Abstract
The T-cell-mediated immune response plays a crucial role in defense against hepatotropic viruses as well as in the pathogenesis of viral chronic hepatitides. However, very little is known about the role of specific T cells during hepatitis delta virus (HDV) infection in humans. In this study, the T-cell response to HDV in chronic hepatitis B virus (HBV) carriers with HDV superinfection was investigated at different levels. Analysis of peripheral blood mononuclear cell (PBMC) proliferation in response to a recombinant form of large hepatitis delta antigen (HDAg) revealed that 8 of 30 patients studied (27%) specifically responded to HDAg. By employing synthetic peptides spanning the entire HDAg sequence, we found that T-cell recognition was directed against different antigenic determinants, with patient-to-patient variation in the pattern of response to peptides. Interestingly, all responders had signs of inactive HDV-induced disease, while none of the patients with active disease and none of the control subjects showed any significant proliferation. More accurate information about the specific T-cell response was obtained at the clonal level. A panel of HDAg-specific CD4+ T-cell clones from three HDV-infected individuals and fine-specificity analysis revealed that the clones tested individually recognized four epitopes corresponding to amino acids (aa) 26 to 41, 50 to 65, 66 to 81, or 106 to 121 of HDAg sequence. The study of human leukocyte antigen (HLA) restriction revealed that peptides 50 to 65 and 106 to 121 were presented to specific T cells in association with multiple class II molecules. In addition, peptide 26 to 41 was efficiently generated after processing of HDAg through the endogenous processing pathway. Cytokine secretion analysis showed that all the CD4+ T-cell clones assayed were able to produce high levels of gamma interferon (IFN-gamma), belonging either to T helper-1 (Th1) or Th0 subsets and that some of them were cytotoxic in a specific assay. This study provides the first evidence that detection of a specific T-cell response to HDAg in the peripheral blood of individuals with hepatitis delta is related to the decrease of HDV-induced disease activity. The HDAg epitopes identified here and particularly those recognized by CD4+ T cells in association with multiple major histocompatibility complex class II molecules may be potentially exploited for the preparation of a vaccine for prophylaxis and therapy of HDV infection.
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- Abrams S. I., Wang R., Munger W. E., Russell J. H. Detachment and lysis of adherent target cells by CD4+ T cell clones involve multiple effector mechanisms. Cell Immunol. 1993 Mar;147(1):188–202. doi: 10.1006/cimm.1993.1059. [DOI] [PubMed] [Google Scholar]
- Adorini L., Guéry J. C., Fuchs S., Ortiz-Navarrete V., Hämmerling G. J., Momburg F. Processing of endogenously synthesized hen egg-white lysozyme retained in the endoplasmic reticulum or in secretory form gives rise to a similar but not identical set of epitopes recognized by class II-restricted T cells. J Immunol. 1993 Oct 1;151(7):3576–3586. [PubMed] [Google Scholar]
- Adorini L., Ullrich S. J., Appella E., Fuchs S. Inhibition by brefeldin A of presentation of exogenous protein antigens to MHC class II-restricted T cells. Nature. 1990 Jul 5;346(6279):63–66. doi: 10.1038/346063a0. [DOI] [PubMed] [Google Scholar]
- Barnaba V., Franco A., Alberti A., Balsano C., Benvenuto R., Balsano F. Recognition of hepatitis B virus envelope proteins by liver-infiltrating T lymphocytes in chronic HBV infection. J Immunol. 1989 Oct 15;143(8):2650–2655. [PubMed] [Google Scholar]
