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220A AASLD ABSTRACTS HEPATOLOGY, October, 2015<br />

26<br />

Elevation of Galectin-9 is associated with the cytotoxicity<br />

of NK cells in chronic hepatitis<br />

Akira Nishio, Tomohide Tatsumi, Takatoshi Nawa, Takahiro<br />

Suda, Atsuo Takigawa, Tadashi Kegasawa, Yoshiki Onishi, Seiichi<br />

Tawara, Teppei Yoshioka, Satoshi Aono, Minoru Shigekawa,<br />

Hayato Hikita, Ryotaro Sakamori, Naoki Hiramatsu, Tetsuo Takehara;<br />

Department of Gastroenterology and Hepatology, Osaka<br />

University Graduate School of Medicine, Suita, Japan<br />

Background & Aims: NK cells play an essential role in the<br />

pathogenesis of chronic hepatitis C (CHC). NK cells are activated<br />

in CHC and activated NK cells exhibit elevated cytotoxicity<br />

leading to liver injury. Recently, the activated NK cells<br />

contribute to exhaustion of virus-specific T cells, which is associated<br />

with persistent viral infection. However, the mechanism<br />

of NK cell activation has not been clearly understood. The<br />

immunoregulatory protein Galectin-9 (Gal-9) is elevated in the<br />

serum and liver in CHC patients, suggesting that Gal-9 might<br />

be involved in the pathogenesis of CHC. In this study, we investigated<br />

the effect of Gal-9 on the activation of NK cells in CHC.<br />

Methods: Serum Gal-9 levels were analyzed in 39 healthy<br />

donors, 50 CHC patients and 24 IFN-treated patients achieving<br />

sustained viral response (SVR) by ELISA. The cytotoxicity of<br />

NK cells and Gal-9 levels in the supernatant were evaluated by<br />

flow cytometry and ELISA. Immunofluorescence staining was<br />

performed in CHC liver tissue. Results: Serum Gal-9 levels in<br />

CHC patients were significantly higher than those in healthy<br />

donors, and those in SVR patients were significantly lower<br />

than those in CHC patients (median, 0-90 percentile, CHC:<br />

146 pg/ml, 0-508, healthy donors: 0, 0-55.4, SVR: 53.6,<br />

0-185.6). In CHC patients, serum levels of Gal-9 in elevated<br />

ALT patients were significantly higher than those in normal ALT<br />

patients, suggesting that elevated Gal-9 might be associated<br />

with liver injury. Serum Gal-9 levels were not associated with<br />

HCV viral loads. In vitro study revealed that addition of recombinant<br />

Gal-9 resulted in significant increase of the cytotoxicity<br />

of naïve NK cells in a dose dependent manner, independent of<br />

Tim-3. Gal-9-activated NK cells showed the cytotoxicity against<br />

CD4+ or CD8+ T cells, which might contribute to persistent<br />

infection by depleting T cell. We found that a large amount of<br />

Gal-9 production was induced in the co-culture of PBMCs with<br />

JFH-1/Huh7.5.1 cells, but not with uninfected Huh7.5.1 cells.<br />

A transwell system revealed that cell-cell contact was required<br />

for Gal-9 production. In vitro depletion study revealed CD14+<br />

monocytes were required for Gal-9 in the co-culture, and both<br />

Gal-9 and CD14 positive cells were observed in immunofluorescence<br />

staining, indicating that Gal-9 was produced by<br />

Kupffer cells in the liver. The cytotoxicity of NK cells was significantly<br />

elevated when co-cultured with JFH-1 cells compared<br />

with control. Conclusion: Monocytes-derived Gal-9 induces the<br />

cytotoxicity of NK cells, which might be involved in liver injury<br />

and persistent HCV infection. These results suggest the role of<br />

Gal-9 in the pathogenesis of chronic hepatitis C.<br />

Disclosures:<br />

Hayato Hikita - Grant/Research Support: Bristol-Myers Squibb<br />

Tetsuo Takehara - Grant/Research Support: Chugai Pharmaceutical Co., MSD<br />

K.K., Bristol-Meyer Squibb, Mitsubishi Tanabe Pharma Corparation, Toray Industories<br />

