Citation: Jia Liu, Anna Kosinska, Mengji Lu, Michael Roggendorf. New therapeutic vaccination strategies for the treatment of chronic hepatitis B .VIROLOGICA SINICA, 2014, 29(1) : 10-16.  http://dx.doi.org/10.1007/s12250-014-3410-5

New therapeutic vaccination strategies for the treatment of chronic hepatitis B

  • Corresponding author: Michael Roggendorf, michael.roggendorf@uni-due.de
  • Received Date: 21 December 2013
    Accepted Date: 08 January 2014
    Published Date: 17 January 2014
    Available online: 01 February 2014
  • Chronic hepatitis B virus (CHB) is currently treated with either interferon-based or nucleot(s)ide-based antiviral therapies. However, treatment with pegylated interferon alpha results in a durable antiviral response in only about 30% patients and is associated with side effects. Most patients receiving nucleot(s)ide analogue treatment do not establish long-term, durable control of infection and have rebounding viremia after cessation of therapy. Thus, novel therapy strategies are necessary to achieve the induction of potent and durable antiviral immune responses of the patients which can maintain long-term control of viral replication. Therapeutic vaccination of HBV carriers is a promising strategy for the control of hepatitis B. Here the authors review new therapeutic vaccination strategies to treat chronic hepatitis B which may be introduced for patient treatment in the future.

  • 加载中
    1. Barber D L, Wherry E J, Masopust D, Zhu B, Allison J P, Sharpe A H, Freeman G J, and Ahmed R. 2006. Restoring function in exhausted CD8 T cells during chronic viral infection. Nature, 439: 682-687.
        doi: 10.1038/nature04444

    2. Blum H E, Gerok W, and Vyas G N. 1989. The molecular biology of hepatitis B virus. Trends Genet: TIG, 5: 154-158.
        doi: 10.1016/0168-9525(89)90057-7

    3. Boni C, Bertoletti A, Penna A, Cavalli A, Pilli M, Urbani S, Scognamiglio P, Boehme R, Panebianco R, Fiaccadori F, and Ferrari C. 1998. Lamivudine treatment can restore T cell responsiveness in chronic hepatitis B. J Clin Invest, 102: 968-975.
        doi: 10.1172/JCI3731

    4. Boni C, Fisicaro P, Valdatta C, Amadei B, Di Vincenzo P, Giuberti T, Laccabue D, Zerbini A, Cavalli A, Missale G, Bertoletti A, and Ferrari C. 2007. Characterization of hepatitis B virus (HBV)-specific T-cell dysfunction in chronic HBV infection. J Virol, 81: 4215-4225.
        doi: 10.1128/JVI.02844-06

    5. Boni C, Penna A, Bertoletti A, Lamonaca V, Rapti I, Missale G, Pilli M, Urbani S, Cavalli A, Cerioni S, Panebianco R, Jenkins J, and Ferrari C. 2003. Transient restoration of anti-viral T cell responses induced by lamivudine therapy in chronic hepatitis B. J Hepatol, 39: 595-605.
        doi: 10.1016/S0168-8278(03)00292-7

    6. Chisari F V, Isogawa M, and Wieland S F. 2010. Pathogenesis of hepatitis B virus infection. Pathol Biol, 58: 258-266.
        doi: 10.1016/j.patbio.2009.11.001

    7. Couillin I, Pol S, Mancini M, Driss F, Brechot C, Tiollais P, and Michel M L. 1999. Specific vaccine therapy in chronic hepatitis B: induction of T cell proliferative responses specific for envelope antigens. J Infect Dis, 180: 15-26.
        doi: 10.1086/314828

    8. Dahmen A, Herzog-Hauff S, Bocher W O, Galle P R, and Lohr H F. 2002. Clinical and immunological efficacy of intradermal vaccine plus lamivudine with or without interleukin-2 in patients with chronic hepatitis B. J Med Virol, 66: 452-460.
        doi: 10.1002/jmv.2165

    9. Dandri M, and Locarnini S. 2012. New insight in the pathobiology of hepatitis B virus infection. Gut, 61 Suppl 1: i6-17.
        doi: 10.1136/gutjnl-2012-302056

