ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00031.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—An antigen‐antibody system has been identified by immunofluorescence in patients with non‐A, non‐B hepatitis. The non‐A, non‐B antigen was localized in the hepatocyte nuclei of liver biopsies from patients with acute post‐transfusion or sporadic non‐A, non‐B hepatitis and in those from patients with chronic post‐transfusion non‐A, non‐B hepatitis, the percentage of positive cells being most prominent in patients receiving immunosuppressive treatment. Absence of the antigen in normal livers and in livers from patients with type B hepatitis infection indicated its specific association with non‐A, non‐B infection. Antibody reacting with the nuclear antigen became detectable in serum during post‐transfusion acute non‐A, non‐B hepatitis in 11 out of 15 cases; it was absent before transfusion. Six out of 12 cases of sporadic acute non‐A, non‐B hepatitis were also found to produce the antibody, which was repeatedly found to be absent during the acute phase in five patients with type A and in eight with type B hepatitis. The non‐A, non‐B antibody, mainly an IgM antibody, persisted in serum for prolonged periods of time after onset, both in patients showing biochemical resolution of their illness and in those who continued to have liver damage after the acute phase. Accordingly, eight out of nine patients withchronic non‐A, non‐B hepatitis were found positive for the antibody in serum, seven at the time the non‐A, non‐B antigen was detected in their liver. Thus this non‐A, non‐B associated antigen‐antibody system shares remarkable similarities of be

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00032.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Using direct immunofluorescence, a nuclear antigen was found in liver of chronic hepatitis patients with circulating NANBe Ag or anti‐NANBe, and selected sera from either group were used as source of conjugates. The new Ag/Ab system was designated NANBc Ag and anti‐NANBc since it behaved like the core Ag of HBV. N ANBc Ag was detected in coded frozen liver biopsies from patients with chronic persistent 15/25 (60 %) or active 27/50 (54 %) hepatitis and cryptogenic cirrhosis 16/30 (53.3%) devoid of HBV markers. Only 2/30 alcoholic cirrhosis cases (7%) used as controls were positive (p≤0.001). The homologous anti‐NANBc antibody was always detectable by indirect immunofluorescence in the patients' serum when N ANBc Ag was found in the liver. It was also found in 11/135 (8%) additional cases without any other NANB marker. A correlation was observed between coded detection of the NANBc Ag/Ab system by immunofluorescence and demonstration of NANBe Ag or anti‐NANBe by immunodiffusion. In acute post‐transfusion NANB hepatitis, anti‐NANBc was first detectable 14 days after transfusion and persisted as long as ALT remained elevated, or longer. IgM anti‐NANBc present at onset became associated with an increasing proportion of IgG after the 28th day. The prevalence of anti‐NANBc in sporadic NANB hepatitis (11/50 = 22%) was significantly lower (p≤0.001) than in cases with parenteral exposure such as post‐transfusion, occupational or drug addict hepatitis (47/72 = 65%). Immunofluorescent tests for NANBc Ag and Ab are promising assays for the serological diag

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00033.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—A follow‐up study of acute non‐A, non‐B post‐transfusion hepatitis with a mean follow‐up period of 30 months was carried out in 24 patients in whom liver biopsy was done within 3 months of onset. Of the 24, 13 patients (54%) developed chronic biochemical liver disease with elevated serum aminotransferases for more than 6 months, and in 11 the elevated liver enzymes were normalized within 6 months. Although there were no statistically significant differences in the mean peak values of liver enzymes, length of incubation period and number of transfusions between the chronic and resolved groups, the former tended to have a slow rise and multiple peaks of serum liver enzymes. Analysis of the liver biopsies made in the acute phase revealed that limiting plate erosion, hepatocellular degeneration, and poor regenerative activities were indicative of subsequent transition to chronicity. Multiple biopsies were taken in five patients who were followed for an average of 29 months, and the subsequent histological diagnosis was chronic persistent hepatitis in two, chronic active hepatitis in two and cirrh

