The interference of an autoimmune mechanism in the pathogeny of chronic active liver diseases

The part played by the human hepatocytic antigens in the self-perpetuation of the inflammatory processes was investigated in two groups of patients with chronic active liver disease (CALD). In the 26 patients of the first group (14 with chronic active hepatitis and 12 with active cirrhosis), their serum was put in contact with a suspension of hepatocytes in a culture of liver from a 5.5 month-old human embryo, in presence of rabbit complement. The hepatocytic lysis was evaluated by the test of microcytotoxicity (MCT), considered positive at values above 60%. Ten healthy subjects and 8 patients with atrophic gastritis were used as controls. In 12 other patients with CALD (2nd group), the authors performed the test of inhibition of the macrophage migration (IMM) and that of lymphoblastic transformation (LT) in presence of an autologous liver antigen, obtained by liver biotic puncture. In the first group, the MCT test was positive in 57.6% of the patients, in correlation with a particular biomorphologic aggressivity and marked immune disturbances, while in controls it was negative in 17 of the 18 cases. In the second group, the extract of autologous hepatocytes induced a marked inhibition of the macrophage migration and a significantly increased lymphoblastic transformation. It is concluded to the existence, in the patients with CALD, of cytotoxic hepatocytic antibodies, as well as to a stimulation of the macrophagic-lymphocytic function in presence of the autologous liver antigen. The participation af an autoimmune mechanism in the perpetuation of the hepatocytic lesions in such patients is also suggested.