    10. Day C L, Kaufmann D E, Kiepiela P, Brown J A, Moodley E S, Reddy S, Mackey E W, Miller J D, Leslie A J, DePierres C, Mncube Z, Duraiswamy J, Zhu B, Eichbaum Q, Altfeld M, Wherry E J, Coovadia H M, Goulder P J, Klenerman P, Ahmed R, Freeman G J, and Walker B D. 2006. PD-1 expression on HIV-specific T cells is associated with T-cell exhaustion and disease progression. Nature, 443: 350-354.
        doi: 10.1038/nature05115

    11. Dikici B, Bosnak M, Ucmak H, Dagli A, Ece A, and Haspolat K. 2003. Failure of therapeutic vaccination using hepatitis B surface antigen vaccine in the immunotolerant phase of children with chronic hepatitis B infection. J Gastroen Hepatol, 18: 218-222.
        doi: 10.1046/j.1440-1746.2003.02950.x

    12. Fiedler M, Kosinska A, Schumann A, Brovko O, Walker A, Lu M, Johrden L, Mayer A, Wildner O, and Roggendorf M. 2013. Prime/boost immunization with DNA and adenoviral vectors protects from hepatitis D virus (HDV) infection after simultaneous infection with HDV and woodchuck hepatitis virus. J Virol, 87: 7708-7716.
        doi: 10.1128/JVI.00645-13

    13. Finnefrock A C, Tang A, Li F, Freed D C, Feng M, Cox K S, Sykes K J, Guare J P, Miller M D, Olsen D B, Hazuda D J, Shiver J W, Casimiro D R, and Fu T M. 2009. PD-1 blockade in rhesus macaques: impact on chronic infection and prophylactic vaccination. J Immunol, 182: 980-987.
        doi: 10.4049/jimmunol.182.2.980

    14. Freeman G J, Wherry E J, Ahmed R, and Sharpe A H. 2006. Reinvigorating exhausted HIV-specific T cells via PD-1-PD-1 ligand blockade. J Exp Med, 203: 2223-2227.
        doi: 10.1084/jem.20061800

    15. Ganem D, and Prince A M. 2004. Hepatitis B virus infection--natural history and clinical consequences. New Engl J Med, 350: 1118-1129.
        doi: 10.1056/NEJMra031087

    16. Ha S J, Mueller S N, Wherry E J, Barber D L, Aubert R D, Sharpe A H, Freeman G J, and Ahmed R. 2008. Enhancing therapeutic vaccination by blocking PD-1-mediated inhibitory signals during chronic infection. J Exp Med, 205: 543-555.
        doi: 10.1084/jem.20071949

    17. Hervas-Stubbs S, Lasarte J J, Sarobe P, Vivas I, Condreay L, Cullen J M, Prieto J, and Borras-Cuesta F. 2001. T-helper cell response to woodchuck hepatitis virus antigens after therapeutic vaccination of chronically-infected animals treated with lamivudine. J Hepatol, 35: 105-111.
        doi: 10.1016/S0168-8278(01)00063-0

    18. Horiike N, Fazle Akbar S M, Michitaka K, Joukou K, Yamamoto K, Kojima N, Hiasa Y, Abe M, and Onji M. 2005. In vivo immunization by vaccine therapy following virus suppression by lamivudine:a novel approach for treating patients with chronic hepatitis B. J Clin Virol:the official publication of the Pan American Society for Clinical Virology, 32: 156-161.
        doi: 10.1016/j.jcv.2004.07.004

    19. Jung M C, Spengler U, Schraut W, Hoffmann R, Zachoval R, Eisenburg J, Eichenlaub D, Riethmuller G, Paumgartner G, Ziegler-Heitbrock H W, and et al. 1991. Hepatitis B virus antigen-specific T-cell activation in patients with acute and chronic hepatitis B. J Hepatol, 13: 310-317.

