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Effets antiviraux de l'agonisation des Toll-like Récepteurs dans les cellules du foie, une nouvelle stratégie immunothérapeutique dans la lutte contre HBV

Abstract : HBV chronically infects 240 million peoples around the world. HBV chronic infection is a major public health problem and can lead to cirrhosis or/and hepatocarcinoma (HCC). Even if some efficient treatments are already available, based in particular on the use of nucleos(t)ides analogues that induce a decrease of viral load in patients, these drugs do not lead to a definitive HBV cure They enable an important decrease of liver cancer risk but need to be taken life-long. HBV infects hepatocytes the major liver cells which are involve in many vital mechanisms into the organism. The HBV minichromosome, which is formed into infected cells also called cccDNA (i.e., covalently-closed-circular DNA), is not affected by nucleos(t)ides treatments and thus is responsible for HBV persistence. The use of immune receptors (e.g. Toll-like receptors/TLR) agonists can lead to 1) an important cytokines/interferon (IFN) secretion; 2) promote immune cells activation/recruitment and 3) induction of many Interferon-Stimulated Genes (ISG). These mechanisms could lead to a greater viral clearance by cccDNA degradation or silencing. The need for new strategies to permanently eliminate HBV infection led many laboratories, including ours, to explore the use of immunotherapeutic treatments in a context of chronic infection, including innate immune stimulators (e.g. TLR7, TLR8 or RIG-I agonist are under clinical trials). To this end, we got interested on the potential anti-HBV effects of many TLR agonists in liver cells. Our strategy is to stimulate both infected hepatocytes and immune cells. We first characterized the expression of innate immune sensors in primary liver cells as well as in some liver cell lines. This allowed us to: 1) identify which sensors are expressed by liver cells, especially in hepatocytes (TLR2, TLR3, TLR4, TLR5); 2) evaluate their ability to produce cytokines (IL-6, IP-10) upon agonisation; 3) evaluation of cell lines model which are immunologically closed to the primary liver cells. HepaRG and a new liver macrophage cell line call iKC are immunologically close to their primary cells and appear to be relevant models for immune-therapeutics studies. The use of TLR2 and TLR3 agonists on HBV chronically infected hepatocytes showed a strong antiviral effect (i.e., decrease of HBV replication and cccDNA level) mediated directly by NF- kB-inducible and ISG genes activation and indirectly by cytokines secretion. Furthermore, this effect was shown stable over time without any viral replication rebound. This strategy targets not only infected hepatocytes but also immune cells, whose cytokines production also has a strong antiviral effect. Despite a weak in vivo effect in mice, a tuning in agonist doses used and better liver delivery could be an interesting immune-therapeutic strategy. Finally, we were investigated the particular case of TLR9 agonisation in presence of HBV. We showed an interaction between synthetic or not DNA ligands such as CpG ODN and HBV particles. This interaction leads in one hand, to HBV entry inhibition in hepatocytes, on the other hand, to a blockage of ligand delivery to TLR9 in pDC, which is not due to an inhibition of the TLR9 pathway, but to a lack of access of the ligand to its receptor. These two mechanisms are responsible for a decrease of viral infection during its establishment and a decrease in IFN synthesis by pDC, respectively. A decrease in IFN production, which this time was linked to a bona fide inhibition of the TLR9 pathway, in the presence of the sub-viral particles HBsAg was still observed, without retention of TLR9 ligand of the latter. It would seem, therefore, that use of TLR agonists represent an interesting strategy in setting up new anti-HBV immune-therapeutic approaches. However, their improvement will depend on the evaluation of viro-induced inhibitory mechanisms as well as better ways of in vivo delivering these ligands
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Ludovic Aillot. Effets antiviraux de l'agonisation des Toll-like Récepteurs dans les cellules du foie, une nouvelle stratégie immunothérapeutique dans la lutte contre HBV. Biologie moléculaire. Université de Lyon, 2018. Français. ⟨NNT : 2018LYSE1139⟩. ⟨tel-01911181⟩

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