Abstract
Immunofluorescence (IF) to detect HCV antigens and non-isotopic in situ hybridization (NISH) to detect HCV RNA genome were carried out on bone marrow (BM) and peripheral blood (PB) mononuclear cells (MC) of 11 chronically HCV-infected patients. In four patients (36·4%) HCV antigens were detected in monocytes/macrophages as well as in B lymphocytes in both BMMC and PBMC. Positive T lymphocytes in BMMC were found in three of them, but only one patient showed positive T cells in PBMC. NISH invariably demonstrated minus and plus HCV RNA genomic strands either in monocytes/macrophages or B and T lymphocytes in BMMC and PBMC in the four HCV antigen-positive patients and in two further patients not expressing viral proteins in blood MC. IF signals appeared diffusely distributed within the cytoplasm, or as brilliant granules in distinct submembrane areas or else in cytoplasm membrane. Nuclei never stained. Similarly, NISH displayed HCV RNA accumulation restricted to MC cytoplasm only, nuclei being persistently negative. NISH, however, was unable to detect cell membrane signal. Infection of blood MC is a common event in naturally acquired HCV infection, since none of these patients was conditioned by immunomodulating or immunosuppressive therapies. No difference was found in terms of mean age, length of disease, anti-HCV immune response, type and severity of chronic liver damage between patients with HCV-infected MC and patients without cell infection. These results demonstrate that HCV can infect BMMC and PBMC that represent important extrahepatic sites of virus replication, and may help to explain the immunological abnormalities observed in chronic HCV carriers.
Keywords: chronic liver disease, hepatitis C virus, immunofluorescence, in situ hybridization mononuclear cells
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References
- 1.Choo QL, Weiner AJ, Overby LR, Kuo G, Houghton M. Hepatitis C virus: the major causative agent of viral non-A, non-B hepatitis. Br Med Bull. 1990;46:423–41. doi: 10.1093/oxfordjournals.bmb.a072408. [DOI] [PubMed] [Google Scholar]
- 2.Colombo M, Choo QL, Del Ninno E, et al. Prevalence of antibodies to hepatitis C virus in Italian patients with hepatocellular carcinoma. Lancet. 1989;2:1006–8. doi: 10.1016/s0140-6736(89)91016-7. [DOI] [PubMed] [Google Scholar]
- 3.Gerber MA, Shieh YSC, Shim K-S, et al. Detection of replicative hepatitis C virus sequences in hepatocellular carcinoma. Am J Pathol. 1992;141:1271–7. [PMC free article] [PubMed] [Google Scholar]
- 4.Paterlini P, Driss F, Nalpas B, Pisi E, Franco D, Berthelot P, Brechot C. Persistence of hepatitis B and hepatitis C viral genomes in primary liver cancers from HBsAg-negative patients: a study of low-endemic area. Hepatology. 1993;17:20–29. [PubMed] [Google Scholar]
- 5.Houghton M, Weiner A, Han J, Kuo G, Choo QL. Molecular biology of the hepatitis C viruses: implications for diagnosis, development and control of viral disease. Hepatology. 1991;14:381–8. [PubMed] [Google Scholar]
- 6.Choo QL, Richman KH, Han JH, et al. Genetic organization and diversity of the hepatitis C virus. Proc Natl Acad Sci USA. 1991;88:2451–5. doi: 10.1073/pnas.88.6.2451. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Dienstag JL. Hepatitis non-A, non-B: C at last. Gastroenterology. 1990;99:1177–80. doi: 10.1016/0016-5085(90)90641-d. [DOI] [PubMed] [Google Scholar]
- 8.Erickson AL, Houghton M, Choo QL, Weiner AJ, Ralston R, Muchmore E, Walker CM. Hepatitis C virus-specific CTL responses in the liver of chimpanzees with acute and chronic hepatitis C. J Immunol. 1993;151:4189–99. [PubMed] [Google Scholar]
- 9.Minutello AM, Pileri P, Unutmatz D, et al. 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;178:17–25. doi: 10.1084/jem.178.1.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Ferrari C, Valli A, Galati L, et al. T-cell response to structural and nonstructural hepatitis C virus infections. Hepatology. 1994;19:286–95. [PubMed] [Google Scholar]
- 11.Alter HJ. To C or not to C: these are the questions. Blood. 1995;85:1681–95. [PubMed] [Google Scholar]
