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Kongreß pp 102-110 | Cite as

Chronizität — ein immunologisches Problem. Eine Analyse am Beispiel der viralen und autoimmunen Hepatitis

  • P. A. Berg
Conference paper
Part of the Verhandlungen der Deutschen Gesellschaft für Innere Medizin book series (VDGINNERE, volume 93)

Zusammenfassung

Ein chronischer Verlauf bei der Virushepatitis kann klinisch, morphologisch, virologisch und immunologisch differenziert werden. Er liegt vor, wenn auch 6 Monate nach akutem Beginn die Transaminasen noch erhöht sind, das HBs-Antigen im Blut und Core-Antigen in der Leber nicht eliminiert worden sind und sich im Leberparenchym noch lyrische Nekrosen und in den Portalfeldern noch lymphozytäre Infiltrate nachweisen lassen. Da man bei der B-Hepatitis und wohl auch für die A-Hepatitis annehmen darf, daß das Virus selbst nicht zytopathisch ist, die Läsion also durch die gegen Virusantigene gerichtete Immunatwort beding ist, darf Chronizität auch mit einer Immunabwehrstörung ursächlich in Zusammenhang gebrachr warden [6, 11, 23, 30].

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Literatur

  1. 1.
    Alexander GJM, Mondeil M, Naumov NV, Nouriaria KT, Vergani D, Lowe D, Eddieston ALWF, Williams R (1986) Functional characterization of peripheral blood lymphozytes in chronic HBsAg carriers. Clin Exp Immunol 63: 498–507PubMedGoogle Scholar
  2. 2.
    Barnaba V, Musca A, Cordova C, Levrero M, Ruocco G, Albertini-Petroni V, Balsano F (1983) Relationship between T cell subsets and suppressor cell activity in chronic hepatitis B virus ( HBV) infection. Clin Exp Immunol 53: 281–288PubMedGoogle Scholar
  3. 3.
    Berg PA, Brattig N (1982) Die Bedeutung immunregulativer Faktoren für die prognostische Beurteilung der Virushepatitis. Med Klin 77: 419–424Google Scholar
  4. 4.
    Berg PA, Brattig N (1984) Der Serum-inhibitionsfaktor bei der akuten Virushepatitis. Leber Magen Darm 14: 261–269PubMedGoogle Scholar
  5. 5.
    Berg PA, Brattig N, Hausch F, Henning H, Müting G (1983) Clinical significance of the evaluation of T cell functions in patients with HBsAg-positive and negative acute and chronic ciral hepatitis. In: Frada G (ed) Immunologia clinica del fegato e del rene e immunterapia. Recenti progressi. Piccin, Padova, pp 125–135Google Scholar
  6. 6.
    Bianchi L (1986) Necroinflammatory liver diseases. Seminars in Liver Disease 6: 185–198PubMedCrossRefGoogle Scholar
  7. 7.
    Brattig NW, Ortmans H, Wildhirt W, Klinge O, Berg PA (1987) Prognostic relevance of serum inhibitory factors ( SIF) in protracted and persistent hepatitis B. J Hepatol 4: 218–223PubMedCrossRefGoogle Scholar
  8. 8.
    Brusdeilins M, Hapke C, Huberts HH, Schumacher K (1983) Identification of the apparently lymphocyte-specific human liver-derived inhibitory protein (LIP) as cytoplasmic liver 1-arginase. J Immunol 131: 2427–2431PubMedGoogle Scholar
  9. 9.
    Chisari FV (1982) Regulation of lymphocyte function and viral transformation by hepatic bioregulatory molecules. Hepatology 2: 97S–106SGoogle Scholar
  10. 10.
    Chisari FV, Nakamura M, Milich DR, Han K, Molden D, Leroux-Roels GG (1985) Production of two distinct and independent hepatic immunoregulatory molecules by the perfused rat liver. Hepatology 5: 735–743PubMedCrossRefGoogle Scholar
  11. 11.
    Ferrari C, Penna A, Sansoni P, Ciuberti T, Neri TM, Chisari FV, Fiaccadori F (1986) Selective sensitization of peripheral blood T lymphocytes to hepatitis B core antigen in patients with chronic active hepatitis type B. Clin Exp Immunol 67: 497–506Google Scholar
  12. 12.
    Govindarajan S, Uchida T, Peters RL (1983) Identification ofT lymphocytes and subsets in liver biopsy cores of acute viral hepatitis. Liver 3: 13–18PubMedGoogle Scholar
  13. 13.
    Kakumu S, Yata K, Kashio T (1980) Immunoregulatory T-cell function in acute and chronic liver disease. Gastroenterology 79: 613–619PubMedGoogle Scholar
  14. 14.
    Kamada N (1985) Transplantation tolerance and immunosuppression following liver grafting in rats. Immunology Today 6: 336–342CrossRefGoogle Scholar
  15. 15.
    Kashio T, Hotta R, Kakumu S (1981) Lymphocyte suppressor cell activity in acute and chronic liver disease. Clin Exp Immunol 44: 459–466PubMedGoogle Scholar