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00034.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Thirteen patients are reported who developed evidence of hepatic damage after exposure to paraquat and subsequently died. At autopsy, the main changes involved the bile excretory pathways. Ten of the thirteen cases had cholestasis, usually localized to the centrilobular zone. There was cholangiocellular injury involving the small and medium‐sized bile ducts in portal areas. It consisted of shrinkage of cells, poor definition of outline, separation from the basement membrane, desquamation of cells into the lumen, infiltration of the wall by neutrophils and possible loss of integrity of the basement membrane. These bile duct lesions have not been previously described in association with paraquat toxicity. On the basis of the overall histologic findings in this study and extrapolation from experimental studies, it is hypothesized that paraquat injury to the liver is biphasic; it is initially hepatocellular but becomes cholangiocellular after the first 2 d

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00035.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—Forty patients with bridging necrosis (BN) on biopsies taken during the course of acute viral hepatitis B were included in a prospective study to assess the prognostic significance of this lesion. Of the 22 patients with complete clinical, biochemical and histological follow‐up (histological follow‐up 5–33 months), only two failed to eliminate HBs‐ and HBe‐antigen in serum, a finding paralleled by transition to chronic active hepatitis and by the persistence of focal HBc‐ and HBs‐antigen expression in liver tissue. Nineteen of 22 patients showed complete histological healing; one developed inactive cirrhosis. It is concluded that, in the setting of acute viral hepatitis B, the histological lesion of BN is of no particular prognostic significance, and that transition to chronic liver disease is much less frequent than has been assumed from previous studies of etiologically heterogeneous patient populations. Markers of poor prognosis are the failure of serological elimination of HBs‐ and HBe‐antigen and the persistence of spotty expression of HBc‐ and HBs‐antigen on immun

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00036.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—In primary biliary cirrhosis (PBC) enhanced lymphocyte cytotoxicity, disruption by mononuclear cells of intrahepatic bile ducts, as well as high levels of circulating autoantibodies, immunoglobulins and immune complexes are found. These observations suggest the presence in PBC of defective regulation of immune functions. To evaluate immune regulation of T‐cell and B‐cell function in PBC, we measured the capability of suppressor cells generated by concanavalin A (Con A) from peripheral blood mononuclear cells (PBMC) to inhibit allogeneic T‐cell proliferative responses as well as B‐cell immunoglobulin synthesisin vitro.The inhibitory effect of Con A‐induced suppressor cells on T‐cell proliferation was significantly reduced in PBC patients compared to controls. This immunoregulatory defect did not correlate with indicators of disease activity and was not seen in patients with chronic extrahepatic biliary obstruction. In contrast, Con A‐induced suppressor cells from PBC patients inhibitedin vitroIgG and IgM synthesis normally. Finding that the potential to generate suppressor cell activity of B‐cell immunoglobulin synthesis was preserved in PBC, we explored other mechanisms for elevated globulins in this disease. Comparingin vitroimmunoglobulin synthesis by unstimulated and pokeweed mitogen‐stimulated PBMC from PBC patients and controls, we found that baseline IgG synthesisin vitrowas normal but baseline IgM synthesis significantly depressed in PBC. On the other hand, whereas PBMC from PBC patients responded normally to pokeweed mitogen stimulation of IgM synthesis, the same PBMC were refractory to pokeweed mitogen stimulation of IgG synthesisin vitro.These studies suggest that in PBC there is a dissociation between inducible suppressor cell activity of T‐cell function, which is impaired, and inducible suppressor cell activity of B‐cell immunoglobulin synthesis, which is preserved. Whereas a defect in regulation of cellular immune function may provide a permissive environment for initiation or perpetuation of cell‐mediated autoimmune hepatobiliary injury in PBC, our studies failed to identify an extrinsic immunoregulatory defect to account for humoral immune aberrations, which may result, instead, from altered responsiveness in

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00037.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT—We report the case of a young woman with chronic neutropenia, in whom hepatitis, extensive herpetic eruption and herpes simplex viremia developed after genital herpetic ulceration. Although severe liver necrosis was present, the patient's death did not result from hepatic failure. No inflammatory cell infiltration was found circumscribing the multiple necrotic foci in the liver. This absence of inflammatory cell infiltration reflects the host's inability to normally restrain herpes simplex virus dissemination and, in this patient, might be the consequence of chronic neutropeni

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00038.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1981.tb00039.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY