IL-10与慢性病毒性肝炎

IL-10为重要的免疫抑制因子,具有多种活性,通过对不同免疫细胞的作用,对多种细胞因子的产生具抑制作用.慢性病毒性肝炎的免疫反应既可使病毒清除或长期存在,也常引起组织病理性损伤.近来在其它慢性病毒性感染模型中的研究提示,IL-10 有可能在多种慢性病毒性肝炎过程具有重要的作用,对于研究后者的发病机制和治疗措施极具意义.     

自身免疫性肝炎与病毒性肝炎患者血清HA RIA

本文探讨自身免疫性肝炎与病毒性肝炎两种不同病因 引起的肝炎患者血清HA的含量变化,现将结果报道如下。 1　材料和方法 1.1　材料 1.1.1　正常对照组　选健康献血员55例,年龄(25～45) 岁,平均34岁。 1.1.2　肝病组　病毒性肝炎患者60例(男20,女40),年龄 (23～50)岁,平均39岁,临床诊断符合第六届全国病毒性肝 炎会议标准。自身免疫性肝炎患者45例(男6,女39),年龄 (28～51)岁,平均42岁,根据美国肝脏病研究学会AIH的诊 断标准[1]。 1.2　方法　于早晨采集空腹静脉血,分离血清。于-70保 存待测。HARIAkit由上海海研生物制品研究所提供,按说…     

肝硬变,病毒性肝炎及正常肝组织中间隙连接蛋白Cx32的表达

间隙连接（ｃｏｎｎｅｘｉｎ，Ｃｘ）是细胞间的蛋白通道结构，由相邻胞膜上的连接子（ｃｏｎｎｅｘｏｎ）相互衔接而成。通过Ｃｘ介导的细胞间连接通讯（ｇａｐｊｕｎｃｔｉｏｎｉｎｔｅｒｃｅｌｕｌａｒｃｏｍｍｕｎｉｃａｔｉｏｎ，ＧＪＩＣ），对细胞的增殖、分化进行...     

病毒性肝炎患者血清TF,Ft含量

我们用放射免疫分析(RIA)法分别对病毒性肝炎119例和正常对照30例血清转运铁蛋白(TF)、铁蛋白(Ft)含量进行检测,现将结果报告如下。 临床资料和方法 一、临床资料:119例(男95,女24)病毒性肝炎均为市传染病院住院病人。根据临床症状、体征和实验室检查确诊。年龄3～72岁,平均33.05岁。按全国病毒性肝炎会议修订的病毒性肝炎防治方案的标准分型,急性肝炎(AH)37例,慢迁肝(CPH)21例,慢活肝(CAH)30例,肝炎后肝硬化(HLC)31例。正常对照组30例(男25,女5),年龄15～53岁,平均31.50岁,均为健康体检者,肝肾功能检查均正常。 二、方法:TF试剂盒系苏州医学院核医学教研室江一民教授馈赠。Ft试剂盒系中国原子能研究院提供,均按说明书操作。测量仪器为西安262厂生     

检测病毒性肝炎患者血清中SEN病毒及其临床意义

目的：检测病毒性肝炎患者血清中SEN病毒D和H(SENV-D、SENV-H),并探讨其临床意义。方法：采用巢式聚合酶链反应法（nPCR）检测甲、乙、丙、戊型肝炎和非甲－戊型肝炎患者血清中SENV-D和SENV-H DNA。结果：在180例病毒性肝炎患者血清中，SENV-D和SENV-H检出率分别为17.2%(31/180)和5.6%(10/180)，总检出率为18.3%(33/180)、甲、乙、丙、戊型肝炎患者的SENV-D/H检出率高于非甲－戊型肝炎患者。从甲、乙、丙、戊型肝炎和非甲－戊型肝炎患者分离的SENV-D/H核苷酸序列，与SENV-D/H原型株比较，其同源性在94％以上。甲、乙、丙和戊型肝炎患者有无SENV-D/H合并感染，其血清生化学指标无明显差异。结论：SENV-D/H可能不是非甲-戊型肝炎的病原，甲、乙、丙和戊型肝炎患者合并感染SENV-D/H并不加重病情。     