  16. 16.
    Mackay IR, Frazer IH, Toh B-H, Pedersen JS, Alter HJ (1985) Absence of autoimmune serological reactions in chronic non A, non B viral hepatitis. Clin Exp Immunol 61: 39–43PubMedGoogle Scholar
  17. 17.
    Nonomura A, Tanino M, Kurumaya H, Ohta G, Kato Y, Kobayashi K (1982) Disordered immunoregulatory functions in patients with chronic active hepatitis. Clin Exp Immunol 47: 595–605PubMedGoogle Scholar
  18. 18.
    Nouri-Aria KT, Alexander GJM, Portmann B, Vergani D, Eddieston ALWF, Williams R (1986) In vitro study of IgG production and concanavalin A induced suppressor cell function in acute and chronic hepatitis B virus infection. Clin Exp Immunol 64: 50–58PubMedGoogle Scholar
  19. 19.
    Omata M, Iwama S, Sumida M, Ito Y, Okuda K (1981) Clinicopathological study of acute non-A, non-B post-transfusion hepatitis: histological features of liver biopsies in acute phase. Liver 1: 201–208PubMedGoogle Scholar
  20. 20.
    Pignatelli M, Waters J, Brown D, Lever A, Iwarson S, Schaff Z, Gerety R, Thomas HC (1986) HLA class I antigens on the hepatocyte membrane during recovery from acute hepatitis B virus infection. Hepatology 6: 349–353PubMedCrossRefGoogle Scholar
  21. 21.
    Van den Oord JJ, De Vos R, Desmet VJ (1986) In situ distribution of major histocompatibility complex products and viral antigens in chronic hepatitis B virus infection: evidence that HBc-containing hepatocytes may express HLA-DR antigens. Hepatology 6: 981–989PubMedCrossRefGoogle Scholar
  22. 22.
    Pizzo C, Lee D, Chisari FV (1982) Suppression of lymphocyte activation by a protein released from isolated perfused rat liver. Hepatology 2: 295–303PubMedCrossRefGoogle Scholar
  23. 23.
    Popper H (1983) Changing concepts of the evolution of chronic hepatitis and the role of piecemeal necrosis. Hepatology 3: 758–762PubMedGoogle Scholar
  24. 24.
    Sakaguchi S, Fukuma K, Kuribayashi K, Masuda T (1985) Organspecific autoimmune diseases induced in mice by elimination of T cell subset. 1. Evidence for the active participation of T cells in natural self-tolerance; deficit of a T cell subset as a possible cause of autoimmune disease. J Exp Med 161: 72–87PubMedCrossRefGoogle Scholar
  25. 25.
    Sanders G, Perrillo RP (1982) Rosette inhibitory factor: T-lymphocyte subpopulation specificity and potential immunoregulatory role in hepatitis B virus infection. Hepatology 2: 547–552PubMedCrossRefGoogle Scholar
  26. 26.
    Sanders GE, Perrillo RP (1985) Suppression of T helper function: An immunoregulatory effect of rosette inhibitory factor in hepatitis B virus infection. Hepatology 5: 392–396PubMedCrossRefGoogle Scholar
  27. 27.
    Scheuer PJ (1986) Changing views on chronic hepatitis. Histopathology 10: 1–4PubMedCrossRefGoogle Scholar
  28. 28.
    Taguchi O, Nishizuka Y (1987) Seif tolerance and localized autoimmunity. J Exp Med 165: 146–156PubMedCrossRefGoogle Scholar
  29. 29.
    Thomas HC, Brown D, Routhier G, Janossy G, Kung PC, Goldstein G, Sherlock S (1982) Inducer and suppressor T-cells in hepatitis B virus-induces liver disease. Hepatology 2: 202–204PubMedCrossRefGoogle Scholar
  30. 30.
    Thomas HC, Montano L, Goodall A, De Koning R, Oladapo J, Wiedmann KH (1982) Immunological mechanisms in chronic hepatitis B virus infection. Hepatology 2: 116S–121SCrossRefGoogle Scholar
  31. 31.
    Tremolada F, Fattovich G, Panebianco G, Ongaro G, Realdi G (1980) Suppressor cell activity in viral and non-viral chronic active hepatitis. Clin Exp Immunol 40: 89–95PubMedGoogle Scholar
  32. 32.
    Vanstapel MJ, Van Steenbergen W, De Wolf-Peeters C, Desmyter J, Fevery J, De Groote J, Desmet VJ (1983) Prognostic significance of piecemeal necrosis in acute viral hepatitis. Liver 3: 46–57PubMedGoogle Scholar
  33. 33.
    De Vos R, De Wolf-Peeters C, Van den Oord JJ, Desmet V (1985) Ultrastructural immunocytochemical demonstration of HLA class I antigens in human pathological liver tissue. Hepatology 5: 1071–1075PubMedCrossRefGoogle Scholar

Copyright information

© J. F. Bergmann Verlag, München 1987

Authors and Affiliations

  • P. A. Berg
    • 1
  1. 1.Medizinische Klinik TübingenDeutschland

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