Strategies for serum chemokine/cytokine assessment as biomarkers of therapeutic response in HCV patients as a prototype to monitor immunotherapy of infectious diseases

Antiviral Res. 2017 May:141:19-28. doi: 10.1016/j.antiviral.2017.02.001. Epub 2017 Feb 2.

Abstract

In this study, strategies for serum biomarker assessment were developed for therapeutic monitoring of HCV patients. For this purpose, serum chemokine/cytokine levels were measured by cytometric-bead-array in HCV patients, categorized according to immunotherapy response as: non-responder/NR, relapser/REL and sustained-virologic-responder/SVR. The results demonstrated an overall increase of serum chemokine/cytokine levels in HCV patients. In general, therapeutic failure was associated with presence of a predominant baseline proinflammatory pattern with enhanced CCL5/RANTES, IFN-α, IFN-γ along with decreased IL-10 levels in NR and increased IL-6 and TNF in REL. SVR displayed lower baseline proinflammatory status with decreased CXCL8/IL-8, IL-12 and IL-17 levels. The inability to uphold IFN-α levels during immunotherapy was characteristic of NR. Serum chemokine/cytokine signatures further support the deleterious effect of proinflammatory baseline status and the critical role of increased/persistent IFN-α levels to guarantee the sustained virologic response. The prominent baseline proinflammatory milieu observed in NR and REL yielded a restricted biomarker network with small number of neighborhood connections, whereas SVR displayed a network with integrated cytokine connectivity. Noteworthy was that SVR presented a shift towards a proinflammatory pattern upon immunotherapy, assuming a pattern similar to that observed in NR and REL at baseline. Moreover, the immunotherapy guided REL towards a profile similar to SVR at baseline. Analysis of baseline-fold changes during treatment pointed out IFN-α and TNF as high-performance biomarkers to monitor immunotherapy outcome. This knowledge may contribute for novel insights into the treatment and control of the continuous public health threat posed by HCV infection worldwide.

Keywords: Biomarkers; Chemokines; Cytokines; HCV; IFN-α.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • Biomarkers, Pharmacological / blood
  • Chemokines / blood*
  • Cytokines / blood*
  • Drug Monitoring / methods*
  • Female
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / therapy*
  • Humans
  • Immunotherapy
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use
  • Interleukin-12 / blood
  • Interleukin-17 / blood
  • Interleukin-8 / blood
  • Male
  • Middle Aged
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins / therapeutic use
  • Viral Load / drug effects
  • Young Adult

Substances

  • Antiviral Agents
  • Biomarkers, Pharmacological
  • CXCL8 protein, human
  • Chemokines
  • Cytokines
  • Interferon alpha-2
  • Interferon-alpha
  • Interleukin-17
  • Interleukin-8
  • Recombinant Proteins
  • Interleukin-12
  • Polyethylene Glycols
  • peginterferon alfa-2b