Early Changes in Interferon Signaling Define Natural Killer Cell Response and Refractoriness To Interferon-based Therapy of Hepatitis C

Natural killer (NK) cells exhibit a polarized phenotype with increased cytotoxicity and decreased IFN- γ production in chronic hepatitis C virus (HCV) infection. Here we asked whether this is due to type I interferon (IFN)-induced expression and phosphorylation levels of signal transducer and activator of transcription (STAT) molecules in NK cells and whether it affects the response and refractoriness of NK cells to IFN-α-based therapy of hepatitis C. STAT1 levels in NK cells were significantly higher in patients with chronic HCV infection than in uninfected controls. STAT1 levels and induction of phosphorylated STAT1 (pSTAT1) increased further during IFN-α-based therapy with preferential STAT1 over STAT4 phosphorylation. Induction of pSTAT1 correlated with increased NK cytotoxicity (TRAIL expression and degranulation) and decreased IFN-γ production. NK cells from patients with a greater than 2 log10 first phase HCV RNA decline to IFN-α-based therapy (>99 % IFN effectiveness) displayed strong pSTAT1 induction in vivo and were refractory to further stimulation in vitro. In contrast, NK cells from patients with a less than 2 log10 first phase HCV RNA decline exhibited lower pSTAT1 induction in vivo (p=0.024) but retained greater IFN-α responsiveness in vitro (p=0.024). NK cells of all patients becam