Dysregulation of blood lymphocyte subsets and natural killer cells in schistosomal liver cirrhosis and hepatocellular carcinoma

Abstract. Immunological factors are important in the pathogenesis ofa wide spectrum of hepatobiliary diseases. Using flow cytometry,we determined the changes in lymphocyte subsets and naturalkiller cells in 123 individuals (81 patients with liver diseaseand 42 healthy volunteers). The liver diseases includedperiportal fibrosis (PPF, 10 patients), liver cirrhosis (LC, 31patients), and hepatocellular carcinoma (HCC, 40 patients).Schistosomiasis and viral hepatitis B and C were the putativeetiological agents of liver diseases. Immunophenotyping byindirect immunofluorescence was conducted using monoclonalantibodies to CD3 (T-lymphocytes), CD4 (helper/inducer T-cells),CD8 (suppressor/cytotoxic T-cells), and CD57 (natural killercells) cell surface markers. Immunophenotyping of PPF patientsshowed no significant changes in all markers compared with thehealthy controls. However, there was a significant decrease(P<0.01) in CD3 and CD4T-cells, and a highly significant increase (P<0.001) in CD57 T-cells in patientswith LC or HCC. In addition, LC and HCC patients showed nosignificant change in CD8 T-cells compared with controls. Inconclusion, the progression of liver diseases is associated witha dysregulation of cellular immune responses. T-lymphocytes andnatural killer cells may play a role in the immunopathogenesisof liver cirrhosis and HCC.