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Percy A. Knolle, Robert Thimme  Gastroenterology 

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1 Hepatic Immune Regulation and Its Involvement in Viral Hepatitis Infection 
Percy A. Knolle, Robert Thimme  Gastroenterology  Volume 146, Issue 5, Pages (May 2014) DOI: /j.gastro Copyright © 2014 AGA Institute Terms and Conditions

2 Figure 1 Schematic view of the microarchitecture of the hepatic sinusoid. Hepatocytes are separated from blood passing through the sinusoids by stellate cells, LSECs, and Kupffer cells. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions

3 Figure 2 Generation of iMATEs facilitates local CD8+ T-cell expansion in the liver and thereby contributes to control of viral infection. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions

4 Figure 3 CD8+ T cells primed locally in the liver by LSECs under noninflammatory conditions are not deleted but undergo a unique differentiation program. Such liver-primed T cells have memory-like function and relocate to secondary lymphoid tissues such as conventional central memory T cells. During infectious inflammation, liver-primed T cells provide protection against bacterial and viral infection, thus complementing conventional memory T-cell formation that occurs during inflammation. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions

5 Figure 4 Cross-presentation of viral antigen derived from virus-infected hepatocytes by LSECs leads to local activation of CD8+ T cells in hepatic sinusoids. TNF released from these CD8+ T cells activated by cross-presentation elicits death of virus-infected hepatocytes as a consequence of proapoptotic TNF receptor signaling that occurs selectively in virus-infected but not healthy hepatocytes. This TNF-mediated noncanonical CD8+ T-cell effector mechanism accounts for 50% of total antiviral T-cell activity in viral hepatitis. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions

6 Figure 5 Different mechanisms and cell types have inhibitory or regulatory effects on HBV- and HCV-specific CD8+ T cells such as NK cells, immunoregulatory cytokines, CD4+ T cells, and Tregs. CD8+ T cells may also become exhausted, characterized by the expression of inhibitory receptors, and finally be deleted. Virus-specific CD8+ T cells perform their effector functions by cytolytic-mediated (granzyme and perforin) or noncytolytic-mediated (IFN-γ or TNF-α) effector functions. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions


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