Cochrane A M, Moussouros A, Smith A, Thomson A D, Eddleston A L, Williams R
Gut. 1976 Sep;17(9):714-8. doi: 10.1136/gut.17.9.714.
Lymphocyte cytotoxicity for isolated hepatocytes has been demonstrated in 93% of cases of acute viral hepatitis tested within two weeks of the onset of symptoms. The frequency of cytotoxicity during this time was similar for HBsAg positive and negative cases. However, after this time it was significantly higher in HBsAg positive than negative cases, 90% and 25% respectively (P less than 0-01). Cytotoxicity was found in B-cell, but not T-cell, enriched fractions of lymphocytes, compatible with an antibody-dependent K-cell mediated reaction. In two cases the assay remained positive on retesting six months later, and follow-up liver biopsies showed the features of chronic aggressive hepatitis. These findings suggest that, in addition to the known immunological reactions against viral antigens that occur during the acute phase of viral hepatitis, an autoimmune reaction directed against a liver specific protein is also initiated; and if this reaction persists then chronic hepatitis may develop.
在症状出现两周内进行检测的急性病毒性肝炎病例中，93%显示出淋巴细胞对分离的肝细胞具有细胞毒性。在此期间，HBsAg阳性和阴性病例的细胞毒性频率相似。然而，在此之后，HBsAg阳性病例的细胞毒性显著高于阴性病例，分别为90%和25%（P小于0.01）。在淋巴细胞的B细胞富集部分而非T细胞富集部分发现了细胞毒性，这与抗体依赖性K细胞介导的反应相符。在两例病例中，六个月后重新检测时该检测仍为阳性，后续肝活检显示为慢性侵袭性肝炎的特征。这些发现表明，除了在病毒性肝炎急性期发生的针对病毒抗原的已知免疫反应外，还启动了针对肝脏特异性蛋白的自身免疫反应；如果这种反应持续存在，则可能发展为慢性肝炎。
