Skip to main content
SpringerLink
Log in

The diagnostic significance of intrahepatocellular hepatitis-B-surface-antigen (HB s Ag), hepatitis-B-core-antigen (HB c Ag) and IgG for the classification of inflammatory liver diseases

Untersuchungen anHB s Ag-positiven und -negativen Patienten

Die diagnostische Bedeutung von intrahepatocellulärem Hepatitis-B-surface-Antigen (HB s Ag), Hepatitis-B-core-Antigen (HB c Ag) undIgG für die Klassifizierung von entzündlichen Lebererkrankungen

Studies on HB s Ag-positive and -negative patients

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Zusammenfassung

Wir untersuchten mit der direkten Immunfluorescenztechnik die Leberbiopsien von Patienten mit entzündlichen Lebererkrankungen auf intracelluläres HB s Ag, HB c Ag und IgG. Die Untersuchungen haben folgende Ergebnisse erbracht:

1. Klinisch gesunde HB s Ag-Träger hatten in den meisten Fällen HB s Ag im Cytoplasma, jedoch niemals HB c Ag in den Leberzellkernen.

2. Patienten mit HB s Ag-positiver akuter Hepatitis hatten in der Frühphase HB c Ag und/oder HB s Ag in den Hepatocyten. Unsere Befunde sprechen bei normalem Verlauf für eine komplette Immunelimination der HB-Komponenten zu verschiedenen Stadien der Erkrankung mit völliger Wiederherstellung.

3. Kontrollpunktate 1 Jahr nach Beginn einer HB s Ag-positiven Hepatitis zeigten bei völlig gesunden Patienten kein HB s Ag oder HB c Ag. Bei zwei Patienten ohne Immunelimination von HB s Ag entwickelte sich innerhalb eines Jahres eine chronisch aktive Hepatitis. Diese Patienten hatten HB c Ag in den Leberzellkernen.

4. Patienten mit HB s Ag-positiver CAH und Zeichen entzündlicher Aktivität hatten HB c Ag in den Zellkernen und in geringem Prozentsatz HB s Ag im Cytoplasma.

HB s Ag-negative Fälle zeigten niemals HB-Komponenten im Gewebe.

5. In keinem Fall einer HB s Ag-positiven und -negativen CAH in Remission ließ sich HB s Ag und HB c Ag in Hepatocyten nachweisen.

6. In den meisten Fällen von HB s Ag-positiver AH und CAH, die HB c Ag-positiv waren, fand sich in den gleichen Zellkernen IgG. Die strenge Koinzidenz von HB c Ag und IgG läßt an das Vorliegen von anti-HB c in den Zellkernen denken. Die Bedeutung dieses Antikörpers in den Zellkernen für den weiteren Verlauf der Erkrankung ist unbekannt.

Summary

Liver biopsies of patients with inflammatory liver diseases and clinically healthy HB s Ag-carriers were examined for presence of intracellular HB s Ag, HB c Ag and IgG by direct immunofluorescence. The studies revealed the following results:

  1. 1.

    In most cases healthy HB s Ag-carriers had HB s Ag in the cytoplasm, but they did never show HB c Ag in the nuclei of hepatocytes.

  2. 2.

    In the early phase some patients with HB s Ag-positive acute hepatitis had HB c Ag and/or HB s Ag in their hepatocytes. In a normal course with complete recovery the immunoelimination may clear either phenomenon at variable stages of the disease.

  3. 3.

    Cases one year after complete recovery of acute virus B-hepatitis had no HB-components in their liver tissue. 2 cases without immunoelimination of HB s Ag developed chronic active hepatitis within one year and had HB c Ag in their liver cell nuclei.

  4. 4.

    Patients with HB s Ag-positive CAH and highly inflammatory activity had HB c Ag in the nuclei and a low percentage of cells with HB s Ag in the cytoplasm of hepatocytes. HB s Ag-negative cases with CAH never had HB-components in their tissue.

  5. 5.

    Patients with HB s Ag-positive and -negative CAH in complete remission never had HB c Ag and HB s Ag in their hepatocytes.

  6. 6.

    Most cases with HB s Ag-positive acute hepatitis and chronic active hepatitis positive for HB c Ag had also IgG in the same liver cell nuclei. The coincidence of this finding gives strong evidence for the presence of anti-HB c in these liver cell nuclei. The importance of this finding for the course of the disease is unknown.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Akeyama, T., Kamada, T., Koizumi, T., Abe, H.: The localization of the Australia-antigen in the liver by immunofluorescence. J. clin. Path.25, 1071 (1972)

    Google Scholar 

  • Almeida, J.D., Zuckerman, A.J., Taylor, P.E.: Immune electron microscopy of the Australia-SH (serum hepatitis) antigen. Microbios1, 117 (1969)

    Google Scholar 

  • Arnold, W., Mayersbach, H. v.: Changes in the solubility of immunoglobulines after fluorescent labelling and its influence on immunofluorescent techniques. J. Histochem. Cytochem.12, 975 (1972)

    Google Scholar 

  • Brzosko, W.J., Madalinski, K., Krawczynski, K., Nowoslawski, A.: Duality of hepatitis B antigen and its antibody. I. Immunofluorescence studies. J. Infect. Dis.127, 424 (1973)