病毒性肝炎慢性化研究近况

乙型肝炎病毒（HBV）感染波及全球，全世界HBV携带者约3．5亿人，其中有一半集中在亚太地区。成人感染HBV后，大部分呈现亚临床感染过程，部分表现为急性病毒性肝炎，病毒很快被清除，极少部分发展为重型肝炎，另有小部分转变为慢性乙型肝炎，反复发病，持续多年，其中有些最终形成肝硬变或肝癌[1]。新生儿期感染HBV后，病毒不易清除，90％转变为HBV长期携带者。丙型肝炎病毒（HCV）感染的重要特点之一是极易发生慢性化，其发生率可高达50％～80％[2-4]，不论是成人或婴儿期感染，都以慢性感染为多，多半隐匿起病，也可由急性演变而…     

病毒性肝炎患者的血清SOD含量

病毒性肝炎患者的血清ＳＯＤ含量龚守军，李光明，朱珊珍超氧化物歧化酶（ＳＯＤ）是大分子自由基清除剂，其血清浓度改变反映了自由基损伤机体的病理过程。本文报道９６例病毒性肝炎患者血清ＳＯＤ的含量。９６例均为临床及实验室检查确诊为病毒性肝炎的住院病人，其中男...     

病毒性肝炎患者Ⅰ型前胶原羧基端肽及表皮生长因子评价

通过观察各型病毒性肝炎及肝硬化患者血清Ⅰ型前胶原羧基端肽(PICP)及表皮生长因子(EGF)水平,以评价其在肝纤维化中的临床意义.本文采用放射免疫分析方法测定了134例病毒性肝炎患者和30名正常人(对照组)的血清PICP及ECF水平.结果表明急性肝炎组两指标与对照组相比无显著差异(P＞0.05),而慢性肝炎轻中型组、慢性肝炎重型组及肝硬化组两指标与对照组相比,均有显著性差异(P＜0.05-0.01),其中慢性肝炎重型组两指标水平最高.以上结果说明,测定血清PICP及EGF水平可以反映肝纤维化程度及慢性肝病的活动度,是临床上判断肝病进展及预后的一项参考指标.     

Non-A, non-B hepatitis in chimpanzees: interference with acute hepatitis A virus and chronic hepatitis B virus infections

Two chimpanzees with persistent non-A, non-B (NANB) hepatitis were superinfected with marmoset-passaged MS-1 HAV. Two control chimpanzees were also infected with marmoset-passaged HAV. Neither animal with persistent NANB hepatitis developed elevated alanine aminotransferase (ALT) activity, whereas both control chimpanzees exhibited ALT elevations within 3 weeks after inoculation. In addition, both NANB-infected chimpanzees demonstrated a delayed anti-HAV antibody response in which one animal failed to produce detectable IgM anti-HAV. With the exception of one stool, all serial liver biopsy specimens and daily stool suspensions from the superinfected chimpanzees were negative for HAV antigen. One chimpanzee with a chronic HBV infection was superinfected with non-A, non-B hepatitis and was shown to develop elevated ALT activity and hepatocyte ultrastructural alterations accompanied by a marked reduction in the titer of serum HBsAg. Our combined findings indicate that acute and persistent non-A, non-B hepatitis infections are capable of interferring with two distinctly different hepatotropic viruses. These results also suggest that in vitro detection of non-A, non-B hepatitis infection or virus(es) may be achieved by antibody-independent methodologies that employ the basic principle of viral interference.     

Perforin and Fas/Fas ligand-mediated cytotoxicity in acute and chronic woodchuck viral hepatitis.

The Fas ligand (FasL)/Fas and the perforin-granzyme cytotoxic pathways presumably play a central role in the development of hepatocellular injury in viral hepatitis. To recognize the potential contribution of FasL and perforin-based cell killing in hepadnaviral infection, we adopted a cytotoxic assay using murine Fas+ P815 and human Fas- K562 cells as targets. Freshly isolated peripheral blood mononuclear cells (PBMC) from woodchucks with newly acquired woodchuck hepatitis virus (WHV) infection (n = 6), with chronic WHV hepatitis (n = 9), and from healthy animals (n = 11) were used as effector cells. We have found that woodchuck lymphoid cells kill cell targets via both the FasL/Fas and the perforin death pathways. The contribution of Fas-dependent cytolysis was ascertained in blocking experiments with anti-Fas antibody and by incubation of PBMC with cyclohexamide to prevent de novo synthesis of FasL. The involvement of the perforin pathway was confirmed by treatment of K562 cells with colchicine to inhibit the microtubule-dependent perforin release. Comparative analysis showed that peripheral lymphoid cells from acute WHV hepatitis, but not those from chronic WHV infection, are more cytotoxic and that this increase seems to be entirely due to activation of perforin-mediated killing. The data indicate that acute infection in woodchucks is associated with the augmented capacity of lymphoid cells to elicit perforin-dependent killing, but in chronic infection, independent of the severity of liver disease and duration of chronicity, these cells have the same or lower cytotoxic potential as PBMC from healthy controls. These findings suggest a role for non-specific cellular immunity, presumably natural killer (NK) cells, in the control of early WHV infection and in the progression of chronic hepatitis.     

