El-Medany O M, El-Din Abdel Wahab K S, Abu Shady E A, Gad El-Hak N
Microbiology Department, Faculty of Medicine, Al-Azhar University, Egypt.
Hepatogastroenterology. 1999 May-Jun;46(27):1895-903.
BACKGROUND/AIMS: This study was designed to evaluate anti-HCV and anti-GOR in chronic liver disease (CLD) caused by HCV alone or with bilharzia.
The parameters of hepatitis C virus (HCV) infection among 45 chronic liver disease (CLD) patients are the subject of this study. The samples that were collected included serum, saliva and liver biopsy. For comparison, 44 serum, saliva and liver biopsies were also collected from non liver disease (NLD) patients undergoing surgery at the Gastroenterology Surgical Center, Mansoura University.
Screening of antihepatitis C (anti-HCV) with a second generation ELISA test showed that 37/45 (82.2%) sera and 17/45 (37.7%) saliva samples from CLD patients were positive for the presence of anti-HCV (IgG), while, anti-HCV (IgG) was detected among 32/44 (72.7%) sera and 6/44 (13.6%) saliva samples from NLD patients. HCV antigen was detected by immunostaining in the liver biopsy sections of 11/45 (24.4%) CLD and in 6/44 (13.6%) NLD patients. HCV antigen was detected in hepatocyte cytoplasm and nuclei, in some endothelial cells lining the hepatic cell cords, and in some bile duct cells. The serum and saliva samples from both CLD and NLD patients were also tested by ELISA for the presence of anti-GOR to determine the prevalence of autoantibody in HCV infected and non-infected patients. Anti-GOR was detected in 19/45 (42.2%) sera and in 1/45 (2.21%) saliva samples from CLD patients, while in the case of NLD patients, anti-GOR antibodies were found in 7/44 (15.9%) sera and in 4/44 (9%) saliva samples. GOR antigen was detected by an indirect immunoperoxidase stain of liver biopsies. Positive GOR antigen signals were found in hepatocytes but granular cytoplasmic, and extrahepatic localization was also noticed. A correlation between the detection of anti-GOR and anti-HCV revealed that, out of 37 anti-HCV positive CLD patients, there were 19 (51.3%) positive for anti-GOR, while 7/32 (21.8%) NLD patients were positive for anti-HCV and for anti-GOR.
The results of the present study confirm the published anti-HCV high seropositivity among Egyptian CLD patients and point to an autoimmune processes in CLD. The liver biopsy findings stress the presence of HCV antigen in extra hepatic cells as well as in hepatocytes in CLD. Our data confirm that anti-GOR is commonly present in sera from CLD patients and show that anti-GOR are secreted in saliva. Our results showed that saliva can not be used reliably, instead of serum, for the diagnosis of HCV infection or auto-antibodies related to HCV infection, but can be used as a parameter for the evaluation of CLD activity, when repeated sampling is necessary.
背景/目的：本研究旨在评估单纯丙型肝炎病毒（HCV）感染或合并血吸虫病所致慢性肝病（CLD）患者体内的抗HCV及抗GOR情况。
本研究以45例慢性肝病（CLD）患者的丙型肝炎病毒（HCV）感染参数为研究对象。采集的样本包括血清、唾液及肝组织活检标本。作为对照，还从曼苏拉大学胃肠外科中心接受手术的非肝病（NLD）患者中采集了44份血清、唾液及肝组织活检标本。
采用第二代酶联免疫吸附试验（ELISA）检测抗丙型肝炎病毒（抗HCV），结果显示CLD患者中37/45（82.2%）的血清及17/45（37.7%）的唾液样本抗HCV（IgG）呈阳性，而NLD患者中32/44（72.7%）的血清及6/44（13.6%）的唾液样本检测到抗HCV（IgG）。通过免疫染色在11/45（24.4%）的CLD患者及6/44（13.6%）的NLD患者肝组织活检切片中检测到HCV抗原。HCV抗原在肝细胞胞质及胞核、部分肝索内衬的内皮细胞及部分胆管细胞中被检测到。采用ELISA检测CLD和NLD患者血清及唾液样本中抗GOR的存在情况，以确定HCV感染及未感染患者自身抗体的流行情况。CLD患者中19/45（42.2%）的血清及1/45（2.21%）的唾液样本检测到抗GOR，而NLD患者中7/44（15.9%）的血清及4/44（9%）的唾液样本检测到抗GOR抗体。通过肝组织活检的间接免疫过氧化物酶染色检测GOR抗原。在肝细胞中发现GOR抗原阳性信号，但呈颗粒状胞质，且还观察到肝外定位。抗GOR与抗HCV检测结果的相关性显示，37例抗HCV阳性的CLD患者中，19例（51.3%）抗GOR阳性，而32例NLD患者中7例（21.8%）抗HCV及抗GOR阳性。
本研究结果证实了埃及CLD患者中已报道的抗HCV高血清阳性率，并指出CLD存在自身免疫过程。肝组织活检结果强调了CLD患者肝外细胞及肝细胞中存在HCV抗原。我们的数据证实抗GOR常见于CLD患者血清中，并表明唾液中可分泌抗GOR。我们的结果表明，唾液不能可靠地替代血清用于HCV感染或与HCV感染相关自身抗体的诊断，但在需要重复采样时，可作为评估CLD活动的一个参数。
