Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 28, 2016; 8(30): 1287-1294
Published online Oct 28, 2016. doi: 10.4254/wjh.v8.i30.1287
Regulatory and activated effector T cells in chronic hepatitis C virus: Relation to autoimmunity
Hanan Fouad, Maissa El Raziky, Eman Medhat Hassan, Ghada Mahmoud Abdel Aziz, Samar K Darweesh, Ahmed Reda Sayed
Hanan Fouad, Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
Hanan Fouad, Department of Pharmacology and Toxicology, Faculty of Pharmacy, Hail University, Hail 81442, Saudi Arabia
Maissa El Raziky, Eman Medhat Hassan, Samar K Darweesh, Department of Hepato-gastroenterology and Tropical Medicine, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
Ghada Mahmoud Abdel Aziz, Ahmed Reda Sayed, Department of Medical Biochemistry, Faculty of Medicine, Beni Suef University, Beni Suef 19206, Egypt
Author contributions: All authors contributed to this work.
Institutional review board statement: The research Ethics Committee of Faculty of Medicine, Cairo University approved the study.
Informed consent statement: Written consent was signed from all subjects of the study.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: We have no data sharing statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hanan Fouad, Professor, Department of Medical Biochemistry, Faculty of Medicine, Cairo University, 110 Manial Street, Manial El-Roda District, Cairo 11562, Egypt. hanan.fouad@kasralainy.edu.eg
Telephone: +20-22-5256002 Fax: +20-22-3632297
Received: April 23, 2016
Peer-review started: April 25, 2016
First decision: June 6, 2016
Revised: July 30, 2016
Accepted: August 27, 2016
Article in press: August 29, 2016
Published online: October 28, 2016
Abstract
AIM

To investigate how Tregs are regulated in chronic hepatitis C virus (HCV) patients via assessment of Tregs markers (granzyme 2, CD69 and FoxP3), Teffs markers [TNFRSF4 (OX40), INFG] and CD4, CD25 genes.

METHODS

A prospective study was conducted on 120 subjects divided into 4 groups: Group I (n = 30) treatment naïve chronic HCV patients; Group II (n = 30) chronic HCV treated with Peg/Riba; Group III (n = 30) chronic HCV associated with non-organ specific autoantibody and Group IV (n = 30) healthy persons as a control group. Tregs and Teffs markers were assessed in peripheral blood mononuclear cells by quantitative real time reverse transcriptase-polymerase chain reaction.

RESULTS

Chronic HCV patients exhibited significant higher levels of both Teffs and Tregs in comparison to healthy control group. Tregs markers were significantly decreased in Peg/Riba treated HCV patients in comparison to treatment naïve HCV group. In HCV patients with antinuclear antibody (ANA) +ve, Tregs markers were significantly decreased in comparison to all other studied groups. Teffs markers were significantly elevated in all HCV groups in comparison to control and in HCV group with ANA +ve in comparison to treatment naïve HCV group.

CONCLUSION

Elevated Tregs cells in chronic HCV patients dampen both CD4+ and CD8+ autologous T cell immune response. Interferon-α and ribavirin therapy suppress proliferation of Tregs. More significant suppression of Tregs was observed in HCV patients with autoantibodies favoring pathological autoimmune response.

Keywords: Autoimmunity, T regulatory cells, Hepatitis C virus, T activator cells, Interferon

Core tip: A prospective study conducted on 120 subjects divided into: Treatment naïve hepatitis C virus (HCV) patients, HCV patients treated with old standard of care, HCV associated with antinuclear antibody (ANA) and healthy control group. Teffs/Tregs imbalance was evaluated. Results showed that HCV patients exhibited significant higher levels of both Teffs and Tregs markers. Interferon-α and ribavirin therapy suppresses proliferation of Tregs. More significant suppression of Tregs was observed in HCV patients with autoantibodies favoring pathological autoimmune response. Teffs markers were significantly elevated in HCV treated group and in HCV group with ANA +ve in comparison to treatment naïve HCV group.