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Insights into Immune Exhaustion in Chronic Hepatitis B: A Review of Checkpoint Receptor Expression

João Panão Costa1,2,3, Armando de Carvalho4,5, Artur Paiva4

  • 1Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal.

Pharmaceuticals (Basel, Switzerland)
|July 27, 2024
PubMed

Insights

Chronic hepatitis B (CHB) infection causes immune exhaustion by altering co-inhibitory and co-stimulatory receptors on immune cells. Understanding these changes is key for developing new immunotherapies for hepatitis B virus (HBV) patients.

Area of Science:

  • Immunology
  • Hepatology
  • Virology

Background:

  • Chronic hepatitis B (CHB) is a significant global health issue, often leading to severe liver disease.
  • Immune exhaustion, characterized by impaired immune cell function, is a hallmark of chronic viral infections like CHB.
  • This exhaustion involves an imbalance between co-inhibitory and co-stimulatory receptors on immune cells.

Purpose of the Study:

  • To review and analyze the expression patterns of co-inhibitory and co-stimulatory receptors on immune cells in CHB patients.
  • To compare immune cell receptor profiles between CHB patients and healthy individuals.
  • To investigate differences in immune exhaustion markers between HBV-specific and total T cells, and between intrahepatic and peripheral immune cells in CHB.

Main Methods:

  • Systematic review and meta-analysis of existing literature on immune cell receptor expression in CHB.
  • Comparative analysis of data from CHB patients and healthy controls.
  • Examination of immune cell subsets, including HBV-specific T cells and intrahepatic vs. peripheral immune cells.

Main Results:

  • Elevated expression of co-inhibitory receptors and/or decreased expression of co-stimulatory receptors on immune cells in CHB patients compared to healthy adults.
  • Distinct receptor expression profiles observed in HBV-specific T cells versus total T cells.
  • Significant differences in immune cell receptor expression between intrahepatic and peripheral compartments in CHB patients.

Conclusions:

  • Immune exhaustion in CHB is driven by specific alterations in co-inhibitory and co-stimulatory receptor expression.
  • These findings highlight the complex immune dysregulation in chronic hepatitis B.
  • The study provides a foundation for developing targeted immunotherapies, potentially involving checkpoint receptor modulation, to restore immune function in CHB.

Keywords:
chronic hepatitis Bco-inhibitory moleculesco-stimulatory moleculeshepatitis B virusimmune checkpoint inhibitor

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