Meyer zum Büschenfelde K H, Arnold W, Knolle J, Hess G
Z Gastroenterol. 1976 May;14(3):365-77.
Humoral and/or cell-mediated (CMI) immune responses to HBAg components, human and rabbit liver specific proteins (HLP and RLP) and tuberculin were tested in patients with acute virus B and non-B-hepatitis, asymptomatic HBsAg carriers and HBsAg positive chronic active hepatitis (CAH). Furthermore, the presence of HBsAg, HBcAg and/or "e"-antigen has been studied in patients with sera and/or liver tissue. Asymptomatic HBsAg carriers are characterized by a status of immunological tolerance against HBsAg. HBcAg in liver nuclei could not be detected. All sera were positive for anti-HBc, some had anti "e". - Patients with uneventful acute virus-B-hepatitis developed CMI against HBsAg 4-6 weeks and anti-HBs 4-6 months after onset of the disease. Acute virus hepatitis without detectable HBsAg are defined as non-B-hepatitis by negative humoral and cell-mediated immune reaction against HBsAg 1-12 months after onset of the disease. - Patients with type B chronic active hepatitis are characterized by inadequate CMI against HBsAg without immune elimination of virus and virusantigens. Acute and chronic type-B-hepatitis showed temporary or constant CMI against HLP. These findings suggest an alteration or a carrier function of membrane antigens of virus infected hepatocytes or an induction of new membrane antigens by a virus. The results indicate that recovery from type B-hepatitis is associated with the ability to elicit a specific immune response to HBsAg. Furthermore immune responses to virus, virus antigens and virusinfected hepatocytes seemed to be the pathogenic principle of virus induced acute and chronic liver diseases.
在急性乙型病毒性肝炎和非乙型病毒性肝炎患者、无症状HBsAg携带者以及HBsAg阳性慢性活动性肝炎(CAH)患者中,检测了对乙肝表面抗原(HBAg)成分、人及兔肝脏特异性蛋白(HLP和RLP)以及结核菌素的体液免疫和/或细胞介导免疫(CMI)反应。此外,还研究了血清和/或肝组织中患者HBsAg、HBcAg和/或“e”抗原的存在情况。无症状HBsAg携带者的特征是对HBsAg处于免疫耐受状态。肝细胞核中未检测到HBcAg。所有血清抗-HBc均为阳性,部分血清有抗“e”抗体。——急性乙型病毒性肝炎病情平稳的患者在疾病发作后4至6周产生针对HBsAg的CMI,4至6个月产生抗-HBs。疾病发作后1至12个月,针对HBsAg的体液免疫和细胞介导免疫反应均为阴性,无HBsAg检出的急性病毒性肝炎被定义为非乙型病毒性肝炎。——B型慢性活动性肝炎患者的特征是针对HBsAg的CMI不足,无法免疫清除病毒和病毒抗原。急性和慢性B型肝炎对HLP表现出暂时或持续的CMI。这些发现提示病毒感染的肝细胞膜抗原发生改变或具有载体功能,或者病毒诱导产生新的膜抗原。结果表明,从B型肝炎康复与对HBsAg引发特异性免疫反应的能力有关。此外,对病毒、病毒抗原和病毒感染肝细胞的免疫反应似乎是病毒诱导的急性和慢性肝病的致病机制。