丁型肝炎患者肝组织中Fas/FasL和肝细胞凋亡表达

目的探讨Fas/FasL及肝细胞凋亡在丁型肝炎患者肝组织中的表达及作用.方法采用免疫组化双重染色和TUNEL技术,检测79例丁肝患者肝组织HDAg,Fas/FasL表达,以及肝细胞凋亡,以54例乙型肝炎作对照.结果Fas以肝细胞浆表达为主,HDAg以核浆型表达为主,二抗原表达及分布有相关性.FasL主要表达在浸润淋巴细胞浆、肝细胞核,与HDAg表达及分布不全一致.HDAg,Fas/FasL和肝细胞凋亡在各型肝炎中的表达强度有显著性差别意义.结论HDV感染可诱导肝细胞Fas/FasL表达,增强Fas/FasL途径介导的肝细胞凋亡,这一机制在丁型肝炎发病机制中可能有一定的重要作用.

Expression of hepatocyte apoptosis and Fas/FasL in liver tissues of patients with hepatitis D

AIM To study the role of hepatocyte apoptosis and Fas/ FasL in pathogenesis of hepatitis D. METHODS Expression of HDAg, Fas, FasL and hepatocyte apoptosis in liver specimens of 79 patients with hepatitis D were studied by immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) technique. The relationship between expression of HDAg and expression of Fas /FasL and hepatocyte apoptosis in liver specimens of patients were studied by double stainings and serial sections. RESULTS Fas was mainly expressed in the cytoplasm of hepatocytes, and HDAg in the nucleus of hepatocytes, FasL in the cytoplasm of infiltrating lymphocytes and in the nucleus of hepatocytes. Most of these positive cells were distributed among infiltrating lymphocytes at the periportal region especially at the advancing edges of areas of " piecemeal necrosis". Most of hepatocyte apoptosis was found to locate near the positive cells of HDAg. There were positive correlations between degree of Fas /FasL expression, hepatocyte apoptosis and HDAg expression (P<0.01,P<0.05), as well as degree of Fas/ FasL expression and hepatocyte apoptosis. Both HDAg and Fas or FasL might be mostly expressed in the same hepatocyte, but the hepatocytes where HDAg and FasL coexisted were fewer than those of HDAg and Fas. CONCLUSION The distribution and the expression of Fas/ FasL, HDAg and hepatocyte apoptosis are significantly correlated with the activity of inflammation and the severity of the liver damage, and HDV infection may induce the expression of Fas in the hepatocytes, and apoptosis caused by Fas-FasL interaction may play an important role in the liver cell injury by HDV infection.