NK细胞与CD8+T细胞在慢性乙型肝炎病毒感染中免疫耗竭的研究进展  

Research progress on immune exhaustion of NK cells and CD8+T cells in chronic hepatitis B virus infection

作　　者：伍杨 李甜[2] 王顺娜 张润兵 朱惠娟 朱玲玲 张亚妮 史婷婷 郭佩佩 于晓辉 张久聪 WU Yang;LI Tian;WANG Shunna;ZHANG Runbing;ZHU Huijuan;ZHU Lingling;ZHANG Yani;SHI Tingting;GUO Peipei;YU Xiaohui;ZHANG Jiucong(Department of Gastroenterology,the 940th Hospital of Joint Logistic Support Force of PLA,Lanzhou 730050;The First Clinical Medical College of Gansu University of Chinese Medicine;The Second Hospital of Lanzhou University,China)

机构地区：[1]中国人民解放军联勤保障部队第九四〇医院消化内科,甘肃兰州730050 [2]甘肃中医药大学第一临床医学院 [3]兰州大学第二医院

出　　处：《胃肠病学和肝病学杂志》2025年第3期458-461,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：甘肃省科技计划项目(21JR7RA017);甘肃省卫生健康行业科研计划项目(GSWSKY2023-34);甘肃中医药大学导师专项(2023YXKY020);兰州市青年科技人才创新项目(2024-QN-39)。

摘　　要：乙型肝炎病毒(hepatitis B virus,HBV)感染是一个全球性的公共卫生问题,目前临床多采用核苷(酸)类似物或干扰素(interferon,IFN)-α进行治疗,但由于HBV感染后将其共价闭合环状DNA嵌合到宿主基因组,导致上述药物无法彻底清除HBV,多数临床HBV患者表现为功能性治愈,需要长期甚至终生治疗,因此探索一种新的治疗方式具有重大意义。HBV感染后宿主免疫反应的强弱是影响HBV能否被清除的重要因素,其中自然杀伤(natural killer,NK)细胞和CD8+T细胞在清除病毒感染和抑制病毒复制中至关重要。研究发现,在慢性乙型肝炎(chronic hepatitis B,CHB)患者中,NK细胞和CD8+T细胞会表现出一种功能和数量低下的免疫耗竭状态,这极大减弱了机体的抗病毒能力。免疫耗竭的发生机制复杂,目前仍尚不完全明确,因此本文旨在总结当前慢性HBV感染中NK细胞和CD8+T细胞发生免疫耗竭的作用机制,为临床CHB患者治疗方案的优化提供理论依据。Hepatitis B virus(HBV)infection poses a significant global public health challenge.Currently,clinical treatments primarily involve nucleoside(acid)analogues or interferon(IFN)-α.However,due to the presence of covalently closed circular DNA integrated into the host genome following HBV infection,these therapies cannot completely eradicate the virus.Consequently,most patients with chronic HBV infection achieve only a functional cure and require long-term,often lifelong,treatment.Thus,exploring novel therapeutic strategies is essential.The strength of the host′s immune response post-HBV infection plays a critical role in determining the virus′s elimination potential.Key players in this immune response include natural killer(NK)cells and CD8+T cells,which are vital for eradicating viral infections and suppressing viral replication.In patients with chronic hepatitis B(CHB),however,NK cells and CD8+T cells often exhibit a state of immune exhaustion characterized by decreased functionality and cell numbers,significantly impairing the body′s antiviral capabilities.The mechanisms underlying immune exhaustion are complex and not yet fully elucidated.This paper aimed to summarize the mechanisms of immune exhaustion affecting NK cells and CD8+T cells in chronic HBV infection,providing a theoretical foundation for optimizing clinical treatment strategies for CHB patients.

关 键 词：慢性乙型肝炎病毒感染 自然杀伤细胞 CD8+T细胞 免疫耗竭 研究进展 

分 类 号：R575[医药卫生—消化系统]