Non-A, non-B hepatitis in Omdurman, Sudan

One-hundred nineteen patients (cases) at least 13 years of age with acute hepatitis were studied to determine the viral etiology of acute hepatitis in Omdurman, Sudan. Ninety-eight control subjects (controls) were also evaluated to determine the risk factors associated with the development of clinical disease. Acute hepatitis non-A, non-B was diagnosed in 88 cases (73.9%), hepatitis B in 15 cases (12.6%), delta infection in 15 (12.6%), and hepatitis A in just one patient (0.8%). A higher percentage of hepatitis B cases had received a parenteral injection for medical therapy during the previous 6 months than control subjects (26.7% vs 4.1%, p less than 0.05). The data in this study indicate that hepatitis non-a, non-B may be the major cause of acute hepatitis in adults in this area of Sudan. The suggested association of parenteral therapy with the transmission of hepatitis B could have important implications for the spread of other parenterally-transmitted diseases.     

Imported epidemic non-A, non-B hepatitis in Qatar

During one year, 198 patients were admitted to the Hamad General Hospital, Qatar, with acute viral hepatitis. Sera from 126 of these were tested for HBsAg, IgM anti-HBc, IgG anti-HAV, IgM anti-HAV, and delta antibody in those positive for HBsAg. Only 6% of the patients were Qatari nationals and the remainder were immigrants. Of the 126 patients tested, 7 had acute hepatitis A, 29 had acute hepatitis B (none were positive for delta antibody), and the remaining 91 were regarded as having had acute non-A, non-B hepatitis. Of this latter group, 75% were Indian immigrants of whom 59% presented within six weeks of arrival in Qatar and only 2 patients presented later than eight weeks. These patients were thought to have contracted the infection in transit camps in India before immigration to Qatar.     

Concurrent hepatitis C virus and hepatitis delta virus superinfection in patients with chronic hepatitis B virus infection.

Since hepatitis C virus (HCV) and hepatitis delta virus (HDV) are transmitted by the same routes as hepatitis B virus (HBV), simultaneous or concurrent HCV and HDV infection in patients with chronic HBV infection may occur. To test this hypothesis and to examine the clinicohistological and immunopathological presentations of such multiple hepatitis virus infections, acute and/or convalescent serum specimens from 86 patients with acute HDV superinfection were tested by enzyme immunoassay for antibodies to HCV. Of the 86 patients, 18 (20.9%) were associated with HCV infection. Although patients with early mortality cannot be evaluated by the HCV markers used in this study, the results showed that the clinical and histologic features were similar except that patients with HCV infection were older than those without HCV infection (P less than 0.01). Immunopathological studies carried out within 2 months after the onset of acute HDV superinfection demonstrated that hepatitis B core antigen (HBcAg) was not detected in any patient and HDV antigen was detected in 18.2% of the patients with HCV infection whereas HBcAg and HDAg were found in 7% and 65.1%, respectively, of those without HCV coinfection (P less than 0.02). It is concluded that concurrent HCV and HDV superinfections can and do occur in patients with chronic HBV infection. In these triple viral infections, HCV may even transiently suppress HDV and HBV.     

Changing views on chronic hepatitis

The histological classification of chronic hepatitis is reviewed. The relative importance of piecemeal necrosis and of lobular necrosis in the progression to cirrhosis is assessed. Recent advances in virological and serological aspects of acute hepatitis are outlined and the importance of concomitant infection with more than one virus is discussed. The pathologist cannot assess prognosis on a histological basis alone without other clinical and serological information.     

