Immunopathogenesis of Acute Flare of Chronic Hepatitis B: With Emphasis on the Role of Cytokines and Chemokines

doi:10.3390/ijms23031407

Review

. 2022 Jan 26;23(3):1407.

doi: 10.3390/ijms23031407.

Immunopathogenesis of Acute Flare of Chronic Hepatitis B: With Emphasis on the Role of Cytokines and Chemokines

Chieh Liu¹, Yi-Fen Shih², Chun-Jen Liu^{3

4

5}

Affiliations

¹ Department of Medicine, Chung-Shan Medical University, Taichung 40201, Taiwan.
² Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan.
³ Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei 10002, Taiwan.
⁴ Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei 10002, Taiwan.
⁵ Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei 10002, Taiwan.

PMID: 35163330
PMCID: PMC8835919
DOI: 10.3390/ijms23031407

Review

Immunopathogenesis of Acute Flare of Chronic Hepatitis B: With Emphasis on the Role of Cytokines and Chemokines

Chieh Liu et al. Int J Mol Sci. 2022.

. 2022 Jan 26;23(3):1407.

doi: 10.3390/ijms23031407.

Authors

Chieh Liu¹, Yi-Fen Shih², Chun-Jen Liu^{3

4

5}

Affiliations

¹ Department of Medicine, Chung-Shan Medical University, Taichung 40201, Taiwan.
² Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan.
³ Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei 10002, Taiwan.
⁴ Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei 10002, Taiwan.
⁵ Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei 10002, Taiwan.

PMID: 35163330
PMCID: PMC8835919
DOI: 10.3390/ijms23031407

Abstract

Acute flares (AFs) of chronic hepatitis B usually occur during the immune-active stage (both immune clearance phase and immune reactivation phase), as the host immune system tries to control the virus. Successful host immune control over viral replication is usually presented as hepatitis B surface antigen seroclearance; however, 20-30% individuals with chronic hepatitis B may encounter repeated AFs with accumulative liver injuries, finally leading to the development of cirrhosis and hepatocellular carcinoma. AF can also develop in other clinical situations such as organ transplantation, cancer chemotherapy, and under treatment for chronic hepatitis B or treatment for chronic hepatitis C in patients with co-infected hepatitis B/hepatitis C. Understanding the natural history and immunopathogenesis of AF would help develop effective strategies to eradicate the virus and improve the clinical outcomes of patients with chronic hepatitis B. In this review article, the immunopathogenesis of AF, and the involvement of innate and adaptive immune responses on the development of hepatitis B flare will be briefly reviewed, with the emphasis on the role of cytokines and chemokines.

Keywords: acute exacerbation; acute flare; chemokine; cytokine; hepatitis B; immunopathogenesis; reactivation.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

1. Liaw Y.F., Chu C.M. Hepatitis B virus infection. Lancet. 2009;373:582–592. doi: 10.1016/S0140-6736(09)60207-5. - DOI - PubMed
1. Perrillo R.P. Acute flares in chronic hepatitis B: The natural and unnatural history of an immunologically mediated liver disease. Gastroenterology. 2001;120:1009–1022. doi: 10.1053/gast.2001.22461. - DOI - PubMed
1. Chang M.L., Liaw Y.F. Hepatitis B flares in chronic hepatitis B: Pathogenesis, natural course, and management. J. Hepatol. 2014;61:1407–1417. doi: 10.1016/j.jhep.2014.08.033. - DOI - PubMed
1. Liaw Y.F., Chu C.M., Su I.J., Huang M.J., Lin D.Y., ChangChien C.S. Clinical and histological events preceding hepatitis B e antigen seroconversion in chronic type B hepatitis. Gastroenterology. 1983;84:216–219. doi: 10.1016/S0016-5085(83)80114-0. - DOI - PubMed
1. Lok A.S., Lai C.L. Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection. Incidence, predisposing factors and etiology. J. Hepatol. 1990;10:29–34. doi: 10.1016/0168-8278(90)90069-4. - DOI - PubMed

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[1] Liaw Y.F., Chu C.M. Hepatitis B virus infection. Lancet. 2009;373:582–592. doi: 10.1016/S0140-6736(09)60207-5. - DOI - PubMed

[2] Liaw Y.F., Chu C.M. Hepatitis B virus infection. Lancet. 2009;373:582–592. doi: 10.1016/S0140-6736(09)60207-5. - DOI - PubMed

[3] Perrillo R.P. Acute flares in chronic hepatitis B: The natural and unnatural history of an immunologically mediated liver disease. Gastroenterology. 2001;120:1009–1022. doi: 10.1053/gast.2001.22461. - DOI - PubMed

[4] Perrillo R.P. Acute flares in chronic hepatitis B: The natural and unnatural history of an immunologically mediated liver disease. Gastroenterology. 2001;120:1009–1022. doi: 10.1053/gast.2001.22461. - DOI - PubMed

[5] Chang M.L., Liaw Y.F. Hepatitis B flares in chronic hepatitis B: Pathogenesis, natural course, and management. J. Hepatol. 2014;61:1407–1417. doi: 10.1016/j.jhep.2014.08.033. - DOI - PubMed

[6] Chang M.L., Liaw Y.F. Hepatitis B flares in chronic hepatitis B: Pathogenesis, natural course, and management. J. Hepatol. 2014;61:1407–1417. doi: 10.1016/j.jhep.2014.08.033. - DOI - PubMed

[7] Liaw Y.F., Chu C.M., Su I.J., Huang M.J., Lin D.Y., ChangChien C.S. Clinical and histological events preceding hepatitis B e antigen seroconversion in chronic type B hepatitis. Gastroenterology. 1983;84:216–219. doi: 10.1016/S0016-5085(83)80114-0. - DOI - PubMed

[8] Liaw Y.F., Chu C.M., Su I.J., Huang M.J., Lin D.Y., ChangChien C.S. Clinical and histological events preceding hepatitis B e antigen seroconversion in chronic type B hepatitis. Gastroenterology. 1983;84:216–219. doi: 10.1016/S0016-5085(83)80114-0. - DOI - PubMed

[9] Lok A.S., Lai C.L. Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection. Incidence, predisposing factors and etiology. J. Hepatol. 1990;10:29–34. doi: 10.1016/0168-8278(90)90069-4. - DOI - PubMed

[10] Lok A.S., Lai C.L. Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection. Incidence, predisposing factors and etiology. J. Hepatol. 1990;10:29–34. doi: 10.1016/0168-8278(90)90069-4. - DOI - PubMed

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Immunopathogenesis of Acute Flare of Chronic Hepatitis B: With Emphasis on the Role of Cytokines and Chemokines

Affiliations

Immunopathogenesis of Acute Flare of Chronic Hepatitis B: With Emphasis on the Role of Cytokines and Chemokines

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