Cellular and humoral immune reactions in chronic active liver disease. I. Lymphocyte subsets in liver biopsies of patients with untreated idiopathic autoimmune hepatitis, chronic active hepatitis B and primary biliary cirrhosis.

In liver biopsies of 37 patients with chronic active liver disease (CALD) the inflammatory infiltrate was studied with monoclonal antibodies to the surface antigens on helper/inducer (OKT4+), suppressor/cytotoxic (OKT8+), killer/natural killer (OKM1,2+) cells and common T cell antigens (OKT1+, OKT3+). Furthermore OKT11 antibody was applied, which defines the E rosette receptor. Special emphasis was given to areas with piece-meal necrosis (PMN). In areas with PMN in idiopathic autoimmune CALD (IA-CALD, n = 15) OKT8+ and OKM+ lymphocytes and IgG plasma cells were present, whereas in hepatitis B-CALD (HB-CALD, n = 12) almost exclusively OKT8+ cells were found. In PBC (n = 10) OKT4+ cells in central parts of portal tracts and OKT8+ cells in areas with PMN predominated. These findings indicate that in IA-CALD antibody-dependent cell-mediated cytotoxicity (ADCC), as well as T cell cytotoxicity may be responsible for liver cell damage, while in HB-CALD T cell cytotoxicity seems to be the only mechanism. In PBC liver cell damage also predominantly is the result of T cell cytotoxicity. In addition, helper T lymphocytes seem to play a role since these are found in central areas of the portal tracts.