The Role of CTLA-4 in T Cell Exhaustion in Chronic Hepatitis B Virus Infection

Ása Didriksen Apol, Anni Assing Winckelmann, Rasmus Bülow Duus, Jens Bukh, Nina Weis*

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

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Abstract

Patients with chronic hepatitis B (CHB) gradually develop T cell exhaustion, and the inhibitory receptor molecule, cytotoxic T-lymphocyte antigen-4 (CTLA-4), may play a role in this phenomenon. This systematic review investigates the role of CTLA-4 in the development of T cell exhaustion in CHB. A systematic literature search was conducted on PubMed and Embase on 31 March 2023 to identify relevant studies. Fifteen studies were included in this review. A majority of the studies investigating CD8+ T cells demonstrated increased expression of CTLA-4 in CHB patients, though one study found this only in HBeAg-positive patients. Three out of four studies investigating the expression of CTLA-4 on CD4+ T cells found upregulation of CTLA-4. Several studies showed constitutive expression of CLTA-4 on CD4+ regulatory T cells. CTLA-4 blockade resulted in heterogeneous responses for all T cell types, as it resulted in increased T cell proliferation and/or cytokine production in some studies, while other studies found this only when combining blockade of CTLA-4 with other inhibitory receptors. Although mounting evidence supports a role of CTLA-4 in T cell exhaustion, there is still insufficient documentation to describe the expression and exact role of CTLA-4 in T cell exhaustion in CHB.

Original languageEnglish
Article number1141
JournalViruses
Volume15
Issue number5
ISSN1999-4915
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • chronic hepatitis B
  • CTLA-4
  • immune checkpoint inhibitors
  • T cell exhaustion

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