Inc. ; Speaking and Teaching: MSD K.K., Bristol-Meyer Squibb, Janssen<br />

Pharmaceutical Companies<br />

The following authors have nothing to disclose: Akira Nishio, Tomohide Tatsumi,<br />

Takatoshi Nawa, Takahiro Suda, Atsuo Takigawa, Tadashi Kegasawa, Yoshiki<br />

Onishi, Seiichi Tawara, Teppei Yoshioka, Satoshi Aono, Minoru Shigekawa,<br />

Ryotaro Sakamori, Naoki Hiramatsu<br />

27<br />

De novo formation and maturation of hepatitis C virus<br />

replication membranes visualized by pulse-chase imaging<br />

Hongliang Wang 1 , Andrew W. Tai 1,2 ; 1 Internal Medicine, University<br />

of Michigan, Ann Arbor, MI; 2 VA Ann Arbor Healthcare<br />

System, Ann Arbor, MI<br />

Hepatitis C virus (HCV) replicates on an altered host membrane<br />

structure called the “membranous web” (MW). Little is known<br />

regarding temporal events in MW formation and association<br />

with putative sites of virus assembly at or near lipid droplets<br />

(LDs). For example, it is not known whether membranous webs<br />

are stable structures that are continually renewed by newly<br />

synthesized viral proteins, or whether newly synthesized viral<br />

proteins are directed to form new MWs de novo. The HCV<br />

nonstructural protein NS5A is believed to be a component of<br />

MWs. We have developed pulse-chase fluorescent labeling<br />

and imaging approaches that allow us to discriminate ‘old’<br />

from ‘new’ NS5A-positive membranous structures (NS5A foci).<br />

With this system, we find that ‘new’ NS5A-positive foci form at<br />

sites distinct from ‘old’ NS5A foci, supporting a model of de<br />

novo MW formation instead of renewal of previously formed<br />

MWs. We also find that the phosphatidylinositol 4-kinase<br />

PI4KA and oxysterol-binding protein, which are known to be<br />

required for normal MW morphogenesis, are required to maintain<br />

the normal morphology of both ‘old’ and ‘new’ foci, and<br />

that these two proteins appear to play a role in de novo NS5A<br />

focus formation. Finally, we observe increasing colocalization<br />

of NS5A-positive foci with HCV core protein and LDs over time.<br />

Overall, these data support a model in which HCV MWs are<br />

formed de novo rather than renewed. We hypothesize that<br />

newly-formed NS5A foci undergo a process of maturation and<br />

movement towards sites of putative virion assembly at or near<br />

LDs. This may have implications for our understanding of how<br />

replication membranes are formed for other positive-sense RNA<br />

viruses.<br />

Disclosures:<br />

The following authors have nothing to disclose: Hongliang Wang, Andrew W.<br />

Tai<br />

28<br />

Rapid normalization of antiviral and pro-inflammatory<br />

transcriptional signatures in peripheral blood of patients<br />

and livers of humanized mice treated with DAAs<br />

Matthew A. Burchill 1 , Lucy Golden-Mason 1 , Megan Wind-Rotolo 2 ,<br />

Michael Gale 3 , Hugo R. Rosen 1 ; 1 GI-Hepatology, University of<br />

Colorado-Denver, Aurora, CO; 2 Exploratory Clinical and Translational<br />

Research, Bristol-Myers Squibb, Lawrenceville, NJ; 3 Immunology,<br />

University of Washington, Seattle, WA<br />

Chronic HCV infection results in sustained immune activation<br />

in both the periphery and hepatic tissue. Recently, novel<br />

direct acting antiviral (DAA) regimens have been shown to<br />

induce rapid and sustained clearance of HCV. DAAs have<br />

provided the unique opportunity to determine whether successful<br />

treatment-induced eradication of viral RNA normalizes<br />

the dysregulated antiviral innate immune response in patients<br />

chronically infected with HCV. Methods: We used both a<br />

prospective cohort of patients and a novel humanized mouse<br />

model. Results: First, in 35 patients receiving DAAs, we found<br />

that a regimen of daclatasvir, asunaprevir, and BMS-791325<br />

induced not only rapid viral clearance, but also a re-setting<br />

of antiviral responses in the peripheral blood. Specifically,<br />

we observed that following treatment with DAAs, there was<br />

a significant reduction in IFITM1 and the chemokines CXCL10

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