    20. Jung M C, Gruner N, Zachoval R, Schraut W, Gerlach T, Diepolder H, Schirren C A, Page M, Bailey J, Birtles E, Whitehead E, Trojan J, Zeuzem S, and Pape G R. 2002. Immunological monitoring during therapeutic vaccination as a prerequisite for the design of new effective therapies:induction of a vaccine-specific CD4+ T-cell proliferative response in chronic hepatitis B carriers. Vaccine, 20: 3598-3612.
        doi: 10.1016/S0264-410X(02)00309-2

    21. Kosinska A D, Johrden L, Zhang E, Fiedler M, Mayer A, Wildner O, Lu M, and Roggendorf M. 2012. DNA prime-adenovirus boost immunization induces a vigorous and multifunctional T-cell response against hepadnaviral proteins in the mouse and woodchuck model. J Virol, 86: 9297-9310.
        doi: 10.1128/JVI.00506-12

    22. Kosinska A D, Zhang E, Johrden L, Liu J, Seiz P L, Zhang X, Ma Z, Kemper T, Fiedler M, Glebe D, Wildner O, Dittmer U, Lu M, and Roggendorf M. 2013. Combination of DNA prime--adenovirus boost immunization with entecavir elicits sustained control of chronic hepatitis B in the woodchuck model. PLoS Pathog, 9: e1003391.
        doi: 10.1371/journal.ppat.1003391

    23. Li F J, Zhang Y, Jin G X, Yao L, and Wu D Q. 2013. Expression of LAG-3 is coincident with the impaired effector function of HBV-specific CD8(+) T cell in HCC patients. Immunol Lett, 150: 116-122.
        doi: 10.1016/j.imlet.2012.12.004

    24. Liang T J. 2009. Hepatitis B:the virus and disease. Hepatology, 49: S13-21.
        doi: 10.1002/hep.22881

    25. Locarnini S, and Mason W S. 2006. Cellular and virological mechanisms of HBV drug resistance. J Hepatol, 44: 422-431.
        doi: 10.1016/j.jhep.2005.11.036

    26. Lu M, Yao X, Xu Y, Lorenz H, Dahmen U, Chi H, Dirsch O, Kemper T, He L, Glebe D, Gerlich W H, Wen Y, and Roggendorf M. 2008. Combination of an antiviral drug and immunomodulation against hepadnaviral infection in the woodchuck model. J Virol, 82: 2598-2603.
        doi: 10.1128/JVI.01613-07

    27. Maier H, Isogawa M, Freeman G J, and Chisari F V. 2007. PD-1:PD-L1 interactions contribute to the functional suppression of virus-specific CD8+ T lymphocytes in the liver. J Immunol, 178: 2714-2720.
        doi: 10.4049/jimmunol.178.5.2714

    28. Maini M K, Boni C, Lee C K, Larrubia J R, Reignat S, Ogg G S, King A S, Herberg J, Gilson R, Alisa A, Williams R, Vergani D, Naoumov N V, Ferrari C, and Bertoletti A. 2000. The role of virus-specific CD8(+) cells in liver damage and viral control during persistent hepatitis B virus infection. J Exp Med, 191: 1269-1280.
        doi: 10.1084/jem.191.8.1269

    29. Mancini-Bourgine M, Fontaine H, Brechot C, Pol S, and Michel M L. 2006. Immunogenicity of a hepatitis B DNA vaccine administered to chronic HBV carriers. Vaccine, 24: 4482-4489.
        doi: 10.1016/j.vaccine.2005.08.013

    30. Mancini-Bourgine M, Fontaine H, Scott-Algara D, Pol S, Brechot C, and Michel M L. 2004. Induction or expansion of T-cell responses by a hepatitis B DNA vaccine administered to chronic HBV carriers. Hepatology, 40: 874-882.