    Google Scholar 

  • Caramia, F., De Bac, C., Ricci, G.: Virus-like particles within hepatocytes of Australia-antigen carriers. Am. J. Dis. Child.123, 309 (1972)

    Google Scholar 

  • Doniach, D.: Liver autoimmunity. Current Titles in Immunology, Transplantation and Allergy2, 1 (1974)

    Google Scholar 

  • Edgington, T.S., Ritt, D.J.: Intrahepatic expression of serum hepatitis virus associated antigen. J. exp. Med.134, 871 (1971)

    Google Scholar 

  • Gerber, M.A., Hadziyannis, S., Vissoulis, C., Schaffner, F., Raronetto, E., Popper, H.: Hepatitis B antigen: Nature and distribution of cytoplasmatic antigen in hepatocytes of carriers. Proc. Soc. exp. med. and biol.145, 863 (1974)

    Google Scholar 

  • Gerber, M.J., Phuangsab, D., Sudtn, M.S., Vittal, B.V., Dourdourekas, D., Steigmann, F., Clowdns, B.F.: Cell-mediated immune response to hepatitis B-antigen in patients with liver diseases. Digestive Diseases19, 637 (1974)

    Google Scholar 

  • Gudat, F., Bianchi, L., Sonnabend, W., Thiel, G., Aenishaenshin, W., Stalder, G.A.: Pattern of core and surface expression in liver tissue reflects state of specific immune response in hepatitis B. Lab. Invest.32, 1 (1975)

    Google Scholar 

  • Hadziyannis, S., Gerber, M.A., Vissoulis, C., Popper, H.: Cytoplasmatic hepatitis B antigen in “ground glass” hepatocytes of carriers. Arch. Path.96, 327 (1973)

    Google Scholar 

  • Hadziyannis, S., Moussouros, A., Giustozi, A., Almeida, J.: Immunofluorescence of the “core” antigen in the liver (Abstr.). Digestion8, 66 (1973)

    Google Scholar 

  • Hoofnagle, J.G., Gerety, R.J., Barker, L.F.: Antibody to hepatitis B-virus core in man. Lancet II, 869 (1973)

    Google Scholar 

  • Hunag, S.N., Groh, V., Beaudoin, J.G., Dauphinee, W.D., Guttmann, R.D., Morehouse, D.D., Aronoff, A., Gault, H.: A study of the relationship of virus-like particles and Australia antigen in liver. Human Pathology5, 209 (1974)

    Google Scholar 

  • Meyer zum Büschenfelde, K.H., Alberti, A., Arnold, W., Freudenberg, J.: Organ-specifity and diagnostic value of cell-mediated immunity against a liver specific membrane protein-studies in hepatic and non-hepatic diseases. Klin. Wschr.53, 1061 (1975)

    Google Scholar 

  • Nowoslawski, A., Brzosko, W.J., Madalinski, K., Krawzynski, K.: Cellular localisation of Australia-antigen in the liver of patients with lymphoproliferative disorders. Lancet I, 494 (1970)

    Google Scholar 

  • Nielsen, J.O., Dietrichson, O., Elling, P., Christoffersen, P.: Incidence and meaning of persistence of Australia-antigen in patients with acute viral hepatitis: development of chronic hepatitis. New Engl. J. Med.285, 1157 (1971)

    Google Scholar 

  • Nielsen, J.O., Elling, P.: Investigations of liver biopsies for Australia-antigen by immunofluorescent technique. Clin. exp. Immunol.9, 699 (1971)

    Google Scholar 

  • Stein, O., Fainaru, M., Stein, Y.: Virus like particles in cytoplasm of livers of Au-antigen carriers. Lancet II, 90 (1971)

    Google Scholar 

  • Stein, O., Feinaru, M., Stein, Y.: Virus-like particles in the cytoplasm of the livers of Australia antigen carriers. Am. J. Dis. Child.123, 313 (1972)

    Google Scholar 

  • Ten Kate, F.J.W., Feltkamp-Vroom, T., Helder, A.W., Roos, C.M., Van Blankenstein, M.: Demonstration of HB-antigens in liver tissue (Abstr.). Digestion10, 305 (1974)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. II. Med. Univ.-Klinik der Johannes Gutenberg-Universität Mainz, Germany

    W. Arnold, K. H. Meyer zum Büschenfelde, G. Hess & J. Knolle

Authors
  1. W. Arnold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. H. Meyer zum Büschenfelde
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Hess
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Knolle
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was supported by the Deutsche Forschungsgemeinschaft, ‘Sonderforschungsbereich’ 107 and Ar 106/1, Me 244/8 and 9, Mainz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arnold, W., Meyer zum Büschenfelde, K.H., Hess, G. et al. The diagnostic significance of intrahepatocellular hepatitis-B-surface-antigen (HB s Ag), hepatitis-B-core-antigen (HB c Ag) and IgG for the classification of inflammatory liver diseases. Klin Wochenschr 53, 1069–1074 (1975). https://doi.org/10.1007/BF01614383

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01614383

Schlüsselwörter

Key words

Search

Navigation