活化的肝星状细胞（Ito 细胞） - 慢性丙型病毒性肝炎肝纤维化程度的标志：一项初步研究。

Activated Hepatic Stellate Cells (Ito Cells) - Marker of Advanced Fibrosis in Chronic Viral Hepatitis C: A Pilot Study.

机构信息

Discipline of Histology, Department of Morphological Sciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. .

Department 5 Internal Medicine, 4th Medical Clinic, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj- Napoca, Romania.

出版信息

J Gastrointestin Liver Dis. 2023 Jun 22;32(2):170-181. doi: 10.15403/jgld-4726.

DOI:10.15403/jgld-4726

PMID:37345607

Abstract

BACKGROUND AND AIMS

The aim of this study is to determine whether activated hepatic stellate cells (HSCs) may represent a prognostic marker of progressive liver fibrosis in chronic viral hepatitis C (VHC) before antiviral therapy. The possible correlation between HSCs immunohistochemical features, histopathological aspects and clinical data before therapy were also studied.

METHODS

This retrospective pilot study was conducted on 27 liver biopsies from VHC patients before antiviral therapy. HSCs's immunohistochemical analysis used the antibodies alpha-smooth muscle actin (α-SMA), glial fibrillary acidic protein (GFAP) and vinculin. We correlated immunopositive HSCs with HCV load, liver stiffness (LS), fibrosis stage and necro-inflammatory degree before treatment. Also, we assessed the association between liver fibrosis after therapy, the sustained virological response at 12 weeks after therapy (SVR 12) and the type of therapy.

RESULTS

HSCs were increased in VHC patients compared to controls, mainly in the intermediate and periportal lobular regions. α-SMA and vinculin HSCs correlated positively with fibrosis stage (p=0.044), (p=0.028). Furthermore, α-SMA and vinculin HSCs were associated with LS (p=0.027), (p=0.002) and viral load (p=0.021), (p=0.006), but not with necro-inflammation degree. GFAP HSCs inversely correlated with fibrosis stage (r= -0.475), LS (r= -0.422) and HCV load (r= -0.517), but positively with necro-inflammation degree (p=0.038). Liver fibrosis post therapy correlated positively with SVR12 (p<0.001) and the type of therapy (p=0.006) and SVR12 correlated positively with treatment's type (p=0.002).

CONCLUSIONS

Activated HSCs may represent a marker of increased liver fibrosis in VHC. Different immunohistochemical markers can detect various HSCs subpopulations involved in the evolution of VHC and liver fibrosis.

摘要

背景和目的

本研究旨在确定在抗病毒治疗前，慢性丙型肝炎病毒（HCV）患者的活化肝星状细胞（HSCs）是否可以作为进展性肝纤维化的预后标志物。还研究了 HSCs 免疫组织化学特征与治疗前组织病理学特征和临床数据之间的可能相关性。

方法

这项回顾性试点研究对 27 例抗病毒治疗前的 HCV 患者的肝活检进行了研究。HSCs 的免疫组织化学分析使用了抗 α-平滑肌肌动蛋白（α-SMA）、胶质纤维酸性蛋白（GFAP）和 vinculin 的抗体。我们将免疫阳性的 HSCs 与治疗前的 HCV 载量、肝硬度（LS）、纤维化分期和坏死性炎症程度相关联。此外，我们评估了治疗后肝纤维化、治疗后 12 周持续病毒学应答（SVR12）和治疗类型之间的关联。

结果

与对照组相比，HCV 患者的 HSCs 增加，主要在中间和门管区小叶区域。α-SMA 和 vinculin HSCs 与纤维化分期呈正相关（p=0.044），（p=0.028）。此外，α-SMA 和 vinculin HSCs 与 LS 相关（p=0.027），（p=0.002）和病毒载量（p=0.021），（p=0.006），但与坏死性炎症程度无关。GFAP HSCs 与纤维化分期呈负相关（r=-0.475），LS（r=-0.422）和 HCV 载量（r=-0.517），但与坏死性炎症程度呈正相关（p=0.038）。治疗后肝纤维化与 SVR12 呈正相关（p<0.001）和治疗类型（p=0.006），SVR12 与治疗类型呈正相关（p=0.002）。