Cell mediated immunity in acute and chronic hepatitis

Abstract

Peripheral lymphocytes from patients with hepatitis B surface antigen (HB(s)Ag) positive and negative acute hepatitis (AH), chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and normal controls were tested for in vitro cytotoxicity and blast transformation. Cytotoxicity was measured by chromium (51Cr) release into the medium from 51Cr labeled Chang liver cells after incubation for 6 hr with peripheral lymphocytes at a lymphocyte target cell ratio of 200 : 1. Comcomitant 72 hr incubation studies were performed to assess thymus cell dependent (T) lymphocyte function as measured by concanavalin A (Con A) stimulated incorporation of tritiated thymidine (blast transformation) and by cytotoxicity. It was found that lymphocytes from patients with AH are cytotoxic to Chang liver cells compared to controls (P < 0.001); lymphocytes from patients with acute and chronic hepatitis are less cytotoxic when incubated with autologous and homologous HB(s)Ag positive serum; lymphocytes from patients with HB(s)Ag positive and negative AH, CAH, and CPH are as cytotoxic as normal controls when stimulated with a nonspecific mitogen such as Con A; and lymphocytes from patients with CAH while on prednisone therapy showed marked depression of cytotoxicity when stimulated with Con A. Thus, these studies show that patients with AH have circulating T lymphocytes which are capable of causing the destruction of Chang liver cells. There is no defect in T cell function as measured by Con A stimulated cytotoxicity. There is a serum factor (s) in patients with acute and chronic hepatitis which inhibits spontaneous and induced lymphocyte cytotoxicity and blast formation. Finally, prednisone treatment appears to inhibit lymphocyte cytotoxicity in patients with CAH.