Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2014; 20(39): 14156-14171
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14156
Immunopathogenesis of chronic hepatitis B
Irina P Balmasova, Nikolay D Yushchuk, Ospan A Mynbaev, Nageswara R Alla, Elena S Malova, Zhongjie Shi, Chang-Lu Gao
Irina P Balmasova, Nikolay D Yushchuk, Laboratory of Pathogenesis and Treatment Methods in Infection Diseases, Moscow State University of Medicine and Dentistry, Moscow 127374, Russia
Irina P Balmasova, Department of Allergology and Immunology, Peoples’ Friendship University of Russia, Moscow 117198, Russia
Nikolay D Yushchuk, Department of Infectious Diseases and Epidemiology, Moscow State University of Medicine and Dentistry, Moscow 127374, Russia
Ospan A Mynbaev, Laboratory of Pilot Projects, Moscow State University of Medicine and Dentistry, Moscow 127374, Russia
Ospan A Mynbaev, Department of Obstetrics, Gynecology and Reproductive Medicine, Peoples’ Friendship University of Russia, Moscow 117198, Russia
Ospan A Mynbaev, The International Translational Medicine and Biomodeling Research Team, MIPT Center for Human Physiology Studies, Laboratory of Cellular and Molecular Technologies, Moscow Institute of Physics and Technology (State University), Moscow 141700, Russia
Nageswara R Alla, Department of Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15260, United States
Elena S Malova, Medical Company “Hepatologist”, 443011 Samara, Russia
Zhongjie Shi, Department of Cancer Biology, Department of Microbiology and Immunology, Thomas Jefferson University, Philadelphia, PA 19107, United States
Chang-Lu Gao, Department of Surgical Oncology, the 4th Clinical Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Author contributions: Balmasova IP, Yushchuk ND, Malova ES, Mynbaev OA worked on the design and planning, in the acquisition, analysis and interpretation of data and manuscript drafting; Mynbaev OA, Alla NR, Shi Z, Gao CL contributed to the manuscript conception and design, writing, critical review and final revision; all authors agreed on the final version to be published.
Correspondence to: Chang-Lu Gao, Attending Doctor, Department of Surgical Oncology, the 4th Affiliated Hospital of Harbin Medical University, No. 37 Yiyuan Street, Nangang District, Harbin 150001, Heilongjiang Province, China. house.triangle@gmail.com
Telephone: +86-451-85939005 Fax: +86-451-85939005
Received: December 26, 2013
Revised: February 17, 2014
Accepted: April 21, 2014
Published online: October 21, 2014
Processing time: 298 Days and 5 Hours
Abstract

Chronic hepatitis B (CHB) is a widespread infectious disease with unfavorable outcomes and life-threatening consequences for patients, in spite of modern vaccination and antiviral treatment modalities. Cutting-edge experimental approaches have demonstrated key pathways that involve cross-talk between viral particles and host immune cells. All events, including penetration of hepatitis B virus (HBV) particles into host cells, establishing persistence, and chronization of CHB infection, and possibility of complete elimination of HBV particles are controlled by the immune system. Researchers have paid special attention to the replication capacity of HBV in host cells, which is associated with cellular changes that reflect presentation of viral antigens and variability of HBV antigen features. In addition, specific HBV proteins have an immune-modulating ability to initiate molecular mechanisms that “avoid” control by the immune system. The relationship between immunological shifts and chronic infection stages has been intensively studied since it was recognized that the immune system is a direct participant in the recurrent (cyclic) nature of CHB. Understanding the wide diversity of molecular pathways and the crosstalk between innate and adaptive immune system components will provide fresh insight into CHB immune pathogenesis and the possibilities of developing new treatment strategies for this disease.

Keywords: Chronic hepatitis B; Immunopathogenesis; Immune response; Hepatocellular carcinoma; Antiviral drugs

Core tip: Chronic hepatitis B (CHB) immunopathogenesis has been comprehensively studied worldwide. Current evidence on the molecular pathways, crosstalk between viral particles and host cells, the role of viral proteins in triggering immune responses, and the content of recruited cells during different stages of viral infection is reviewed aimed at comprehensive analysis and systematization. Concepts concerning the interactions of immune cells in persistent CHB infection have changed, reflecting the possibility of designing new treatment strategies for this disease based on personalized approaches, molecular pathways, and evidence-based criteria.