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World J Gastroenterol. Nov 28, 2013; 19(44): 7852-7866
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7852
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7852
Between Scylla and Charybdis: The role of the human immune system in the pathogenesis of hepatitis C
Ulrich Spengler, Hans Dieter Nischalke, Jacob Nattermann, Christian P Strassburg, Department of Internal Medicine 1, University of Bonn, 53105 Bonn, Germany
Author contributions: All the authors contributed equally to this manuscript.
Correspondence to: Ulrich Spengler, MD, PhD, Department of Internal Medicine 1, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. spengler@uni-bonn.de
Telephone: +49-561-7891272 Fax: +49-561-7891272
Received: September 28, 2013
Revised: October 25, 2013
Accepted: November 12, 2013
Published online: November 28, 2013
Revised: October 25, 2013
Accepted: November 12, 2013
Published online: November 28, 2013
Core Tip
Core tip: This topic highlight on the immunopathogenesis of chronic hepatitis C addresses changes in innate immunity (interferons and natural killer cells), adaptive immunity and immunoregulation (regulatory T cells). Our review provides a succinct but comprehensive overview and presents the concept, that effective antiviral immunity is associated with pronounced acute liver damage, while during chronic infection the arms of immunity will acquire new functions, which will cause and maintain tissue damage. Thus, the immune response becomes part of the mechanisms that eventually lead to progressive inflammation, liver cirrhosis and death in chronic hepatitis C.