Objective We screened autoimmune hepatitis (AIH) from patients who had abnormal liver function without any viral marker in serum, and investigated the clinical and pathological features of AIH type Ⅰ. Methods According to the revised descriptive criteria and scoring system for diagnosis of autoimmune hepatitis proposed by the International Autoimmune Hepatitis Group, we examined the clinical and pathological characteristics of the patients who were diagnosed as AIH type Ⅰ. Results All patients (32 cases) diagnosed as AIH type Ⅰ were female. The age distribution showed a single peak in the decades of the fifties and sixties. Liver function test of these patients showed hepatic profile. Twenty eight patients (87.5%) had hypergammaglobulinemia, 26(81.3%) and elevated serum IgG level. Twenty six cases were positive for antinuclear antibody (ANA). Twelve patients (37.5%) had concurrent autoimmune diseases. Among fifteen patients who underwent liver biopsy, interface hepatitis and lobular hepatitis were observed in 11(73.3%) and 5(33.3%) patients, respectively. Rosetting of liver cells and liver fibrosis or cirrhosis were also detected in 3(20%) and 6(40%) patients respectively. Twenty one patients (65.5%) were considered to have a complete response to immunosuppressive therapy; 9(28.1%) relapsed; and 12(37.5%) sustained remission. Conclusions Autoimmune hepatitis type Ⅰ is mainly diagnosed in middle aged women, characterized by interface hepatitis on histologic examination, the presence of circulating autoantibody, hypergammaglobulinemia and response to immunosupressive treatment.

Objective To observe the morphological characteristics of oval cells in human chronic liver diseases, and determine whether there is a relationship between the number of oval cells and liver fibrotic stage. Methods Oval cells were detected in paraffin bedded liver sections of 3 normal subjects (as controls) and 29 chronic liver diseases, using histoimmunochemistry. Cells were counted if they fulfiled the morphological criteria for oval cells and showed cytoplasmic staining. Results Oval cells were not observed in normal livers. In chronic liver diseases, oval cells were located predominantly in the periportal region and fibrosis septa, characterized by an ovoid nucleus, small size, and scant cytoplasmic. The number of oval cells increased significantly ( F=22.60, P

Objective To investigate the role of apoptosis in hepatocyte injury in tyep Ⅰ autoimmune hepatitis (AIH). Methods Using transferase mediated UTP biotin nick end labling (TUNEL) technique and immunohistochemistry with anti Fas antibody, we detected apoptosis cells in 10 liver biopsy samples and 3 control livers obtained from normal subjects. Result Hepatocytes in all AIH liver tissues were positively stained by TUNEL and anti Fas antibody in various degree. In contrast, control tissues did not show DNA fragmentation or positive stain with anti Fas antibody. A significant correlation was seen between apoptosis index (AI) and necroinflammatory grading ( r =0.45, P

OBJECTIVETo analyze the association between alleles of HLA-DRB1 and type I autoimmune hepatitis (AIH) in patients from Shanghai, China.

METHODSIn 32 Chinese patients with type I AIH and 48 healthy controls in Shanghai area, polymerase chain reaction amplification with sequence-specific primers (PCR-SSP) was performed to examine the association of the alleles of HLA-DRB1 and its subtypes with type I AIH.

RESULTSHLA-DRB1 typing by PCR-SSP showed that DR4 had a significantly increased frequency among patients with AIH versus healthy control (46.9% versus 20.8%; relative risk=3.35, chi(2)=5.99, P=0.014). No other alleles differed significantly between the two groups. In subtypes of DRB1*04, there was a trend for an increase in gene frequency of DRB1*0405 increased in patients with type I AIH versus healthy controls (21.9% vs 6.3%, chi(2)=4.23, P=0.04, but Pc=0.08). The frequency of arginine at position HLA-DR beta 71 of third hypervariable region significantly increased among patients with AIH versus healthy control (46.9% versus 18.8%, chi(2)=7.14, P=0.008).

CONCLUSIONSType I AIH in Chinese patients of Shanghai area is associated with HLA-DR4 and arginine at position DR beta 71 of third hypervariable region

Alleles ; Asian Continental Ancestry Group ; China ; DNA Primers ; Gene Frequency ; HLA-DR4 Antigen ; HLA-DRB1 Chains ; genetics ; Hepatitis, Autoimmune ; genetics ; Humans ; Polymerase Chain Reaction

Autoimmune liver diseases (AILDs),including mainly autoimmune hepatitis (AIH),primary biliary cholangitis (PBC),primary sclerosing cholangitis (PSC),IgG4-related sclerosing cholangitis (IgG4-SC),and overlap syndromes,are characterized by circulating autoantibodies,inflammatory liver histology,and increased level of serum immunoglobulins. Early diagnosis and management can significantly improve the prognosis of patients and their quality of life. This editorial focused on the research progress and difficulties encountered in studies on AILDs in China.

From the perspective of doctor-patient relationship, this paper put forward the external and internal paths led by the social atmosphere value of respecting medicine and health. The external path is that lead the mass media and publicize positive public opinion; popularize medical knowledge and narrow the distance between doctors and patients; strengthen humanistic care and relieve psychological stress; establish positive models and carry forward advanced deeds; increase salary packages and embody labor value; improve the practice environment and implement safety initiatives. The internal path is that strengthen professional ability and improve professional quality; improve communication skills and enhance mutual understanding; pay attention to psychological counseling and psychological protection; establish prevention awareness and protect personal safety; strengthen professional belief and create an atmosphere of respecting doctors, so as to make respect for medicine and health become common practice.