    31. Menne S, Roneker C A, Tennant B C, Korba B E, Gerin J L, and Cote P J. 2002. Immunogenic effects of woodchuck hepatitis virus surface antigen vaccine in combination with antiviral therapy: breaking of humoral and cellular immune tolerance in chronic woodchuck hepatitis virus infection. Intervirology, 45: 237-250.
        doi: 10.1159/000067914

    32. Menne S, Roneker C A, Korba B E, Gerin J L, Tennant B C, and Cote P J. 2002. Immunization with surface antigen vaccine alone and after treatment with 1-(2-fluoro-5-methyl-beta-L-arabinofuranosyl)-uracil (L-FMAU) breaks humoral and cell-mediated immune tolerance in chronic woodchuck hepatitis virus infection. J Virol, 76: 5305-5314.
        doi: 10.1128/JVI.76.11.5305-5314.2002

    33. Paoletti E. 1996. Applications of pox virus vectors to vaccination:an update. P Natl Acad Sci USA, 93: 11349-11353.
        doi: 10.1073/pnas.93.21.11349

    34. Penna A, Chisari F V, Bertoletti A, Missale G, Fowler P, Giuberti T, Fiaccadori F, and Ferrari C. 1991. Cytotoxic T lymphocytes recognize an HLA-A2-restricted epitope within the hepatitis B virus nucleocapsid antigen. J Exp Med, 174: 1565-1570.
        doi: 10.1084/jem.174.6.1565

    35. Penna A, Pilli M, Zerbini A, Orlandini A, Mezzadri S, Sacchelli L, Missale G, and Ferrari C. 2007. Dysfunction and functional restoration of HCV-specific CD8 responses in chronic hepatitis C virus infection. Hepatology, 45: 588-601.
        doi: 10.1002/hep.21541

    36. Perkus M E, Piccini A, Lipinskas B R, and Paoletti E. 1985. Recombinant vaccinia virus: immunization against multiple pathogens. Science, 229: 981-984.
        doi: 10.1126/science.2992092

    37. Petrovas C, Casazza J P, Brenchley J M, Price D A, Gostick E, Adams W C, Precopio M L, Schacker T, Roederer M, Douek D C, and Koup R A. 2006. PD-1 is a regulator of virus-specific CD8+ T cell survival in HIV infection. J Exp Med, 203: 2281-2292.
        doi: 10.1084/jem.20061496

    38. Pilli M, Zerbini A, Penna A, Orlandini A, Lukasiewicz E, Pawlotsky J M, Zeuzem S, Schalm S W, von Wagner M, Germanidis G, Lurie Y, Esteban J I, Haagmans B L, Hezode C, Lagging M, Negro F, Homburger Y, Neumann A U, Ferrari C, and Missale G. 2007. HCV-specific T-cell response in relation to viral kinetics and treatment outcome (DITTO-HCV project). Gastroenterology, 133: 1132-1143.
        doi: 10.1053/j.gastro.2007.06.059

    39. Pol S, Driss F, Michel M L, Nalpas B, Berthelot P, and Brechot C. 1994. Specific vaccine therapy in chronic hepatitis B infection. Lancet, 344: 342.

    40. Pol S, Nalpas B, Driss F, Michel M L, Tiollais P, Denis J, and Brecho C. 2001. Efficacy and limitations of a specific immunotherapy in chronic hepatitis B. J Hepatol, 34: 917-921.
        doi: 10.1016/S0168-8278(01)00028-9

    41. Rehermann B, and Nascimbeni M. 2005. Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol, 5: 215-229.
        doi: 10.1038/nri1573

    42. Ren F, Hino K, Yamaguchi Y, Funatsuki K, Hayashi A, Ishiko H, Furutani M, Yamasaki T, Korenaga K, Yamashita S, Konishi T, and Okita K. 2003. Cytokine-dependent anti-viral role of CD4-positive T cells in therapeutic vaccination against chronic hepatitis B viral infection. J Med Virol, 71: 376-384.
        doi: 10.1002/jmv.10509

    43. Robinson H L. 2002. New hope for an AIDS vaccine. Nature reviews. Immunology, 2: 239-250.
        doi: 10.1038/nri776

