
6
Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
7
Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
8
School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia.
PMID: 32513066 DOI: 10.1089/vim.2019.0198
Abstract
Hepatitis B virus (HBV) is a noncytopathic virus and billions of HBV-infected patients live uneventful lives and do not suffer from notable liver damage. However, HBV also causes progressive liver diseases characterized by hepatic inflammation, hepatic fibrosis, and liver cancer in millions of HBV-infected patients. The goal of this study was to evaluate the role of mutant HBV in HBV pathogenesis. In a cohort of 360 chronic HBV-infected patients, mutations at T1762/A1764 of HBV genome were detected in most of the patients with HBV-induced liver cirrhosis and hepatocellular carcinoma. To explore if mutations at T1762/A1764 of HBV genome has any role in progressive liver disease, peripheral blood mononuclear cells (PBMCs) and antigen-presenting dendritic cells (DCs) were isolated from five chronic hepatitis B (CHB) patients with mutations at T1762/A1764 and five comparable patients of CHB without mutations at T1762/A1764. DCs were pulsed with hepatitis B surface antigen (HBsAg). The levels of cytokines produced by PBMCs and DCs as well as nitrite production by DCs were evaluated. Significantly higher levels of interleukin-12, tumor necrosis factor-alpha, interferon-gamma, and transforming growth factor-beta were detected in cultures of PBMCs, DCs, and HBsAg-pulsed DCs from CHB patients with mutations at T1762/A1764 compared with those without mutations (p < 0.05). DCs of all CHB patients with mutations produced significantly higher levels of nitrite compared with those without mutation at T1762/A1764 (p < 0.001). This study discusses the inflammatory potential of mutant HBV that may be responsible for diverse levels of pathogenicity of HBV. Further studies involving larger cohorts would provide more insight into these unresolved issues about HBV pathogenesis and these insights may aid in developing immune therapy for CHB patients.
Keywords: chronic hepatitis B; host immunity; viral mutation.
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