Summary
This study was designed to compare the clinical and immunological characteristics of the hepatitis B surface antigen (HBSAg)-positive and HBSAg-negative (cryptogenic) forms of chronic active hepatitis. The data of 48 patients with chronic active hepatitis, 24 with persistent HBS antigenemia and 24 without HBSAg, were analysed. HBSAg was detected by counter-immunoelectrophoresis and radioimmunoassay. The clinical features, biochemical liver function tests, immunoglobulins, complement C3, autoantibodies, and cell-mediated immunoreactivity of the two forms of the disease were compared. Cirrhosis was found to occur more frequently at the time of diagnosis in the HBSAg-negative group, and the serum alkaline phosphatase level was raised significantly compared to the HBSAg-positive form. The elevation of the IgG level was greater in the cryptogenic form, but the difference was not statistically significant compared to the HBSAg-positive patients. There was a marked difference in the frequency of the mitochondrial antibodies, but not of the antinuclear factor and other autoantibody-like serum factors. Lymphoblastic transformation revealed a similar diminution in response to phytohaemagglutinin stimulation in both groups of patients compared to the normal controls. An increase of the3H-thymidine incorporation was seen after stimulation with human liver mitochondrial antigen, and leukocyte migration inhibition could be observed with this antigen in both forms of chronic active hepatitis.
Zusammenfassung
Das Studium wurde durchgeführt, um klinische und immunologische Charakteristika des Hepatitis-B-Oberflächen-Antigens (HBSAg)-positive und -negative (kryptogene Form) Befunde der chronischen aktiven Hepatitis zu vergleichen. Die Angaben von 48 Patienten mit chronischer aktiver Hepatitis, davon 24 mit persistierender HBS-Antigenämie und 24 ohne HB-Befund, wurden analysiert. Die HBS-Antigenämie wurde mit Hilfe von Gegenstromelektrophorese und Radioimmunassay nachgewiesen. Das klinische Bild sowie die Laborbefunde (Leberfunktionsteste, Immunuglobuline, Komplement-C3, Autoantikörper und zellulär ausgelöste Immunantwort der beiden Krankheitsformen) wurden vergliche. Es wurde gefunden, daß eine Zirrhose häufiger in der HBS-negativen Gruppe auftrat und der alkalische Serumphosphatase-Spiegel signifikant anstieg. Die Werte des IgG-Spiegel lagen bei den kryptogenen Formen höher, ohne einen statistisch signifikanten Unterschied im Vergleich zu den HBS-positiven Patienten zu ergeben. Es bestand ein deutlicher Unterschied im Auftreten von mitochondrialen Antikörper. Dies galt jedoch nicht für Antinuklearfaktoren und andere Antikörper ähnlicher Serumfaktoren. Die lymphoblastentransformation ergab in beiden Gruppen eine ähnliche Reaktionseinschränkung gegenüber der Phytohämagglutinin-Stimulierung in beiden Patientengruppen, verglichen mit normalen Kontrollen. Ein Anstieg der3H-Thymidin-Inkorporation wurde nach einer Stimulierung mit humanem mitochondrialen Antigen der Leber beobachtet. Das gleiche galt auch für beiden Formen der chronischen aktiven Hepatitis mit demselben Antigen für die Hemmung der Leukozytenmigration.
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Pár, A., Balázs, M., Patakfalvi, A. et al. Chronic active hepatitis in patients with and without hepatitis B surface antigenemia. Infection 5, 152–158 (1977). https://doi.org/10.1007/BF01639751
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DOI: https://doi.org/10.1007/BF01639751