    44. Safadi R, Israeli E, Papo O, Shibolet O, Melhem A, Bloch A, Rowe M, Alper R, Klein A, Hemed N, Segol O, Thalenfeld B, Engelhardt D, Rabbani E, and Ilan Y. 2003. Treatment of chronic hepatitis B virus infection via oral immune regulation toward hepatitis B virus proteins. Am J Gastroenterol, 98: 2505-2515.
        doi: 10.1111/j.1572-0241.2003.07700.x

    45. Sallberg M, Hughes J, Javadian A, Ronlov G, Hultgren C, Townsend K, Anderson C G, O'Dea J, Alfonso J, Eason R, Murthy K K, Jolly D J, Chang S M, Mento S J, Milich D, and Lee W T. 1998. Genetic immunization of chimpanzees chronically infected with the hepatitis B virus, using a recombinant retroviral vector encoding the hepatitis B virus core antigen. Hum Gene Ther, 9: 1719-1729.
        doi: 10.1089/hum.1998.9.12-1719

    46. Schurich A, Khanna P, Lopes A R, Han K J, Peppa D, Micco L, Nebbia G, Kennedy P T, Geretti A M, Dusheiko G, and Maini M K. 2011. Role of the coinhibitory receptor cytotoxic T lymphocyte antigen-4 on apoptosis-Prone CD8 T cells in persistent hepatitis B virus infection. Hepatology, 53: 1494-1503.
        doi: 10.1002/hep.24249

    47. Tatsis N, and Ertl H C. 2004. Adenoviruses as vaccine vectors. Mol Ther, 10: 616-629.
        doi: 10.1016/j.ymthe.2004.07.013

    48. Thimme R, Wieland S, Steiger C, Ghrayeb J, Reimann K A, Purcell R H, and Chisari F V. 2003. CD8(+) T cells mediate viral clearance and disease pathogenesis during acute hepatitis B virus infection. J Virol, 77: 68-76.
        doi: 10.1128/JVI.77.1.68-76.2003

    49. Trautmann L, Janbazian L, Chomont N, Said E A, Gimmig S, Bessette B, Boulassel M R, Delwart E, Sepulveda H, Balderas R S, Routy J P, Haddad E K, and Sekaly R P. 2006. Upregulation of PD-1 expression on HIV-specific CD8+ T cells leads to reversible immune dysfunction. Nat Med, 12: 1198-1202.
        doi: 10.1038/nm1482

    50. Vandepapeliere P, Lau G K, Leroux-Roels G, Horsmans Y, Gane E, Tawandee T, Merican M I, Win K M, Trepo C, Cooksley G, Wettendorff M, and Ferrari C. 2007. Therapeutic vaccination of chronic hepatitis B patients with virus suppression by antiviral therapy:a randomized, controlled study of co-administration of HBsAg/AS02 candidate vaccine and lamivudine. Vaccine, 25: 8585-8597.
        doi: 10.1016/j.vaccine.2007.09.072

    51. Velu V, Titanji K, Zhu B, Husain S, Pladevega A, Lai L, Vanderford T H, Chennareddi L, Silvestri G, Freeman G J, Ahmed R, and Amara R R. 2009. Enhancing SIV-specific immunity in vivo by PD-1 blockade. Nature, 458: 206-210.
        doi: 10.1038/nature07662

    52. Wang X Y, Zhang X X, Yao X, Jiang J H, Xie Y H, Yuan Z H, and Wen Y M. 2010. Serum HBeAg sero-conversion correlated with decrease of HBsAg and HBV DNA in chronic hepatitis B patients treated with a therapeutic vaccine. Vaccine, 28: 8169-8174.
        doi: 10.1016/j.vaccine.2010.09.093

    53. Webster G J, Reignat S, Brown D, Ogg G S, Jones L, Seneviratne S L, Williams R, Dusheiko G, and Bertoletti A. 2004. Longitudinal analysis of CD8+ T cells specific for structural and nonstructural hepatitis B virus proteins in patients with chronic hepatitis B: implications for immunotherapy. J Virol, 78: 5707-5719.
        doi: 10.1128/JVI.78.11.5707-5719.2004

    54. Wen Y M, Wu X H, Hu D C, Zhang Q P, and Guo S Q. 1995. Hepatitis B vaccine and anti-HBs complex as approach for vaccine therapy. Lancet, 345: 1575-1576.

