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乙肝DNA疫苗联合佐剂的免疫效果评价及抗H7N9流感病毒新策略的研究
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摘要
感染性疾病一直严重威胁着人类的健康和公共卫生的安全,已知60%以上的感染性疾病都是由病毒感染所引起的,而我国是乙肝重灾区,将近9.3%的人口是乙肝病毒携带者,每年有近20万人死于HBV感染相关的疾病。2013年3月突如其来的H7N9禽流感病毒已造成超过419人感染,其中约127人死亡,严重威胁着人们的生命安全和社会的安定。但是目前我们对病毒感染性疾病的预防和治疗尚缺乏有效的应对办法,因此研发安全有效的防治措施具有非常重要的意义。
     由于DNA疫苗可以同时激活体液免疫和细胞免疫反应,因此被广泛应用于慢性乙肝等病毒感染性疾病的治疗,但在临床研究过程中发现DNA疫苗在大动物和人体内引起的免疫反应相对较弱。本实验室之前的研究发现临床上正在应用的两种小分子药物:西咪替丁和吡喹酮可以通过不同的方式增强乙肝DNA疫苗的治疗效果,本研究主要探讨西咪替丁联合吡喹酮是否可以产生协同效果进一步增强乙肝DNA疫苗的治疗效果。结果显示,西咪替丁联合吡喹酮作为乙肝DNA疫苗的佐剂可以显著降低体内CD4+CD25+Foxp3+调节性T细胞的数量和功能,从而增强乙肝DNA疫苗所诱导的抗原特异性CD8+T细胞的杀伤功能,进一步研究发现CD8+T细胞主要通过分泌IFN-y和IL-17A来发挥其杀伤作用,在HBsAg转基因小鼠模型中进一步证明了其治疗效果。鉴于这两种药物的既往临床安全性,有望作为乙肝DNA疫苗的候选佐剂。
     IL-17是一种主要由Th17细胞分泌的新型细胞因子,被认为是连接固有免疫和适应性免疫反应的桥梁,而且在多种自主免疫性疾病(如银屑病、炎症性肠炎、多发性硬化症和类风湿性关节炎等)的发病过程中起到非常重要的作用。之前研究发现如果体内的IL-17A缺失后,小鼠对流感病毒的易感性明显增强,伴随着小鼠的体重和存活率下降,表明IL-17A在病毒感染过程中具有非常重要的作用。本研究通过检测不同流感病毒感染后患者血清中各种细胞因子的变化水平,我们发现血清中IL-17A的浓度越高,流感患者的病情相对较轻,预示着IL-17A可能参与到流感病毒感染的过程中并起到保护性的效果。在小鼠H7N9流感病毒的攻毒模型基础上,我们进一步证明IL-17A可以促进体内细胞因子IFN-γ的表达,从而抑制流感病毒的复制,降低肺部的病毒载量,增强小鼠抵抗H7N9禽流感病毒感染的能力。而且IL-17A在体外同样能够促进人外周血中的CD8+T细胞分泌IFN-γ的能力。本研究结果为研发基于IL-17A的新型抗H7N9禽流感病毒感染策略提供了新思路。
Infectious diseases continue to be the most serious threat to the public health. In fact, over sixty percentages of infectious diseases are caused by viral infections and hepatitis B are the highest incidence of infectious diseases in China. At present, there are over nine percentages of the population are infected with HBV and over200,000people died from HBV-related diseases each year. Since March2013, we had confirmed over419cases infected with newly-emerged H7N9avian influenza virus, with127deads. The high mortality rates and pandemic potentials threaten the social security and people's health. However, there are still no preferred preventions and treatment against viral infections. Therefore, investigations on developing novel therapeutic strategies have great significant for the prevention and control of viral infectious diseases.
     DNA vaccine has a great potential to be used for the treatment of chronic HBV infection, owing to their advantage in stimulating both humoral immune responses and cellular immune responses. However, it drives significantly weaker immune responses in non-human primates and in humans compared with mice. Previously, we have shown that either cimetidine or praziquantel could enhance the therapeutic effects of HBV DNA vaccine through different pathways. The primary objectives of this study were to confirm whether cimetidine could synergize with praziquantel to enhance the immune response of HBV DNA vaccine. Here we show that combination of CIM and PZQ as adjuvants for a HBV DNA vaccine could not only significantly reduce the number and function of CD4+CD25+Foxp3+Tregs. In addition, the HBsAg-specific cytotoxic CD8+T cell was also elevated significantly, which is critical for the eradication of HBV infected cells. Further investigations demonstrated that the cytotoxic function of activated CD8+T cells was dependent on the expression of IFN-y and IL-17A. Using a HBsAg transgenic mouse model, the expression of HBsAg in the hepatic cells was also significantly reduced after immunized with pCD-S2in the presence of0.5%of CIM and0.25%of PZQ. Therefore, relative safety records for CIM and PZQ could make them as effective adjuvants for the development of therapeutic vaccines against chronic viral infections.
     IL-17A is a newly-defined cytokine, mainly produced by Th17cells and considered to be a potent mediator to bridge innate and adaptive immune systems. Recently, IL-17A has been demonstrated to be involved in several autoimmune diseases, including psoriasis, rheumatoid arthritis, multiple sclerosis, and Crohn's diseases. Several investigations have reported the protective role of IL-17A in animal models of PR8influenza infection since neutralization of IL-17A in mice increases weight loss and reduces survival. This led us a great interest to investigate the protective role of IL-17A against H7N9virus infection and its mechanism. Here we analyzed the levels of different cytokines in the serum samples from patients infected with different influenza viruses and found that elevated serum levels of IL-17A are apparently associated with less severe disease in the H7N9-infected patients. Using an H7N9influenza virus infected mice model, we further confirmed that pre-administration with IL-17A could protect mice against lethal H7N9virus infection, the protective effects of IL-17A seems to be dependent on the secretion of IFN-y, an important host factor for viral clearance. In addition, IL-17A could also activate CD8+T cells isolated from healthy individuals' blood in vitro and upregulate the secretion of IFN-γ. Together, these findings reveal that IL-17A plays pivotal roles in hosts against lethal H7N9virus infection, provide us with new ideas on developing IL-17A based strategy to combat the emerging lethal Influenza viruses and give a new direction for developing anti-viral drugs.
引文
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