Natural killer p46High expression defines a natural killer cell subset that is potentially involved in control of hepatitis C virus replication and modulation of liver fibrosis

Natural killer (NK) cells play a role in the early control and natural course of hepatitis C virus (HCV) infection. NK cell function is regulated by a multitude of receptors, including activating NKp46 receptor. However, reports on NKp46 in hepatitis C are controversial. Therefore, we investigated the hepatic recruitment and function of NKp46(+) NK cells, considering differential surface expression of NKp46 resulting in NKp46High and NKp46Dim subsets. Intra‐ and extrahepatic NK‐cell subsets from HCV‐infected patients were characterized by flow cytometry. Cytotoxic activity and interferon‐gamma (IFN‐γ) secretion were studied using K‐562, P815, and primary hepatic stellate cells as targets. Anti‐HCV activity of NK‐cell subsets was studied using the replicon system. Density of NKp46 surface expression clearly segregated NKp46Dim and NKp46High subsets, which differed significantly with respect to the coexpression of maturation markers and NK‐cell receptors. More important, NKp46High NK cells showed a higher cytolytic activity and stronger IFN‐γ secretion than NKp46Dim NK cells. Accordingly, NKp46High NK cells efficiently blocked HCV replication in vitro. Blocking experiments confirmed an important role for the NKp46 receptor. Furthermore, we found an intrahepatic accumulation of NKp46High NK cells. Of note, high cytolytic activity of NKp46High NK cells was also confirmed in the intrahepatic NK‐cell population, and the frequency of intrahepatic NKp46High NK cells was inversely correlated with HCV‐RNA levels and fibrosis stage. Conclusions: NKp46High expression defines a specific NK‐cell subset that may be involved in both the suppression of HCV replication and HCV‐associated liver damage underpinning the role of NK cells in the immunopathogenesis of HCV. (HEPATOLOGY 2012)