Toward a new era of hepatitis B virus therapeutics:The pursuit of a functional cure

查看全文 作　　者：Efthymios P [1]Tsounis;Evanthia [1]Tourkochristou;Athanasia [2]Mouzaki;Christos [1]Triantos

机构地区：[1]Division of Gastroenterology,Department of Internal Medicine,Medical School,University of Patras,Patras 26504,Greece;[2]Division of Hematology,Department of Internal Medicine,Medical School,University of Patras,Patras 26504,Greece

出　　处：《World Journal of Gastroenterology》索引2021年第27卷第21期,共31页

摘　　要：Hepatitis B virus(HBV)infection,although preventable by vaccination,remains a global health problem and a major cause of chronic liver disease.Although current treatment strategies suppress viral replication very efficiently,the optimal endpoint of hepatitis B surface antigen(HBsAg)clearance is rarely achieved.Moreover,the thorny problems of persistent chromatin-like covalently closed circular DNA and the presence of integrated HBV DNA in the host genome are ignored.Therefore,the scientific community has focused on developing innovative therapeutic approaches to achieve a functional cure of HBV,defined as undetectable HBV DNA and HBsAg loss over a limited treatment period.A deeper understanding of the HBV life cycle has led to the introduction of novel direct-acting antivirals that exert their function through multiple mechanisms,including inhibition of viral entry,transcriptional silencing,epigenetic manipulation,interference with capsid assembly,and disruption of HBsAg release.In parallel,another category of new drugs aims to restore dysregulated immune function in chronic hepatitis B accompanied by lethargic cellular and humoral responses.Stimulation of innate immunity by pattern-recognition receptor agonists leads to upregulation of antiviral cytokine expression and appears to contribute to HBV containment.Immune checkpoint inhibitors and adoptive transfer of genetically engineered T cells are breakthrough technologies currently being explored that may elicit potent HBV-specific T-cell responses.In addition,several clinical trials are attempting to clarify the role of therapeutic vaccination in this setting.Ultimately,it is increasingly recognized that elimination of HBV requires a treatment regimen based on a combination of multiple drugs.This review describes the rationale for progressive therapeutic interventions and discusses the latest findings in the field of HBV therapeutics. 关键词：Chronic hepatitis B Functional cure Direct-acting antivirals Gene silencing Immunotherapy Therapeutic vaccination

相关文献

参考文献（196）
引证文献（12）
耦合文献（103）

参考文献(196)

引证文献(12)

耦合文献(103)

互联网出版许可证新出网证(渝)字10号全国400电话 - 免长途话费

Toward a new era of hepatitis B virus therapeutics:The pursuit of a functional cure

参考文献(196)

引证文献(12)

耦合文献(103)

用户提示