1. Ribavirin Improves NK Cell IFNγ Response During Sofosbuvir-based DAA Therapy in HCV-infected Liver Transplant Recipients
- Author
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Jens U. Marquardt, Edward K. Geissler, Matthias Hornung, Hans J. Schlitt, Kilian Weigand, Tim Zimmermann, G Peschel, Akinbami Adenugba, Hauke Lang, P Kupke, Henrik Junger, and Jens M. Werner
- Subjects
medicine.medical_specialty ,Time Factors ,Sofosbuvir ,Cell ,610 Medizin ,Antiviral Agents ,Gastroenterology ,Cell Degranulation ,Virus ,Interferon-gamma ,Liver disease ,chemistry.chemical_compound ,Interferon ,Internal medicine ,Ribavirin ,medicine ,Humans ,STAT1 ,Phosphorylation ,STAT4 ,Cells, Cultured ,Transplantation ,biology ,business.industry ,Hepatitis C, Chronic ,STAT4 Transcription Factor ,medicine.disease ,Liver Transplantation ,Killer Cells, Natural ,STAT1 Transcription Factor ,Treatment Outcome ,medicine.anatomical_structure ,chemistry ,Case-Control Studies ,biology.protein ,Drug Therapy, Combination ,business ,medicine.drug - Abstract
Background. Chronic hepatitis C virus (HCV) infection is characterized by activation of natural killer (NK) cells. Here, we asked whether HCV elimination by sofosbuvir-based direct-acting antivirals (DAAs) and the addition of ribavirin (RBV) improve NK cell function in liver transplant (LTx) recipients. Methods. We analyzed NK cell degranulation and interferon (IFN)γ-response along with STAT1 and STAT4 phosphorylation in 29 HCV-infected LTx recipients and 17 HCV-infected patients during DAA treatment. Results. Compared with uninfected LTx recipients, NK cells from HCV-infected LTx recipients were polarized toward cytotoxicity with increased CD107a-degranulation (10.1% versus 14.6%; P = 0.0263) and reduced capacity to produce IFNγ (43.0% versus 26.7%; P = 0.0002). The altered phenotype of NK cells in HCV-infected LTx recipients was accompanied by increased STAT1 (44.6% versus 87.4%; P < 0.0001) and STAT1 phosphorylation (0.7% versus 8.9%; P = 0.0005) compared with pSTAT4 IFNα-induction (29.9% versus 17.6%; P = 0.0014). Successful DAA therapy did not affect CD107a-degranulation but decreased STAT1. RBV cotreatment with DAA therapy for HCV increased CD56Bright NK cell IFNγ-responses in LTx recipients (70.9% versus 89.2%; P = 0.002), and this correlated to an increase in the inducibility of pSTAT4 (MFI 157 versus 173; P = 0.0002). Conclusions. RBV cotreatment of HCV infection improved pSTAT4-dependent IFNγ-production in NK cells. This is relevant especially for immunocompromised patients such as LTx recipients or patients with end-stage liver disease.
- Published
- 2021
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