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Liver infiltrating mononuclear cells in children with type 1 autoimmune hepatitis
  1. M B De Biasio1,
  2. N Periolo1,
  3. A Avagnina2,
  4. M T García de Dávila3,
  5. M Ciocca4,
  6. J Goñi5,
  7. E de Matteo6,
  8. C Galoppo7,
  9. M C Cañero-Velasco8,
  10. H Fainboim9,
  11. A E Muñoz10,
  12. L Fainboim1,
  13. A C Cherñavsky1
  1. 1División inmunogenética, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Buenos Aires, Argentina
  2. 2Anatomía patológica, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires
  3. 3Sección Anatomía patológica, Hospital Nacional de Pediatría “J P Garrahan”, Buenos Aires
  4. 4Hepatología, Hospital Nacional de Pediatría “J P Garrahan”, Buenos Aires
  5. 5Transplante hepático, Hospital Nacional de Pediatría “J P Garrahan”, Buenos Aires
  6. 6Unidad de Anatomía patológica, Hospital Nacional de Pediatría “J P Garrahan”, Buenos Aires
  7. 7Hepatología, Hospital Nacional de Pediatría “J P Garrahan”, Buenos Aires
  8. 8Unidad de Hepatología, Hospital municipal de niños de San Justo, Buenos Aires, Argentina
  9. 9Unidad de Hepatología, Hospital general de infecciosas “F J Muñiz”, Buenos Aires
  10. 10Unidad de Hepatología, Hospital de Gastroenterología “Dr C Bonorino Udaondo”, Buenos Aires
  1. Correspondence to:
    Dr A C Cherñavsky
    División Inmunogenética, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Av Córdoba 2351, (1120) Buenos Aires, Argentina; accher{at}fibertel.com.ar

Abstract

Objective: To investigate infiltrating cells in the liver of children with type 1 autoimmune hepatitis (AH-1).

Methods: liver biopsies from 24 untreated AH-1 patients (14 children, 10 adults), five patients with hepatitis C virus related chronic hepatitis (HCV), and 10 control liver specimens (CL) were processed for immunohistochemical cell characterisation.

Results: Two different cell distribution patterns were detected in the liver of patients with AH-1: (1) CD4+ and CD20+ cells were found in the central areas of the portal tracts (portal distribution); (2) CD8+ cells were observed at the periphery of the portal space (periportal distribution). Some cell subsets, like CD56, CD57, Fas-L, and Bak, showed a non-defined distribution pattern. The presence of two well defined patterns of cell distribution was not observed in HCV and CL (CD4+, CD20+, and CD8+ cells were uniformly distributed in the portal space). In AH-1 and CL, the NK markers CD56 and CD57 were found scattered throughout the liver parenchyma. However, in HCV biopsies, CD56+ cells were also clearly increased in both the portal and the periportal areas. Biopsies of AH-1 and HCV patients showed a uniform distribution of Fas-L and Bak in the portal and periportal areas, with Bak staining also detected in the hepatic parenchyma.

Conclusions: Despite clinical and genetic differences, there was a similar distribution of liver infiltrating mononuclear cells in children and adults with AH-1. These results raise the possibility of reclassifying cryptogenic chronic hepatitis by immunohistochemical analysis of infiltrating liver cells.

  • AAH, adult autoimmune hepatitis type 1
  • AH-1, type 1 autoimmune hepatitis
  • ANA, antinuclear antibodies
  • CL, control liver specimen
  • HCV, hepatitis C virus related chronic hepatitis
  • PAH, paediatric autoimmune hepatitis type 1
  • SMA, smooth muscle antibodies
  • type 1 autoimmune hepatitis
  • immunohistochemistry
  • mononuclear cell infiltrate
  • children

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