Persistent hepatotropic viral infections are a common etiologic agent of chronic liver disease. Unresolved infection can be attributed to non-functional intrahepatic CD8+ T cell responses. In light of dampened CD8+ T cell responses, liver disease often manifests systemically as Ig-related syndromes due to aberrant B cell functions. These two opposing yet co-existing phenomena implicate the potential of altered CD4+ T cell help. Elevated CD4+ Foxp3+ T cells were evident in both human liver disease and a mouse model of chemically induced liver injury despite marked activation and spontaneous IgG production by intrahepatic B cells. While this population suppressed CD8+ T cell responses, aberrant B cell activities were maintained due to expression of CD40L on a subset of CD4+ Foxp3+ T cells. In vivo blockade of CD40L attenuated B cell abnormalities in a mouse model of liver injury. A phenotypically similar population of CD4+ Foxp3+ CD40L+ T cells was found in diseased livers explanted from patients with chronic hepatitis C infection. This population was absent in non-diseased liver tissues and peripheral blood.Conclusion-Our data indicate that liver disease elicits alterations in the intrahepatic CD4+ T cell compartment that suppress T cell immunity while concomitantly promoting aberrant IgGmediated manifestations. (9) and in human patients (5,6,10). While this is beneficial for the liver, this population has been implicated in aiding establishment of chronic hepatotropic infections, such as HCV, in human patients by suppressing CD8+ T cell responses (6,11,12). Aside from the effects on CD4+ T cell functions, HSC-derived RA can augment B cell survival, plasmablast differentiation and IgG production (4). Aberrant B cell function during liver fibrosis has been linked to systemic manifestations such as hyperglobulinemia, elevated titers of autoimmune anti-nuclear antibody (ANA), and mixed cryoglobulinemia (MC) (reviewed in (13)). The dual effects of fibrotic processes on local suppression of CD8+ T cell responses by accumulation of CD4+Foxp3+T cells with concomitant dysfunctional intrahepatic B cells suggests a potential interplay between fibrosis, CD4+ T cell helper functions and B cells.
KeywordsHere, we investigated the effects of hepatic fibrosis on the CD4+ T cell compartment and its consequence on the IgG-mediated sequelae of liver disease. Using chemically induced liver injury in mice we found that fibrotic animals demonstrated a CD4+ T cell-dependent increase in serum IgG levels. Despite constitutive intrahepatic B cell production of IgG, there was a liver-specific accumulation of "regulatory" CD4+Foxp3+ T cells during liver injury. Fibrosis-elicited CD4+Foxp3+ T cells effectively suppressed CD8+ T cell responses to cognate antigen while concomitantly permitting B cell activation in vitro. Phenotypic analysis demonstrated that a subset of the fibrosis-elicited CD4+Foxp3+ T cell population expressed CD40L and failed to suppress B cell functions in vitro. In accordance to our findings in the mouse model,...