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Original Article

Dissecting antibody-mediated NK cell effects reveals a cytotoxic CX3CR1⁺KLRC2⁻CD16hisubset linked to HBV outcomes

Libo Tang1, Yuhao Wang1, Zihan Jin1, Yurong Gu2, Zhaofeng Zeng1, Linnan Song1, Xuan Yi1, Lingtao Zhang1, Yujing Zhang1, Weiying He1, Liping Wang1, Weixin He1, Jianru Sun1, Xiaoqin Lan1, Xiangyong Li2, Shihong Zhong1, Yongyin Li1
Published online: December 19, 2025
1Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China; State Key Laboratory of Multi-organ Injury Prevention and Treatment; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology, Guangzhou, China
2Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Corresponding author:  Xiangyong Li, Tel: +86-13728015729, 
Email: lixyong2@sysu.edu.mail.cn
Shihong Zhong, Tel: +86-20-61641944, Fax: +86-20-61641944, 
Email: shihongzhong2021@foxmail.com
Yongyin Li, Tel: +86-20-82787830, Fax: +86-20-82787830, 
Email: yongyinli@foxmail.com

Libo Tang, Yuhao Wang, Zihan Jin and Yurong Gu contributed equally to this study as co-first authors.
Received: 18 August 2025   • Revised: 16 November 2025   • Accepted: 15 December 2025
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Background/Aims
Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody-mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment.
Methods
A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets.
Results
The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2⁻CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2-CD16hisubset tended to exhibit functional restoration in HBsAg loss individuals.
Conclusions
Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2-CD16hiNK subset as a potential therapeutic target.

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Dissecting antibody-mediated NK cell effects reveals a cytotoxic CX3CR1⁺KLRC2⁻CD16hisubset linked to HBV outcomes
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Dissecting antibody-mediated NK cell effects reveals a cytotoxic CX3CR1⁺KLRC2⁻CD16hisubset linked to HBV outcomes
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