Gerber M A, Sarno E, Vernace S J
N Engl J Med. 1976 Apr 22;294(17):922-5. doi: 10.1056/NEJM197604222941704.
To localize immune complexes in viral hepatitis Type B and to assess their pathogenic role, we examined by the direct fluorescent-antibody technic 21 liver specimens with hepatitis B core antigen (HBc Ag) in hepatocytic nuclei from 10 patients with HBs Ag-seropositive acute viral hepatitis and from 11 patients with HBs Ag-seropositive chronic active hepatitis. IgG with in vitro fixation of complement was demonstrated in HBc Ag-containing hepatocytic nuclei of all patients with chronic active, but not in those with acute viral hepatitis. All patients except for one had antibody to HBc Ag in the serum as determined by indirect immunofluorescence. The evidence suggests that intranuclear IgG in chronic active hepatitis has anti-HBc specificity and forms immune complexes with HBc Ag. The binding of IgG to intranuclear HBc Ag might have pathogenic importance in chronic active hepatitis.
为了定位乙型病毒性肝炎中的免疫复合物并评估其致病作用，我们采用直接荧光抗体技术检查了21份肝标本，这些标本取自10例HBs Ag血清阳性的急性病毒性肝炎患者和11例HBs Ag血清阳性的慢性活动性肝炎患者，其肝细胞核内含有乙型肝炎核心抗原（HBc Ag）。在所有慢性活动性肝炎患者的含HBc Ag的肝细胞核中均显示有体外固定补体的IgG，但在急性病毒性肝炎患者中未显示。通过间接免疫荧光法测定，除1例患者外，所有患者血清中均有抗HBc Ag抗体。证据表明，慢性活动性肝炎中的核内IgG具有抗HBc特异性，并与HBc Ag形成免疫复合物。IgG与核内HBc Ag的结合可能在慢性活动性肝炎中具有致病重要性。