- 12.Krawczynski K, Beach MJ, Bradley DW, et al. Hepatitis C virus antigen in hepatocytes: immunomorphologic detection and identification. Gastroenterology. 1992;103:622–9. doi: 10.1016/0016-5085(92)90856-t. [DOI] [PubMed] [Google Scholar]
- 13.Hiramatsu N, Hayashi N, Haruna Y, et al. Immunohistochemical detection of hepatitis C virus-infected hepatocytes in chronic liver disease with monoclonal antibodies to core, envelope and NS3 regions of the hepatitis C virus genome. Hepatology. 1992;16:306–11. doi: 10.1002/hep.1840160205. [DOI] [PubMed] [Google Scholar]
- 14.Sansonno D, Dammacco F. Hepatitis C virus c100 antigen in liver tissue from patients with acute and chronic infection. Hepatology. 1993;18:240–5. [PubMed] [Google Scholar]
- 15.Blight K, Lesniewski RR, Labrooy JT, Gowans EJ. Detection and distribution of hepatitis C-specific antigens in naturally infected liver. Hepatology. 1994;20:553–7. [PubMed] [Google Scholar]
- 16.Negro F, Pacchioni D, Shimizu Y, Miller RH, Bussolati G, Purcell RH, Bonino F. Detection of intrahepatic replication of hepatitis C virus RNA by in situ hybridization and comparison with histopathology. Proc Natl Acad Sci USA. 1992;89:2247–51. doi: 10.1073/pnas.89.6.2247. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Yamada S, Kojl T, Nozawa M, Kiyosama K, Nakane PK. Detection of hepatitis C virus (HCV) RNA in paraffin embedded tissue sections of human liver of non-A, non-B hepatitis patients by in situ hybridization. J Clin Lab Anal. 1992;6:40–46. doi: 10.1002/jcla.1860060109. [DOI] [PubMed] [Google Scholar]
- 18.Tigges MA, Koelle D, Hartog K, Sekulovich RE, Corey L, Burke RL. Human CD8+ herpes simplex virus-specific cytotoxic T-lymphocyte clones recognize diverse virion protein antigens. J Virol. 1992;66:1622–34. doi: 10.1128/jvi.66.3.1622-1634.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Oldstone MBA. Viral persistence. Cell. 1989;56:517–20. doi: 10.1016/0092-8674(89)90573-4. [DOI] [PubMed] [Google Scholar]
- 20.Lamelin JP, Zoulim F, Trepo C. Lymphotropism of hepatitis B and C virus: an update and a newcomer. Int J Clin Lab Res. 1995;25:1–6. doi: 10.1007/BF02592570. [DOI] [PubMed] [Google Scholar]
- 21.Bouffard P, Hayashi PH, Acevedo R, Levy N, Zeldis JB. Hepatitis C virus is detected in a monocyte/macrophage subpopulation of peripheral blood mononuclear cells of infected patients. J Infect Dis. 1992;166:1276–80. doi: 10.1093/infdis/166.6.1276. [DOI] [PubMed] [Google Scholar]
- 22.Zignego AL, Macchia D, Monti M, et al. Infection of peripheral mononuclear blood cells by hepatitis C virus. J Hepatol. 1992;15:382–6. doi: 10.1016/0168-8278(92)90073-x. [DOI] [PubMed] [Google Scholar]
- 23.Bartolomè J, Castillo I, Quiroga JA, Navas S, Carreno V. Detection of hepatitis C virus RNA in serum and peripheral blood mononuclear cells. J Hepatol. 1993;17:s90–s93. doi: 10.1016/s0168-8278(05)80431-3. [DOI] [PubMed] [Google Scholar]
- 24.Ferri C, Monti M, La Civita L, et al. Infection of peripheral blood-mononuclear cells by hepatitis C virus in mixed cryoglobulinemia. Blood. 1993;82:3701–4. [PubMed] [Google Scholar]
- 25.Gabrielli A, Manzin A, Candela M, Caniglia ML, Paolucci S, Danieli MG, Clementi M. Active hepatitis C virus infection in bone marrow and peripheral blood mononuclear cells from patients with mixed cryoglobulinemia. Clin Exp Immunol. 1994;97:87–93. doi: 10.1111/j.1365-2249.1994.tb06584.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Moldvay J, Deny P, Pol S, Brechot C, Lamas E. Detection of hepatitis C virus RNA in peripheral blood mononuclear cells of infected patients by in situ hybridization. Blood. 1994;83:269–73. [PubMed] [Google Scholar]
- 27.Gutierrez C, Bernabe RR, Vega J, Kreisler M. Purification of human T and B cells by a discontinuous density gradient of Percoll. J Immunol Methods. 1979;29:57–63. doi: 10.1016/0022-1759(79)90125-x. [DOI] [PubMed] [Google Scholar]
- 28.Houghton M, Choo QL, Kuo G. European Patent Application. Publication no. 0318216 and no. 0388232. [Google Scholar]
- 29.Yamada G, Nishimoto H, Endou H, et al. Localization of hepatitis C viral RNA and capsid protein in human liver. Dig Dis Sci. 1993;38:882–7. doi: 10.1007/BF01295915. [DOI] [PubMed] [Google Scholar]