- Barnaba V., Franco A., Alberti A., Benvenuto R., Balsano F. Selective killing of hepatitis B envelope antigen-specific B cells by class I-restricted, exogenous antigen-specific T lymphocytes. Nature. 1990 May 17;345(6272):258–260. doi: 10.1038/345258a0. [DOI] [PubMed] [Google Scholar]
- Barnaba V., Franco A., Paroli M., Benvenuto R., De Petrillo G., Burgio V. L., Santilio I., Balsano C., Bonavita M. S., Cappelli G. Selective expansion of cytotoxic T lymphocytes with a CD4+CD56+ surface phenotype and a T helper type 1 profile of cytokine secretion in the liver of patients chronically infected with Hepatitis B virus. J Immunol. 1994 Mar 15;152(6):3074–3087. [PubMed] [Google Scholar]
- Battegay M., Moskophidis D., Rahemtulla A., Hengartner H., Mak T. W., Zinkernagel R. M. Enhanced establishment of a virus carrier state in adult CD4+ T-cell-deficient mice. J Virol. 1994 Jul;68(7):4700–4704. doi: 10.1128/jvi.68.7.4700-4704.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bender B. S., Croghan T., Zhang L., Small P. A., Jr Transgenic mice lacking class I major histocompatibility complex-restricted T cells have delayed viral clearance and increased mortality after influenza virus challenge. J Exp Med. 1992 Apr 1;175(4):1143–1145. doi: 10.1084/jem.175.4.1143. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bergmann K. F., Cote P. J., Moriarty A., Gerin J. L. Hepatitis delta antigen. Antigenic structure and humoral immune response. J Immunol. 1989 Dec 1;143(11):3714–3721. [PubMed] [Google Scholar]
- Bonino F., Negro F., Baldi M., Brunetto M. R., Chiaberge E., Capalbo M., Maran E., Lavarini C., Rocca N., Rocca G. The natural history of chronic delta hepatitis. Prog Clin Biol Res. 1987;234:145–152. [PubMed] [Google Scholar]
- Braciale T. J., Morrison L. A., Sweetser M. T., Sambrook J., Gething M. J., Braciale V. L. Antigen presentation pathways to class I and class II MHC-restricted T lymphocytes. Immunol Rev. 1987 Aug;98:95–114. doi: 10.1111/j.1600-065x.1987.tb00521.x. [DOI] [PubMed] [Google Scholar]
- Brunner T., Mogil R. J., LaFace D., Yoo N. J., Mahboubi A., Echeverri F., Martin S. J., Force W. R., Lynch D. H., Ware C. F. Cell-autonomous Fas (CD95)/Fas-ligand interaction mediates activation-induced apoptosis in T-cell hybridomas. Nature. 1995 Feb 2;373(6513):441–444. doi: 10.1038/373441a0. [DOI] [PubMed] [Google Scholar]
- Buchmeier M. J., Welsh R. M., Dutko F. J., Oldstone M. B. The virology and immunobiology of lymphocytic choriomeningitis virus infection. Adv Immunol. 1980;30:275–331. doi: 10.1016/s0065-2776(08)60197-2. [DOI] [PubMed] [Google Scholar]
- Caredda F., Antinori S., Re T., Pastecchia C., Moroni M. Course and prognosis of acute HDV hepatitis. Prog Clin Biol Res. 1987;234:267–276. [PubMed] [Google Scholar]
- Chao M., Hsieh S. Y., Taylor J. Role of two forms of hepatitis delta virus antigen: evidence for a mechanism of self-limiting genome replication. J Virol. 1990 Oct;64(10):5066–5069. doi: 10.1128/jvi.64.10.5066-5069.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chisari F. V., Ferrari C. Hepatitis B virus immunopathogenesis. Annu Rev Immunol. 1995;13:29–60. doi: 10.1146/annurev.iy.13.040195.000333. [DOI] [PubMed] [Google Scholar]
- Chisari F. V. Hepatitis B virus transgenic mice: models of viral immunobiology and pathogenesis. Curr Top Microbiol Immunol. 1996;206:149–173. doi: 10.1007/978-3-642-85208-4_9. [DOI] [PubMed] [Google Scholar]
- Colombo M., Cambieri R., Rumi M. G., Ronchi G., Del Ninno E., De Franchis R. Long-term delta superinfection in hepatitis B surface antigen carriers and its relationship to the course of chronic hepatitis. Gastroenterology. 1983 Aug;85(2):235–239. [PubMed] [Google Scholar]
