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Immunological aspects of chronic hepatitis
Author(s) -
BÜSCHENFELDE KARLHERMANN MEYER ZUM,
MANNS MICHAEL,
GERKEN GUIDO
Publication year - 1988
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1988.tb00234.x
Subject(s) - immune system , immunology , antigen , medicine , antibody , hepatitis , hbcag , monoclonal antibody , hbsag , hepatitis b virus , virus
Chronic active hepatitis (CAH) is a clinically and histologically defined syndrome which is aetiologically heterogeneous. Immune reactions are involved in almost all types of chronic inflammatory liver diseases. The host's immune system is thought to contribute significantly to the degree of liver cell destruction in chronic hepatitis B—HBcAg is regarded as a major target antigen. Auto‐immune type CAH is a syndrome of unknown aetiology, a loss of tolerance against self antigens is thought to be a principal pathogenetic mechanism. At least three different subgroups of auto‐immune type CAH can be distinguished by circulating auto‐antibodies: antinuclear antibodies (ANA), smooth muscle antibodies (SMA), liver membrane auto‐antibodies (LMA); liver‐kidney‐microsomal antibodies (LKM); and antibodies to a soluble liver antigen (SLA). The identification of auto‐immune type CAH has clinical relevance since only auto‐immune type CAH seems to profit from immunosuppressive therapy. A suppressor T cell defect was demonstrated in chronic hepatitis B and auto‐immune type CAH. However, this defect could only be reversed by the addition of prednisone in vitro in auto‐immune type CAH. Present research concentrates on the evaluation of the precise cellular mechanisms leading to liver cell destruction. In vitro cytotoxicity assays including autologous target cell systems have several drawbacks due to the use of peripheral blood lymphocytes and the questionable viability of the hepatocytes isolated from liver biopsies. Immunohistological studies using monoclonal antibodies revealed that T 8 positive T lymphocytes account for the majority of the inflammatory cell infiltrate. In addition, T cell clones derived from liver biopsies are mainly T 8 positive and show cytotoxic function in vitro. At present, little is known about the antigen specificity of these liver‐derived T cell clones.