- 30.Schmitz GG, Walter T, Seibl R, Kessler C. Nonradioactive labeling of oligonucleotides in vitro with the hapten digoxigenin by tailing with terminal transferase. Anal Biochem. 1991;192:222–31. doi: 10.1016/0003-2697(91)90212-c. [DOI] [PubMed] [Google Scholar]
- 31.Eggerding FA, Peters J, Lee RK, Inderlied CB. Detection of rubella virus gene sequences by enzymatic amplification and direct sequencing of amplified DNA. J Clin Microbiol. 1991;29:945–52. doi: 10.1128/jcm.29.5.945-952.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Dammacco F, Sansonno D, Beardsley A, Gowans EJ. Failure to detect hepatitis C virus (HCV) genome by polymerase chain reaction in human anti-HCV-positive intravenous immunoglobulins. Clin Exp Immunol. 1993;92:205–10. doi: 10.1111/j.1365-2249.1993.tb03381.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Gudat F, Bianchi L. Evidence for phasic sequences in nuclear HBcAg formation and cell membrane-directed flow of core particles in chronic hepatitis B. Gastroenterology. 1977;73:1194–7. [PubMed] [Google Scholar]
- 34.Cleaves GR, Ryan TE, Schlesinger RW. Identification and characterization of type 2 Dengue virus replicative form RNAs. Virology. 1981;111:73–83. doi: 10.1016/0042-6822(81)90654-1. [DOI] [PubMed] [Google Scholar]
- 35.Halstead SB, O'Rourke EJ. Antibody-enhanced Dengue virus infection in primate leukocytes. Nature. 1977;265:739–74. doi: 10.1038/265739a0. [DOI] [PubMed] [Google Scholar]
- 36.Peiris JSM, Porterfield JS. Antibody-mediated enhancement of Flavivirus replication in macrophage-like cell lines. Nature. 1979;282:509–11. doi: 10.1038/282509a0. [DOI] [PubMed] [Google Scholar]
- 37.Porterfield JS. Antibody-dependent enhancement of viral infectivity. In: Maramorosch K, Murphy FA, Shatkin AJ, editors. Advances in virus research. Vol. 31. London: Academic Press Inc; 1986. pp. 335–55. [DOI] [PubMed] [Google Scholar]
- 38.Kuo G, Choo QL, Alter HJ, et al. An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science. 1989;244:362–4. doi: 10.1126/science.2496467. [DOI] [PubMed] [Google Scholar]
- 39.Sansonno D, Dammacco F. Antibodies to hepatitis C virus in non-A, non-B post transfusion and cryptogenetic chronic liver disease. Lancet. 1989;ii:798–9. doi: 10.1016/s0140-6736(89)90855-6. [DOI] [PubMed] [Google Scholar]
- 40.Agnello V, Chung RT, Kaplan LM. A role for hepatitis C virus infection in type II cryoglobulinemia. N Engl J Med. 1992;327:1490–5. doi: 10.1056/NEJM199211193272104. [DOI] [PubMed] [Google Scholar]
- 41.Bukh J, Purcell RH, Miller RH. At least 12 genotypes of hepatitis C virus predicted by sequence analysis of the putative E1 gene of isolates collected worldwide. Proc Natl Acad Sci USA. 1993;90:8234–8. doi: 10.1073/pnas.90.17.8234. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 42.Sansonno D, Procaccio P, Dammacco F. Kinetics of anti-hepatitis C virus response during acute hepatitis in an immunosuppressed HCV-chronically infected patient. Digestion. 1991;50:52–60. doi: 10.1159/000200740. [DOI] [PubMed] [Google Scholar]
- 43.Fan FS, Tzeng CH, Hsiao KI, Hu ST, Liu WT, Chen PM. Withdrawal of immunosuppressive therapy in allogenic bone marrow transplantation reactivates chronic viral hepatitis C. Bone Marrow Transplant. 1991;8:417–20. [PubMed] [Google Scholar]
- 44.Dammacco F, Sansonno D. Antibodies to hepatitis C virus in essential mixed cryoglobulinemia. Clin Exp Immunol. 1992;87:352–6. doi: 10.1111/j.1365-2249.1992.tb03001.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 45.Lunel F, Musset L, Franjeul L, et al. Cryoglobulinemia in chronic liver diseases: role of hepatitis C virus and liver damage. Gastroenterology. 1994;106:1291–300. doi: 10.1016/0016-5085(94)90022-1. [DOI] [PubMed] [Google Scholar]
- 46.Lunel F. Hepatitis C virus and autoimmunity: fortuitous association or reality? Gastroenterology. 1994;107:1550–5. doi: 10.1016/0016-5085(94)90564-9. [DOI] [PubMed] [Google Scholar]
- 47.Sansonno D, Cornacchiulo V, Iacobelli AR, Di Stefano R, Lospalluti M, Dammacco F. Localization of hepatitis C virus (HCV) antigens in liver and skin tissues of chronically HCV-infected patients with mixed cryoglobulinemia. Hepatology. 1995;21:305–12. [PubMed] [Google Scholar]