- Del Prete G. F., De Carli M., Ricci M., Romagnani S. Helper activity for immunoglobulin synthesis of T helper type 1 (Th1) and Th2 human T cell clones: the help of Th1 clones is limited by their cytolytic capacity. J Exp Med. 1991 Oct 1;174(4):809–813. doi: 10.1084/jem.174.4.809. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dhein J., Walczak H., Bäumler C., Debatin K. M., Krammer P. H. Autocrine T-cell suicide mediated by APO-1/(Fas/CD95) Nature. 1995 Feb 2;373(6513):438–441. doi: 10.1038/373438a0. [DOI] [PubMed] [Google Scholar]
- Eckart M. R., Dong C., Houghton M., D'Urso N., Ponzetto A. The effects of using recombinant vaccinia viruses expressing either large or small HDAg to protect woodchuck hepadnavirus carriers from HDV superinfection. Prog Clin Biol Res. 1993;382:201–205. [PubMed] [Google Scholar]
- Elsässer-Beile U., von Kleist S., Gallati H. Evaluation of a test system for measuring cytokine production in human whole blood cell cultures. J Immunol Methods. 1991 Jun 3;139(2):191–195. doi: 10.1016/0022-1759(91)90188-l. [DOI] [PubMed] [Google Scholar]
- Erb P., Grogg D., Troxler M., Kennedy M., Fluri M. CD4+ T cell-mediated killing of MHC class II-positive antigen-presenting cells. I. Characterization of target cell recognition by in vivo or in vitro activated CD4+ killer T cells. J Immunol. 1990 Feb 1;144(3):790–795. [PubMed] [Google Scholar]
- Fattovich G., Boscaro S., Noventa F., Pornaro E., Stenico D., Alberti A., Ruol A., Realdi G. Influence of hepatitis delta virus infection on progression to cirrhosis in chronic hepatitis type B. J Infect Dis. 1987 May;155(5):931–935. doi: 10.1093/infdis/155.5.931. [DOI] [PubMed] [Google Scholar]
- Franco A., Barnaba V., Natali P., Balsano C., Musca A., Balsano F. Expression of class I and class II major histocompatibility complex antigens on human hepatocytes. Hepatology. 1988 May-Jun;8(3):449–454. doi: 10.1002/hep.1840080302. [DOI] [PubMed] [Google Scholar]
- Germain R. N. MHC-dependent antigen processing and peptide presentation: providing ligands for T lymphocyte activation. Cell. 1994 Jan 28;76(2):287–299. doi: 10.1016/0092-8674(94)90336-0. [DOI] [PubMed] [Google Scholar]
- Guidotti L. G., Ishikawa T., Hobbs M. V., Matzke B., Schreiber R., Chisari F. V. Intracellular inactivation of the hepatitis B virus by cytotoxic T lymphocytes. Immunity. 1996 Jan;4(1):25–36. doi: 10.1016/s1074-7613(00)80295-2. [DOI] [PubMed] [Google Scholar]
- Guilhot S., Huang S. N., Xia Y. P., La Monica N., Lai M. M., Chisari F. V. Expression of the hepatitis delta virus large and small antigens in transgenic mice. J Virol. 1994 Feb;68(2):1052–1058. doi: 10.1128/jvi.68.2.1052-1058.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hammer J., Valsasnini P., Tolba K., Bolin D., Higelin J., Takacs B., Sinigaglia F. Promiscuous and allele-specific anchors in HLA-DR-binding peptides. Cell. 1993 Jul 16;74(1):197–203. doi: 10.1016/0092-8674(93)90306-b. [DOI] [PubMed] [Google Scholar]
- Jaraquemada D., Marti M., Long E. O. An endogenous processing pathway in vaccinia virus-infected cells for presentation of cytoplasmic antigens to class II-restricted T cells. J Exp Med. 1990 Sep 1;172(3):947–954. doi: 10.1084/jem.172.3.947. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Karayiannis P., Goldin R., Luther S., Carman W. F., Monjardino J., Thomas H. C. Effect of cyclosporin-A in woodchucks with chronic hepatitis delta virus infection. J Med Virol. 1992 Apr;36(4):316–321. doi: 10.1002/jmv.1890360415. [DOI] [PubMed] [Google Scholar]
