title: B cell gene signature with massive intrahepatic production of antibodies to hepatitis B core antigen in hepatitis B virus-associated acute liver failure.
abstract: Hepatitis B virus (HBV)-associated acute liver failure (ALF) is a dramatic clinical syndrome due to a sudden loss of hepatic cells leading to multiorgan failure. The mechanisms whereby HBV induces ALF are unknown. Here, we show that liver tissue collected at the time of liver transplantation in two patients with HBV-associated ALF is characterized by an overwhelming B cell response apparently centered in the liver with massive accumulation of plasma cells secreting IgG and IgM, accompanied by complement deposition. We demonstrate that the molecular target of these antibodies is the hepatitis B core antigen (HBcAg); that these anti-bodies display a restricted variable heavy chain (V(H)) repertoire and lack somatic mutations; and that these two unrelated individuals with ALF use an identical predominant V(H) gene with unmutated variable domain (IGHV1-3) for both IgG and IgM anti-HBc antibodies, indicating that HBcAg is the target of a germline human V(H) gene. These data suggest that humoral immunity may exert a primary role in the pathogenesis of HBV-associated ALF.
authors.affiliation: Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. pfarci@niaid.nih.gov
authors.forename: Patrizia
authors.initials: P
authors.lastname: Farci
authors.forename: Giacomo
authors.initials: G
authors.lastname: Diaz
authors.forename: Zhaochun
authors.initials: Z
authors.lastname: Chen
authors.forename: Sugantha
authors.initials: S
authors.lastname: Govindarajan
authors.forename: Ashley
authors.initials: A
authors.lastname: Tice
authors.forename: Liane
authors.initials: L
authors.lastname: Agulto
authors.forename: Stefania
authors.initials: S
authors.lastname: Pittaluga
authors.forename: Denali
authors.initials: D
authors.lastname: Boon
authors.forename: Claro
authors.initials: C
authors.lastname: Yu
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Engle
authors.forename: Mark
authors.initials: M
authors.lastname: Haas
authors.forename: Richard
authors.initials: R
authors.lastname: Simon
authors.forename: Robert H
authors.initials: RH
authors.lastname: Purcell
authors.forename: Fausto
authors.initials: F
authors.lastname: Zamboni
mesh_terms: D001402:B-Lymphocytes / Q000276:immunology* / Q000821:virology; D019070:Cell Lineage; D016000:Cluster Analysis; D003165:Complement System Proteins / Q000276:immunology; D018450:Disease Progression; D020869:Gene Expression Profiling; D006509:Hepatitis B / Q000097:blood / Q000276:immunology / Q000821:virology; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis; D007075:Immunoglobulin M / Q000096:biosynthesis; D007150:Immunohistochemistry; D008099:Liver / Q000276:immunology* / Q000473:pathology / Q000821:virology; D017114:Liver Failure, Acute / Q000097:blood / Q000235:genetics* / Q000276:immunology / Q000821:virology; D009336:Necrosis / Q000276:immunology / Q000473:pathology / Q000821:virology; D013601:T-Lymphocytes / Q000276:immunology / Q000821:virology; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D003165:Complement System Proteins