RNAi-mediated HBV antigen shutdown enhances the antiviral immune effects of PEGIFNalpha via altering T and B cell crosstalk

PEGylated interferon- (PEGIFN) demonstrates promising therapeutic outcomes against chronic hepatitis B (CHB), whereas patient response to PEGIFN therapy remains unsatisfied. Shutdown of hepatitis B virus (HBV) antigens by RNA interference (RNAi) could enhance PEGIFN efficacy in CHB patients, whereas the underlying immunological mechanisms remain obscure. We performed studies by utilizing our newly established extracellular humanized IFNAR (IFNAR-hEC) mice. An in-house constructed small interfering RNAs (GalNac-siHBV) was administrated to mice either alone or in combination with PEGIFN. The phenotypic and functional characteristics of peripheral and organ-specific immune cells were assessed by flow cytometry, ELISpot, RNA sequencing (RNA-seq), and single-cell RNA-seq (scRNA-seq) analysis. Our results demonstrated that combined treatment with PEGIFN and RNAi exerted a synergistic and prolonged inhibition of HBsAg ([~]4log10 IU/mL, vs PBS) and induced a higher incidence of HBsAg seroconversion ([~]30%), comparing with either monotreatment. Mechanistically, combined therapy improved the functionality of global T and B cells, triggered increased anti-HBs producing B cells, and enhanced IFN{gamma}-producing T cells. scRNA-seq analysis revealed that the combined therapy reduced inhibitory B cell-B cell interaction, enhanced MHC-I signaling mediated T cell-T cell communication, and improved T cell-B cell crosstalk, thus improving the functionality of T and B cells. Enhanced MHC-II signaling networks across B cells and hepatocytes/Cd8+ T cells further promoted HBsAg seroconversion in the combined treatment groups. These results together provided scientific rationale and lessons for the combination of the two towards better therapeutic efficacy. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=133 SRC="FIGDIR/small/626539v1_ufig1.gif" ALT="Figure 1"> View larger version (35K): org.highwire.dtl.DTLVardef@84785aorg.highwire.dtl.DTLVardef@f984fborg.highwire.dtl.DTLVardef@189a966org.highwire.dtl.DTLVardef@d081f9_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_LIShutting down HBsAg through RNA interference augmented the antiviral immune effects of PEGIFN in chronic HBV-carrier IFNAR-hEC mice. C_LIO_LICombined RNAi plus PEGIFN augmented the functionality of T cells, promoted B cell activation and class switch, but also exerted some suppressive effects on B cells. C_LIO_LIReduced inhibitory B cell-B cell interaction, enhanced MHC-I signaling between T cells and T cells, and improved T cell-B cell crosstalk, improved the functionality of T cells and B cells. C_LIO_LIEnhanced MHC-II signaling networks across B cells and hepatocytes/ Cd8+ T cells further promoted HBsAg seroconversion in RNAi plus PEGIFN combined treatment groups. C_LI