    55. Wu C, Shi H, Wang Y, Lu M, Xu Y, and Chen X. 2012. A case of hepatitis B reactivation due to the hepatitis B virus escape mutant in a patient undergoing chemotherapy. Virol Sin, 27: 369-372.

    56. Wu W, Shi Y, Li S, Zhang Y, Liu Y, Wu Y, and Chen Z. 2012. Blockade of Tim-3 signaling restores the virus-specific CD8(+) T-cell response in patients with chronic hepatitis B. Eur J Immunol, 42: 1180-1191.
        doi: 10.1002/eji.201141852

    57. Xu D Z, Zhao K, Guo L M, Li L J, Xie Q, Ren H, Zhang J M, Xu M, Wang H F, Huang W X, Bai X F, Niu J Q, Liu P, Chen X Y, Shen X L, Yuan Z H, Wang X Y, and Wen Y M. 2008. A randomized controlled phase IIb trial of antigen-antibody immunogenic complex therapeutic vaccine in chronic hepatitis B patients. PloS One, 3: e2565.
        doi: 10.1371/journal.pone.0002565

    58. Xu D Z, Wang X Y, Shen X L, Gong G Z, Ren H, Guo L M, Sun A M, Xu M, Li L J, Guo X H, Zhen Z, Wang H F, Gong H Y, Xu C, Jiang N, Pan C, Gong Z J, Zhang J M, Shang J, Xu J, Xie Q, Wu T F, Huang W X, Li Y G, Yuan Z H, Wang B, Zhao K, and Wen Y M. 2013. Results of a phase Ⅲ clinical trial with an HBsAg-HBIG immunogenic complex therapeutic vaccine for chronic hepatitis B patients: experiences and findings. J Hepatol, 59: 450-456.
        doi: 10.1016/j.jhep.2013.05.003

    59. Yalcin K, Acar M, and Degertekin H. 2003. Specific hepatitis B vaccine therapy in inactive HBsAg carriers:a randomized controlled trial. Infection, 31: 221-225.

    60. Yang P L, Althage A, Chung J, Maier H, Wieland S, Isogawa M, and Chisari F V. 2010. Immune effectors required for hepatitis B virus clearance. Proc Natl Acad Sci U S A, 107: 798-802.
        doi: 10.1073/pnas.0913498107

    61. Yao X, Zheng B, Zhou J, Xu D Z, Zhao K, Sun S H, Yuan Z H, and Wen Y M. 2007. Therapeutic effect of hepatitis B surface antigen-antibody complex is associated with cytolytic and non-cytolytic immune responses in hepatitis B patients. Vaccine, 25: 1771-1779.
        doi: 10.1016/j.vaccine.2006.11.019

    62. Zoulim F, and Locarnini S. 2009. Hepatitis B virus resistance to nucleos(t)ide analogues. Gastroenterology, 137: 1593-1608 e1591-1592.

  • 加载中

Figures(1)

Article Metrics

Article views(6867) PDF downloads(19) Cited by()

Related
Proportional views

    New therapeutic vaccination strategies for the treatment of chronic hepatitis B

      Corresponding author: Michael Roggendorf, michael.roggendorf@uni-due.de
    • Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Virchowstraβe 179, 45122 Essen, Germany

    Abstract: Chronic hepatitis B virus (CHB) is currently treated with either interferon-based or nucleot(s)ide-based antiviral therapies. However, treatment with pegylated interferon alpha results in a durable antiviral response in only about 30% patients and is associated with side effects. Most patients receiving nucleot(s)ide analogue treatment do not establish long-term, durable control of infection and have rebounding viremia after cessation of therapy. Thus, novel therapy strategies are necessary to achieve the induction of potent and durable antiviral immune responses of the patients which can maintain long-term control of viral replication. Therapeutic vaccination of HBV carriers is a promising strategy for the control of hepatitis B. Here the authors review new therapeutic vaccination strategies to treat chronic hepatitis B which may be introduced for patient treatment in the future.