- Karayiannis P., Saldanha J., Jackson A. M., Luther S., Goldin R., Monjardino J., Thomas H. C. Partial control of hepatitis delta virus superinfection by immunisation of woodchucks (Marmota monax) with hepatitis delta antigen expressed by a recombinant vaccinia or baculovirus. J Med Virol. 1993 Nov;41(3):210–214. doi: 10.1002/jmv.1890410308. [DOI] [PubMed] [Google Scholar]
- Kojima T., Callea F., Desmyter J., Desmet V. J. Immune electron microscopy of hepatitis delta-antigen in hepatocytes. Lab Invest. 1986 Aug;55(2):217–225. [PubMed] [Google Scholar]
- Kägi D., Ledermann B., Bürki K., Zinkernagel R. M., Hengartner H. Molecular mechanisms of lymphocyte-mediated cytotoxicity and their role in immunological protection and pathogenesis in vivo. Annu Rev Immunol. 1996;14:207–232. doi: 10.1146/annurev.immunol.14.1.207. [DOI] [PubMed] [Google Scholar]
- Lai M. M., Xia Y. P., Hwang S. B., Lee C. Z. Functional domains of hepatitis delta antigen. Prog Clin Biol Res. 1993;382:21–27. [PubMed] [Google Scholar]
- Lukacher A. E., Braciale V. L., Braciale T. J. In vivo effector function of influenza virus-specific cytotoxic T lymphocyte clones is highly specific. J Exp Med. 1984 Sep 1;160(3):814–826. doi: 10.1084/jem.160.3.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Minutello M. A., Pileri P., Unutmaz D., Censini S., Kuo G., Houghton M., Brunetto M. R., Bonino F., Abrignani S. Compartmentalization of T lymphocytes to the site of disease: intrahepatic CD4+ T cells specific for the protein NS4 of hepatitis C virus in patients with chronic hepatitis C. J Exp Med. 1993 Jul 1;178(1):17–25. doi: 10.1084/jem.178.1.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mosmann T. R., Coffman R. L. TH1 and TH2 cells: different patterns of lymphokine secretion lead to different functional properties. Annu Rev Immunol. 1989;7:145–173. doi: 10.1146/annurev.iy.07.040189.001045. [DOI] [PubMed] [Google Scholar]
- Negro F., Baldi M., Bonino F., Rocca G., Demartini A., Passarino G., Maran E., Lavarini C., Rizzetto M., Verme G. Chronic HDV (hepatitis delta virus) hepatitis. Intrahepatic expression of delta antigen, histologic activity and outcome of liver disease. J Hepatol. 1988 Feb;6(1):8–14. doi: 10.1016/s0168-8278(88)80457-4. [DOI] [PubMed] [Google Scholar]
- Negro F., Shapiro M., Satterfield W. C., Gerin J. L., Purcell R. H. Reappearance of hepatitis D virus (HDV) replication in chronic hepatitis B virus carrier chimpanzees rechallenged with HDV. J Infect Dis. 1989 Oct;160(4):567–571. doi: 10.1093/infdis/160.4.567. [DOI] [PubMed] [Google Scholar]
- Nisini R., Matricardi P. M., Fattorossi A., Biselli R., D'Amelio R. Presentation of superantigen by human T cell clones: a model of T-T cell interaction. Eur J Immunol. 1992 Aug;22(8):2033–2039. doi: 10.1002/eji.1830220812. [DOI] [PubMed] [Google Scholar]
- Nuchtern J. G., Bonifacino J. S., Biddison W. E., Klausner R. D. Brefeldin A implicates egress from endoplasmic reticulum in class I restricted antigen presentation. Nature. 1989 May 18;339(6221):223–226. doi: 10.1038/339223a0. [DOI] [PubMed] [Google Scholar]
- Panina-Bordignon P., Tan A., Termijtelen A., Demotz S., Corradin G., Lanzavecchia A. Universally immunogenic T cell epitopes: promiscuous binding to human MHC class II and promiscuous recognition by T cells. Eur J Immunol. 1989 Dec;19(12):2237–2242. doi: 10.1002/eji.1830191209. [DOI] [PubMed] [Google Scholar]
- Purcell R. H. Hepatitis viruses: changing patterns of human disease. Proc Natl Acad Sci U S A. 1994 Mar 29;91(7):2401–2406. doi: 10.1073/pnas.91.7.2401. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roingeard P., Dubois F., Marcellin P., Bernuau J., Bonduelle S., Benhamou J. P., Goudeau A. Persistent delta antigenaemia in chronic delta hepatitis and its relation with human immunodeficiency virus infection. J Med Virol. 1992 Nov;38(3):191–194. doi: 10.1002/jmv.1890380307. [DOI] [PubMed] [Google Scholar]
