Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.

<h4>Unlabelled</h4>Hepatitis C virus (HCV) infection is associated with hepatic and extrahepatic manifestations, including immunological disorders. Chronic Hepatitis C (CHC) is often characterized by cholesterol and lipid metabolism alterations, leading to hepatic steatosis. Cholesterol...

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Main Authors: Roberta Maggio, Carmela Viscomi, Paola Andreozzi, Gabriella D'Ettorre, Giovanni Viscogliosi, Barbara Barbaro, Manuele Gori, Vincenzo Vullo, Clara Balsano
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0112346&type=printable
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author Roberta Maggio
Carmela Viscomi
Paola Andreozzi
Gabriella D'Ettorre
Giovanni Viscogliosi
Barbara Barbaro
Manuele Gori
Vincenzo Vullo
Clara Balsano
author_facet Roberta Maggio
Carmela Viscomi
Paola Andreozzi
Gabriella D'Ettorre
Giovanni Viscogliosi
Barbara Barbaro
Manuele Gori
Vincenzo Vullo
Clara Balsano
author_sort Roberta Maggio
collection DOAJ
description <h4>Unlabelled</h4>Hepatitis C virus (HCV) infection is associated with hepatic and extrahepatic manifestations, including immunological disorders. Chronic Hepatitis C (CHC) is often characterized by cholesterol and lipid metabolism alterations, leading to hepatic steatosis. Cholesterol metabolism, in fact, is crucial for the viral life cycle. Recent works described that a higher dietary cholesterol intake is associated with the progression of HCV-related liver disease. CHC patients have increased levels of T helper 17 (Th17)-cells, a lymphocytic population involved in the pathogenesis of liver inflammation and autoimmune hepatitis. The balance between Th17 and regulatory T (Treg) cells is crucial for chronic inflammation and autoimmunity. Th17-cell differentiation is deeply influenced by the activation LXRs, nuclear receptors modulating cholesterol homeostasis. Moreover, HCV may affect these nuclear receptors, and cholesterol metabolism, through both direct and indirect mechanisms. On these bases, we hypothesized that modulation of cholesterol levels through Normocaloric Low Cholesterol Diet (NLCD) may represent an innovative strategy to reduce the progression of HCV infection, through the modulation of peripheral Th17/Treg balance. To this end, we performed a pilot study to investigate whether a Normocaloric Low Cholesterol Diet may be able to modulate Th17/Treg balance in patients affected by chronic HCV infection. After 30 days of NLCD CHC patients showed a significant reduction in Th17 cells frequency, which correlated with strong reduction of IL-17 and IL-22 serum levels. At the same time, we appreciated an increase in the percentage of Treg cells, thus improving Treg/Th17 balance. Moreover, we observed an increased expression of LXRs and their target genes: SREBP-1c and ABCA-1. In conclusion, NLCD finely regulates Th17/Treg balance, improving immune system response in CHC patients. This study could pave the way for new treatments of CHC patients, suggesting that change in lifestyle could support the management of these patients, promoting well-being and possibly hindering disease progression.<h4>Trial registration</h4>ClinicalTrials.gov NCT02038387.
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spelling doaj-art-4e39dfa4968f4f30b1d926a217d8dbe82025-08-20T02:15:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11234610.1371/journal.pone.0112346Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.Roberta MaggioCarmela ViscomiPaola AndreozziGabriella D'EttorreGiovanni ViscogliosiBarbara BarbaroManuele GoriVincenzo VulloClara Balsano<h4>Unlabelled</h4>Hepatitis C virus (HCV) infection is associated with hepatic and extrahepatic manifestations, including immunological disorders. Chronic Hepatitis C (CHC) is often characterized by cholesterol and lipid metabolism alterations, leading to hepatic steatosis. Cholesterol metabolism, in fact, is crucial for the viral life cycle. Recent works described that a higher dietary cholesterol intake is associated with the progression of HCV-related liver disease. CHC patients have increased levels of T helper 17 (Th17)-cells, a lymphocytic population involved in the pathogenesis of liver inflammation and autoimmune hepatitis. The balance between Th17 and regulatory T (Treg) cells is crucial for chronic inflammation and autoimmunity. Th17-cell differentiation is deeply influenced by the activation LXRs, nuclear receptors modulating cholesterol homeostasis. Moreover, HCV may affect these nuclear receptors, and cholesterol metabolism, through both direct and indirect mechanisms. On these bases, we hypothesized that modulation of cholesterol levels through Normocaloric Low Cholesterol Diet (NLCD) may represent an innovative strategy to reduce the progression of HCV infection, through the modulation of peripheral Th17/Treg balance. To this end, we performed a pilot study to investigate whether a Normocaloric Low Cholesterol Diet may be able to modulate Th17/Treg balance in patients affected by chronic HCV infection. After 30 days of NLCD CHC patients showed a significant reduction in Th17 cells frequency, which correlated with strong reduction of IL-17 and IL-22 serum levels. At the same time, we appreciated an increase in the percentage of Treg cells, thus improving Treg/Th17 balance. Moreover, we observed an increased expression of LXRs and their target genes: SREBP-1c and ABCA-1. In conclusion, NLCD finely regulates Th17/Treg balance, improving immune system response in CHC patients. This study could pave the way for new treatments of CHC patients, suggesting that change in lifestyle could support the management of these patients, promoting well-being and possibly hindering disease progression.<h4>Trial registration</h4>ClinicalTrials.gov NCT02038387.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0112346&type=printable
spellingShingle Roberta Maggio
Carmela Viscomi
Paola Andreozzi
Gabriella D'Ettorre
Giovanni Viscogliosi
Barbara Barbaro
Manuele Gori
Vincenzo Vullo
Clara Balsano
Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.
PLoS ONE
title Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.
title_full Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.
title_fullStr Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.
title_full_unstemmed Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.
title_short Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection.
title_sort normocaloric low cholesterol diet modulates th17 treg balance in patients with chronic hepatitis c virus infection
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0112346&type=printable
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