HEMOSIDERIN DEPOSITION IN INTRAHEPATIC SMALL VESSELS IN CHRONIC HEPATITIS C : PATHOLOGICAL SIGNIFICANCE AND ITS PREDICTING ROLE IN RESPONSE TO INTERFERON

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We found out a peculiar hemosiderosis involving intrahepatic small vessels in portal tracts in chronic hepatitis C.This lesion is closely related to the advancement (fibrosis) of chronic hepatitis C,but not to hepatitis activity. Infrequently, this lesion was also encountered in other forms of chronic liver diseases with advanced liver diseases such as primary biliary cirrhosis and autoimmune hepatitis. The patients with this lesion have a tendency to resist interferon therapy, suggesting that this lesion is a histologic marker representing poor response to this therapy. Pathogenetically, this lesion might have been caused by leakage of iron-containing substance (s) from the hepatocytolysis of periportal regions during hepatocullelar damages due to hepatitis viral infeciton. This lesion may influence the capacity of antigen presentation and other immunological functions inherent to endothelial cells, because this lesions accompany with expression of HLA-class I and HLA-class II and also other adhesion molecules such as ICAM-1 and VCAM-1. However, this could be beneficial for viral proliferation in chronic hepatitis C,because iron is said to an essential element in proliferation of HCV.The fuction of endothelial cells of small vessels in the liver, particularly their functions in advancedliver diseases, remains unclear. This study will geve a clue to understanding of the pathophysiologic fuction of this endothelial segement.