- Romagnani S. Lymphokine production by human T cells in disease states. Annu Rev Immunol. 1994;12:227–257. doi: 10.1146/annurev.iy.12.040194.001303. [DOI] [PubMed] [Google Scholar]
- Smedile A., Farci P., Verme G., Caredda F., Cargnel A., Caporaso N., Dentico P., Trepo C., Opolon P., Gimson A. Influence of delta infection on severity of hepatitis B. Lancet. 1982 Oct 30;2(8305):945–947. doi: 10.1016/s0140-6736(82)90156-8. [DOI] [PubMed] [Google Scholar]
- Smedile A., Lavarini C., Crivelli O., Raimondo G., Fassone M., Rizzetto M. Radioimmunoassay detection of IgM antibodies to the HBV-associated delta (delta) antigen:" clinical significance in delta infection. J Med Virol. 1982;9(2):131–138. doi: 10.1002/jmv.1890090208. [DOI] [PubMed] [Google Scholar]
- Smedile A., Rosina F., Saracco G., Chiaberge E., Lattore V., Fabiano A., Brunetto M. R., Verme G., Rizzetto M., Bonino F. Hepatitis B virus replication modulates pathogenesis of hepatitis D virus in chronic hepatitis D. Hepatology. 1991 Mar;13(3):413–416. [PubMed] [Google Scholar]
- Taylor J., Mason W., Summers J., Goldberg J., Aldrich C., Coates L., Gerin J., Gowans E. Replication of human hepatitis delta virus in primary cultures of woodchuck hepatocytes. J Virol. 1987 Sep;61(9):2891–2895. doi: 10.1128/jvi.61.9.2891-2895.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tishon A., Lewicki H., Rall G., Von Herrath M., Oldstone M. B. An essential role for type 1 interferon-gamma in terminating persistent viral infection. Virology. 1995 Sep 10;212(1):244–250. doi: 10.1006/viro.1995.1477. [DOI] [PubMed] [Google Scholar]
- Tough D. F., Borrow P., Sprent J. Induction of bystander T cell proliferation by viruses and type I interferon in vivo. Science. 1996 Jun 28;272(5270):1947–1950. doi: 10.1126/science.272.5270.1947. [DOI] [PubMed] [Google Scholar]
- Unutmaz D., Pileri P., Abrignani S. Antigen-independent activation of naive and memory resting T cells by a cytokine combination. J Exp Med. 1994 Sep 1;180(3):1159–1164. doi: 10.1084/jem.180.3.1159. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wang K. S., Choo Q. L., Weiner A. J., Ou J. H., Najarian R. C., Thayer R. M., Mullenbach G. T., Denniston K. J., Gerin J. L., Houghton M. Structure, sequence and expression of the hepatitis delta (delta) viral genome. Nature. 1986 Oct 9;323(6088):508–514. doi: 10.1038/323508a0. [DOI] [PubMed] [Google Scholar]
- Xia Y. P., Chang M. F., Wei D., Govindarajan S., Lai M. M. Heterogeneity of hepatitis delta antigen. Virology. 1990 Sep;178(1):331–336. doi: 10.1016/0042-6822(90)90415-n. [DOI] [PubMed] [Google Scholar]
- Young H. A., Hardy K. J. Role of interferon-gamma in immune cell regulation. J Leukoc Biol. 1995 Oct;58(4):373–381. [PubMed] [Google Scholar]
- Zinkernagel R. M., Haenseler E., Leist T., Cerny A., Hengartner H., Althage A. T cell-mediated hepatitis in mice infected with lymphocytic choriomeningitis virus. Liver cell destruction by H-2 class I-restricted virus-specific cytotoxic T cells as a physiological correlate of the 51Cr-release assay? J Exp Med. 1986 Oct 1;164(4):1075–1092. doi: 10.1084/jem.164.4.1075. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zinkernagel R. M. Immunology taught by viruses. Science. 1996 Jan 12;271(5246):173–178. doi: 10.1126/science.271.5246.173. [DOI] [PubMed] [Google Scholar]
- Zinkernagel R. M., Moskophidis D., Kündig T., Oehen S., Pircher H., Hengartner H. Effector T-cell induction and T-cell memory versus peripheral deletion of T cells. Immunol Rev. 1993 Jun;133:199–223. doi: 10.1111/j.1600-065x.1993.tb01517.x. [DOI] [PubMed] [Google Scholar]