Hepatitis B virus-DNA in the serum of patients followed-up longitudinally with acute and chronic hepatitis B

Sera from 79 patients with acute self-limiting hepatitis, 17 patients with acute hepatitis B evolving into chronic HBsAg carriership, and 43 chronic HBsAg carriers without a history of acute hepatitis were analyzed for presence of hepatitis B virus (HBV)-DNA by a molecular hybridization technique. In acute self-limiting hepatitis, HBV-DNA was cleared within a few weeks after the onset of clinical symptoms. The longest period of DNA positivity observed in this group was 42 days. In 29 of 52 patients HBV-DNA was cleared before HBeAg disappeared. Among 17 patients who became chronic HBsAg carriers, HBV-DNA was present for more than 6 months in all but one. Most of the HBsAg carriers eventually cleared HBV-DNA. The DNA clearance frequently preceeded the conversion of HBeAg to anti-HBe. Thus, in many patients there was a transitional period with HBeAg but without HBV-DNA. HBV-DNA was found to be a better index of impending chronicity than HBeAg since persistence of HBeAg for more than 42 days was noted in 10% of the patients who nevertheless cleared HBsAg within 6 months. By that time all those patients had turned negative for HBV-DNA. On the other hand, in 16 of the 17 patients who became chronic carriers of HBsAg, HBV-DNA as well as HBeAg persisted for more than 6 months. The present results also suggest that infectivity in acute hepatitis B is a feature mainly of the presymptomatic and early symptomatic period.     

Hepatitis A virus genotype and its correlation with the clinical outcome of acute hepatitis A in Korea: 2006-2008

Korea has recently experienced a nationwide outbreak of hepatitis A. This study aimed to investigate hepatitis A virus (HAV) genotypes and to compare clinical features between patients infected with HAV genotype IA and those with genotype IIIA. From September 2006 to August 2008, 595 patients with symptomatic hepatitis A were enrolled prospectively in four hospitals in Korea. Among them, 556 patients participated in this study by providing serum or stool samples for genotypic analysis. HAV RNA was detected in 499 patients (89.7%). Major genotypes included IA (n = 244, 48.9%) and IIIA (n = 244, 48.9%), and the remaining genotype was IB (n = 11, 2.2%). From September 2006 to August 2007, the distribution of genotypes IA and IIIA were 64.6% and 35.6%, respectively, which changed to 42.3% and 54.6%, respectively, from September 2007 to August 2008, indicating change of circulating HAV genotypes in the study period from IA to IIIA. Major patterns of amino acid substitution in the VP3/VP1 junction region were observed at position 512 (P → L) in genotype IA and at 520 (R → K) in genotype IIIA. Patients with genotype IIIA infection showed significantly higher aminotransferase levels, prothrombin time, and leukocyte count, with more severe symptoms than those with genotype IA at the time of admission. These results suggest the occurrence of a change of circulating HAV genotypes in recent community‐wide outbreaks of hepatitis A in Korea, and genotype IIIA infection, compared with genotype IA infection, might show more severe clinical manifestations. J. Med. Virol. 83:2073–2081, 2011. © 2011 Wiley Periodicals, Inc.     

Aetiology of acute sporadic hepatitis in adults in Kenya

Markers for acute hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis non-A, non-B (HNANB) infections were examined in the sera of 94 patients presenting with acute hepatitis in Kenya. Hepatitis B virus was responsible for 70% of cases, HNANB for 18%, and HAV for only 12%. The use of an IgM anti-HBc assay increased the rate of diagnosis of acute HBV infection, thereby reducing the proportion of cases designated as NANB.     

Safety and immunogenicity of inactivated hepatitis A vaccine in patients with chronic liver disease

The safety and immunogenicity of inactivated hepatitis A vaccine was evaluated in patients with chronic liver disease. Sixty hepatitis A virus antibody (anti-HAV) seronegative patients A virus antibody (anti-HAV) seronegative patients with chronic liver disease (56 chronic hepatitis B and four chronic hepatitis C) and from 17 to 47 years of age received a dose of 1440 ELISA units of the inactivated hepatitis A vaccine at month 0, and a booster at month 6. Anti-HAV seroconversion (⩾ 33 mlU/mL) was 57.6% (34/59) on day 15, and reached 93.2% (55/59) 1 month after primary vaccination. At month 6, the seropositivity of anti-HAV decreased before the booster to 69.0% (40/58). All vaccinees had measurable titers of anti-HAV 1 month after booster vaccination, and were still seropositive at month 12. After initial vaccination, the geometric mean titers of anti-HAV among vaccine responders were 158, 264, 74, 1309, and 409 mlU/ml at day 15 and months 1, 6, 7, and 12. Overall, 59.7% (71/119) of the vaccine doses administered were followed by mostly minor reactions. The majority of symptoms reported were local, all of which resolved within 3 days after vaccination. No significant changes in serum liver enzyme levels were detected after vaccination. Thus, an inactivated hepatitis A vaccine was safe in patients with chronic liver disease while the immune response was inferior to that observed in healthy subjects reported in a previous study. J. Med. Virol. 52:215–218, 1997. © 1997 Wiley-Liss, Inc.