摘要
乙型肝炎病毒(HBV)是一种独特的嗜肝DNA病毒,在肝细胞核内形成共价闭合环状DNA并可部分整合入宿主基因组,构成病毒持续感染的分子基础。HBV感染复制依赖多种肝细胞富集因子及微环境调控。宿主通过多种方式实现对HBV的自然控制和清除,包括以细胞毒性T细胞及自然杀伤细胞等细胞免疫介导的溶细胞性清除,以干扰素和各类细胞因子驱动的天然免疫与非溶细胞性清除,以及体液免疫中抗体介导的保护与清除。此外,细胞内限制性因子和通路、肝细胞分裂更新及基底硬度等肝脏微环境变化亦共同影响病毒控制和清除的效率与结局。本文深入阐明并动态解析相关机制,将有助于加深理解乙型肝炎慢性化及自愈和治愈的过程,为优化诊疗及研发新型干预策略提供理论基础。
Hepatitis B virus(HBV)is a unique hepatotropic DNA virus that forms covalently closed circular DNA within the nucleus of hepatocytes and can partially integrate into the host genome,establishing the molecular basis for persistent viral infection.HBV infection and replication depends on multiple hepatocyte-enriched host factors and is modulated by the hepatic microenvironment.The host achieves natural control and clearance of HBV through various mechanisms,including cytolytic elimination mediated by cellular immunity such as cytotoxic T lymphocytes and natural killer cells,innate immunity and noncytolytic clearance driven by interferons and various cytokines,and antibody-mediated protection and clearance as part of humoral immune response.In addition,intracellular restriction factors and pathways,hepatocyte turnover through division and replacement,and changes in the hepatic microenvironment(such as the increase in matrix stiffness)collectively influence the efficiency and outcome of viral control and clearance.This article clarifies and elaborates on related mechanisms,so as to deepen the understanding of HBV chronicity,spontaneous resolution,and cure and provide a theoretical basis for optimizing clinical management and developing novel therapeutic strategies.
作者
叶建宇
王冰
顾乐言
樊映廷
陈捷亮
YE Jianyu;WANG Bing;GU Leyan;FAN Yingting;CHEN Jieliang(Department of Medical Microbiology and Parasitology,School of Basic Medical Sciences,Shanghai Medical College,Fudan University,Shanghai 200032,China;MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology,Shanghai 200032,China)
出处
《临床肝胆病杂志》
北大核心
2026年第1期7-13,共7页
Journal of Clinical Hepatology
基金
国家自然科学基金(82372234,32570162)
国家重点研发计划(2022YFA1303600)。
