Nonomura A, Kono N, Mizukami Y, Nakanuma Y
Pathology Section, Kanazawa University Hospital, Japan.
Liver. 1996 Feb;16(1):42-7. doi: 10.1111/j.1600-0676.1996.tb00702.x.
Although eosinophil infiltrate has been recognized in hepatic graft-versus-host disease, its significance in relation to hepatic graft-versus-host disease lesions is unknown. In the present study, we analyzed hepatic eosinophil infiltration in relation to bile duct damage in experimental mouse graft-versus-host disease across minor histocompatibility barriers up to 14 months after transplantation. Portal eosinophil infiltration was found from 1 week after transplantation throughout the entire 14-month observation period. It was most striking during the early chronic stage of hepatic graft-versus-host disease between 2 to 7 months, with a peak at 5 months after transplantation. Microscopic and electron microscopic study revealed eosinophils infiltrated around the bile duct as well as in the bile duct epithelial layer. They were commonly found together with lymphocytes but were also occasionally found singly around the bile duct and in the bile duct epithelial layer. Bile duct epithelial cells in contact with and in the vicinity of eosinophils showed a variety of generative changes, occasionally associated with the presence of extracellular eosinophil granules. Bile duct epithelial cells with eosinophil infiltration just beneath the basement membrane frequently showed further characteristic severe degenerative changes with shedding or dropping-off into the lumen, which features were quite similar to those seen in the bronchial epithelium in asthma patients. These results indicate that not only lymphocytes but also eosinophils may be involved in the production of the bile duct injury in hepatic graft-versus-host disease, especially in its early chronic stage.
虽然嗜酸性粒细胞浸润在肝移植物抗宿主病中已被认识到,但其与肝移植物抗宿主病病变的关系尚不清楚。在本研究中,我们分析了在跨越次要组织相容性屏障的实验性小鼠移植物抗宿主病中,直至移植后14个月肝嗜酸性粒细胞浸润与胆管损伤的关系。从移植后1周开始直至整个14个月的观察期内均发现门静脉嗜酸性粒细胞浸润。在肝移植物抗宿主病的早期慢性阶段,即2至7个月时最为明显,在移植后5个月达到高峰。显微镜和电子显微镜研究显示嗜酸性粒细胞浸润在胆管周围以及胆管上皮层。它们通常与淋巴细胞一起出现,但也偶尔单独出现在胆管周围和胆管上皮层。与嗜酸性粒细胞接触以及在其附近的胆管上皮细胞呈现出各种形态学改变,偶尔伴有细胞外嗜酸性粒细胞颗粒的存在。在基底膜下方有嗜酸性粒细胞浸润的胆管上皮细胞经常表现出进一步的特征性严重退行性改变,伴有脱落或掉入管腔,这些特征与哮喘患者支气管上皮所见的特征非常相似。这些结果表明,不仅淋巴细胞而且嗜酸性粒细胞可能参与肝移植物抗宿主病中胆管损伤的产生,尤其是在其早期慢性阶段。