Analysis of immune-regulatory cell functions in patients with chronic active hepatitis

慢性活动性肝炎(CAH)的特征是门脉周围淋巴细胞浸润并伴有肝细胞坏死(片状坏死)，并存在循环中的抗肝脏自身抗体。因此，免疫调节系统的紊乱，特别是对肝脏的影响，一直被认为在发病机制中发挥了作用，但其性质尚不清楚。为阐明这一点，我们检测了12例CAH患者糖皮质激素治疗8周前后外周血中T淋巴细胞的功能。通过治疗，6例患者的临床症状和实验室指标均有明显改善，故将这6例患者定为激素治疗有效组。在糖皮质激素治疗前，激素治疗有效组和无效组的抑制性T细胞活性均显著低于Heal…组更多的你的控制。同时，两组CAH患者T淋巴细胞对IL-2的反应性均低于对照组。但值得注意的是，患者经糖皮质激素治疗后，T淋巴细胞功能下降恢复到正常范围，并有临床改善。相比之下，在无效组中，即使在激素治疗后T淋巴细胞功能也没有恢复。在强的松龙存在下检测T淋巴细胞的活性或应答时，只有皮质激素有效组的T淋巴细胞功能也有改善。因此，可以想象，在CAH中，T淋巴细胞的功能反映了疾病的活动性。CAH组和CAH组的巡回T淋巴细胞产生IL-2的检测也是正常的。但患者外周血巨噬细胞前列腺素E的生成率较低。提示T淋巴细胞功能紊乱在CAH的发病机制中起重要作用，皮质类固醇激素在CAH中的作用至少部分归因于T淋巴细胞功能的免疫调节。较少

Chronic active hepatitis(CAH) is characterized by periportal lymphocyte infiltration with hepatic cell necrosis(piecemeal necrosis) and the presence of circulating autoantibodies against the liver. Therefore, the disturbance in immune-regulatory system, in particular aginst the liver, has been thought to play a role in the pathogenesis, but its nature remains unknown. To clarify this, the function of T lymphocytes in the peripheral blood was tested in 12 patients with CAH both before and after the corticosteriod theraphy for 8 weeks. By the therapy, six patients had a clear improvements in the clinical symptoms and laboratory data, thus it was defined these six as a corticosteroid theraphy-effective group. Other six patients showed no particular improvements, and were classified as an ineffective group.Before the corticosteroid therapy, the activity of suppressor T cell was found to be significantily lower in both the corticosteroid therapy-effective and ineffective groups than in heal … More thy controls. Concomitantly, the responce in T lymphocytes to interleukin-2(IL-2) was low in the two CAH groups as compared with controls. It is noteworthy, however, that the reduced T lymphocyte functions returned to the normal range when the patients were treated with the corticosteroid administration and had the clinical improvement. By contast, in the ineffective group, no recovery of the T lymphocyte functions was observed even after the corticosteroid therapy. The improvement in the T lymphocyte functions was also observed only in the corticosteroil-effective group when the activity or responce was tested in the pretreated T lymphocytes in the presence of prednisolone. Thus, it is conceivable that in CAH, T lymphocyte function reflects to the activity of the disease.The production of IL-2 by the circutating T lumphocytes was also tested and found to be normal in both CAH groups. However, the production rate of prostaglandin E in the circulating macrophages was low in the patients. These results suggest that the disturbance in the T lymphocyte function plays a significant role in the pathogenesis of CAH thus the corticosteroid effect in CAH is due, at least in part, to an immunomodulation in T luymphocyte function. Less