Chisari F V, Routenberg J A, Edgington T S
J Clin Invest. 1976 May;57(5):1227-38. doi: 10.1172/JCI108391.
The expression of selected lymphocyte surface-membrane markers was evaluated in 37 patients with acute viral hepatitis B, 10 of whom were studied serially through the resolving and convalescent phases of disease. Bone marrow-derived (B) lymphocytes were identified by reference to surface immunoglobulin, whereas normal thymus-derived (T) lymphocytes were assayed by their capacity to form spontaneous nonimmune rosettes with sheep erythrocytes (E rosettes, ER). During the acute and resolving phases of viral hepatitis B, the relative and absolute number of ER-positive lymphocytes was significantly reduced, whereas the number of surface immunoglobulin-positive lymphocytes and the absolute lymphocyte count remained normal. This resulted in the appearance of a third population of cells, deficient in respect to both surface immunoglobulin and ER markers. Such cells accounted for nearly 25% of peripheral blood lymphocytes, approximately 5 x 105ml blood. Depression of the number of ER-positive lymphocytes occurred at least once during the course of disease in every patient studied serially, and was observed in 55 of 67 individual assays of the 37 cases of acute viral hepatitis B. Lymphocytes from some patients reacquired ER function when cultured in fetal calf serum but not in the presence of autologous serum. Such autologous serum was capable of suppressing ER function of lymphocytes from normal donors. The extrinsic suppression of er function by a serum factor (designated as the Rosette Inhibitory Factor), was found to be time dependent, characterized by a 4-h latent period and requiring approximately 18 h for maximum attenuation of ER function. The Serum Rosette Inhibitory Factor was: (a) heat and freeze-thaw stable, (b) nondialyzable, (c) physically separable from hepatitis B surface antigen, (d) not a lymphocytotoxic antibody, and (e) had the buoyant density of a lipoprotein. This extrinsic mechanism was observed in 41.8% of patients with reduced numbers of ER-positive lymphocytes. The Rosette Inhibitory Factor was not detectable in the serum of the remaining 58.2% of the cases of acute and resolving viral hepatitis B despite the presence of reduced numbers of ER-positive lymphocytes. The lymphocytes from these cases did not reacquire ER function when cultured in the absence of autologous serum. The mechanisms responsible for the suppression of normal ER function in these cases appears to be intrinsic to the lymphocytes and not the result of a humoral factor. The T lymphocyte lineage of cells deficient in respect to ER function, whether of intrinsic or extrinsic type, was demonstrated by their capacity to form spontaneous rosettes with neuraminidase-treated sheep erythrocytes. Both intrinsic and extrinsic suppression of T lymphocyte ER function commonly occurred during the first 4 wk of acute viral hepatitis B.9 of the 10 patients followed serially continued to manifest defective ER function at 12 wk...
对37例急性乙型病毒性肝炎患者的某些淋巴细胞表面膜标志物表达进行了评估,其中10例患者在疾病的消退期和恢复期进行了连续研究。通过表面免疫球蛋白鉴定骨髓来源的(B)淋巴细胞,而通过其与绵羊红细胞形成自发非免疫性玫瑰花结(E玫瑰花结,ER)的能力来检测正常胸腺来源的(T)淋巴细胞。在急性乙型病毒性肝炎的急性期和消退期,ER阳性淋巴细胞的相对数量和绝对数量显著减少,而表面免疫球蛋白阳性淋巴细胞的数量和绝对淋巴细胞计数保持正常。这导致出现了第三类细胞群,其表面免疫球蛋白和ER标志物均缺乏。这类细胞占外周血淋巴细胞的近25%,约每毫升血液5×10⁵个。在每例连续研究的患者病程中,ER阳性淋巴细胞数量至少有一次下降,在37例急性乙型病毒性肝炎的67次个体检测中有55次观察到这种情况。一些患者的淋巴细胞在胎牛血清中培养时可恢复ER功能,但在自体血清存在时则不能。这种自体血清能够抑制正常供体淋巴细胞的ER功能。发现一种血清因子(称为玫瑰花结抑制因子)对ER功能的外在抑制具有时间依赖性,其特征为有4小时的潜伏期,最大程度抑制ER功能约需18小时。血清玫瑰花结抑制因子具有以下特性:(a)对热和冻融稳定,(b)不可透析,(c)在物理上可与乙型肝炎表面抗原分离,(d)不是淋巴细胞毒性抗体,(e)具有脂蛋白的浮力密度。在41.8% ER阳性淋巴细胞数量减少的患者中观察到了这种外在机制。在其余58.2%的急性和消退期乙型病毒性肝炎病例血清中未检测到玫瑰花结抑制因子,尽管存在ER阳性淋巴细胞数量减少的情况。这些病例的淋巴细胞在无自体血清培养时未恢复ER功能。这些病例中正常ER功能受抑制的机制似乎是淋巴细胞内在的,而非体液因子的结果。ER功能缺乏的细胞的T淋巴细胞谱系,无论是内在型还是外在型,均可通过其与神经氨酸酶处理的绵羊红细胞形成自发玫瑰花结的能力得以证明。T淋巴细胞ER功能的内在和外在抑制通常发生在急性乙型病毒性肝炎的前4周。10例连续随访的患者中有9例在12周时仍表现出ER功能缺陷……