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Hepatitis B surface antigen seroclearance: Immune mechanisms, clinical impact, importance for drug development
Issam Tout
Dimitri Loureiro
Abdellah Mansouri
Vassili Soumelis
Nathalie Boyer
Tarik Asselah
Published:April 22, 2020DOI:https://doi.org/10.1016/j.jhep.2020.04.013
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Summary
Keywords
Introduction
Molecular virology and structure of HBsAg
HBsAg detection and quantification
HBsAg seroclearance: prevalence and clinical significance
Immune cells and HBsAg
Innate immune cells
Adaptive immune cells
Cytokines and HBsAg
TLRs and HBsAg
HBsAg seroclearance in animal models
HBsAg seroclearance and current therapies
HBsAg seroclearance and novel therapies
Conclusion
Financial support
Authors' contributions
Conflict of interest
Supplementary data
References
Article Info
Figures
Tables
Related Articles
Summary
HBsAg seroclearance occurs rarely in the natural history of chronic hepatitis B (CHB) infection and is associated with improved clinical outcomes. Many factors are associated with HBsAg seroconversion, including immune and viral factors. However, the immune mechanisms associated with HBsAg seroclearance are still difficult to elucidate. HBsAg seroclearance is the ideal aim of HBV treatment. Unfortunately, this goal is rarely achieved with current treatments. Understanding the mechanisms of HBsAg loss appears to be important for the development of curative HBV treatments. While studies from animal models give insights into the potential immune mechanisms and interactions occurring between the immune system and HBsAg, they do not recapitulate all features of CHB in humans and are subject to variability due to their complexity. In this article, we review recent studies on these immune factors, focusing on their influence on CHB progression and HBsAg seroconversion. These data provide new insights for the development of therapeutic approaches to partially restore the anti-HBV immune response. Targeting HBsAg will ideally relieve the immunosuppressive effects on the immune system and help to restore anti-HBV immune responses.
Keywords
Chronic HBV infection
HBsAg seroclearance
Immune system
Interferon
Nucleos(t)ide analogues
HBV therapy
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