Smith / Williams CBE Immunology of the Liver

Proceedings of an International Meeting Held at King's College Hospital Medical School London, on 6th and 7th July, 1970
1. Auflage 2014
ISBN: 978-1-4831-6281-2
Verlag: Elsevier Science & Techn.
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 330 Seiten, Web PDF

Immunology of the Liver contains the proceedings of an International Meeting held at King's College Hospital Medical School in London on July 6-7, 1970. The meeting provided a forum for discussing progress made in understanding the immunology of the liver and tackled topics ranging from the pathology of chronic hepatitis to the occurrence and distribution of tissue antibodies in liver diseases. Cell-mediated responses and manifestations of immunological damage are also explored. Comprised of 33 chapters, this book begins with an introduction to the clinical, morphological, and virological aspects of liver disease. In particular, the clinical spectrum of autoimmune liver disease is considered, along with the pathology of chronic hepatitis. Morphological and immunological studies on chronic aggressive hepatitis and primary biliary cirrhosis are presented. Subsequent chapters focus on antibodies related to mitochondria; leukocyte migration in active chronic hepatitis and primary biliary cirrhosis; immunologic observations and electron microscopy of halothane-induced hepatic injury; and humoral and delayed hypersensitivity in chronic hepatitis. The final sections deal with results of immunosuppressive therapy and the immunology of liver transplantation. This monograph will be of interest to immunologists, pathologists, physiologists, clinicians, and research workers in the field of medicine.

Autoren/Hrsg.

Smith, Martin

Williams CBE, Md

Inhaltsverzeichnis

1;Front Cover;1
2;Immunology of the Liver;4
3;Copyright Page;5
4;Table of Contents;8
5;EDITORS' FOREWORD;6
6;PARTICIPANTS;11
7;OPENING ADDRESS;14
8;PART I: CLINICAL, MORPHOLOGICAL AND VIROLOGICAL ASPECTS;16
8.1;CHAPTER 1. CLINICAL SPECTRUM OF AUTO-IMMUNE LIVER DISEASE;18
8.1.1;HEPATIC DISEASES FULFILLING CRITERIA OF PRIMARY AUTO-IMMUNE DISORDERS;18
8.1.2;ACTIVE CHRONIC HEPATITIS;19
8.1.3;PRIMARY BILIARY CIRRHOSIS;21
8.1.4;CRAIG-SCHIFF-BOONE SYNDROME;21
8.1.5;OCCURRENCE OF LIVER DISEASE IN THE "COLLAGEN DISORDERS";22
8.1.6;FELTY'S SYNDROME;22
8.1.7;PROBLEMS FOR THE FUTURE;25
8.1.8;REFERENCES;25
8.1.9;DISCUSSION;26
8.2;CHAPTER 2. THE PATHOLOGY OF CHRONIC HEPATITIS;28
8.2.1;CHRONIC PERSISTENT HEPATITIS;28
8.2.2;CHRONIC AGGRESSIVE HEPATITIS;28
8.2.3;PRIMARY BILIARY CIRRHOSIS;29
8.2.4;INTERRELATIONS OF ACUTE AND CHRONIC HEPATITIS;29
8.2.5;REFERENCES;31
8.2.6;DISCUSSION;31
8.3;CHAPTER 3. MORPHOLOGICAL AND IMMUNOLOGICAL STUDIES ON CHRONIC AGGRESSIVE HEPATITIS AND PRIMARY BILIARY CIRRHOSIS;34
8.3.1;INTRODUCTION;34
8.3.2;CLASSIFICATION OF CHRONIC HEPATITIS;34
8.3.3;ANALYSIS OF CHRONIC AGGRESSIVE HEPATITIS WITH SPECIAL REFERENCE TO PIECEMEAL NECROSIS;35
8.3.4;PRIMARY BILIARY CIRRHOSIS;40
8.3.5;CONCLUSIONS;41
8.3.6;REFERENCES;42
8.3.7;DISCUSSION;42
8.4;CHAPTER 4. THE AUSTRALIA ANTIGEN IN AUTO-IMMUNE LIVER DISEASE;45
8.4.1;INCIDENCE OF POSITIVE RESULTS;45
8.4.2;RESULTS IN ACTIVE CHRONIC HEPATITIS;46
8.4.3;TRANSMISSION OF Au ANTIGEN FROM MOTHER TO CHILD;47
8.4.4;FACTORS DETERMINING FREQUENCY OF Au ANTIGEN IN ACTIVE CHRONIC HEPATITIS;49
8.4.5;DIFFERENCES BETWEEN Au ANTIGEN POSITIVE AND NEGATIVE ACTIVE CHRONIC HEPATITIS;51
8.4.6;AETIOLOGY OF Au ANTIGEN NEGATIVE ACTIVE CHRONIC HEPATITIS;52
8.4.7;CONCLUSIONS;53
8.4.8;REFERENCES;54
8.4.9;DISCUSSION;54
8.5;CHAPTER 5. AUSTRALIA ANTIGEN IN THE CHILEAN POPULATION;56
8.5.1;INCIDENCE OF AUSTRALIA ANTIGEN IN DIFFERENT POPULATION GROUPS;56
8.5.2;FAMILY STUDIES;56
8.5.3;INCIDENCE OF AUSTRALIA ANTIGEN IN ACUTE AND CHRONIC LIVER DISEASES;57
8.5.4;ANTIBODY TO AUSTRALIA ANTIGEN IN CHILE;59
8.5.5;CONCLUSIONS;61
8.5.6;REFERENCES;61
8.5.7;DISCUSSION;61
8.6;CHAPTER 6. ELECTRON MICROSCOPIC OBSERVATIONS ON SH ANTIGEN USING POSITIVE STAINING;64
8.6.1;POSITIVE STAINING TECHNIQUE;64
8.6.2;DEMONSTRATION OF THREE COMPONENTS IN LARGER PARTICLES;66
8.6.3;CONCLUSIONS;66
8.6.4;REFERENCES;66
8.7;CHAPTER 7. ROUND TABLE DISCUSSION ON CLINICAL, MORPHOLOGICAL AND VIROLOGICAL ASPECTS;67
9;PART II: THE OCCURRENCE AND ROLE OF ANTIBODIES;70
9.1;CHAPTER 8. OCCURRENCE AND DISTRIBUTION OF TISSUE ANTIBODIES IN LIVER DISEASES;72
9.1.1;ACUTE VIRAL HEPATITIS;72
9.1.2;USE IN DIFFERENTIAL DIAGNOSIS;73
9.1.3;PATTERN OF ANTIBODIES IN CHRONIC LIVER DISEASE;74
9.1.4;MITOCHONDRIAL ANTIBODIES WITHOUT OVERT LIVER DISEASE;76
9.1.5;UNIFIED CONCEPT OF AUTO-IMMUNE LIVER DISEASE;82
9.1.6;REFERENCES;82
9.1.7;DISCUSSION;83
9.2;CHAPTER 9. ANTIBODIES RELATED TO MITOCHONDRIA: MULTIPLE SPECIFICITIES AND CLINICAL ASSOCIATIONS;86
9.2.1;LOCALIZATION OF MITOCHONDRIAL ANTIGEN;86
9.2.2;IMMUNOFLUORESCENT STUDIES ON VARIOUS TISSUES;87
9.2.3;MITOCHONDRIA ASSOCIATED ANTIBODIES IN SYPHILIS AND FALSE POSITIVE REACTORS;89
9.2.4;THE RELATION BETWEEN "M" AND CARDIOLIPIN ANTIBODIES;92
9.2.5;A FURTHER MITOCHONDRIAL ANTIBODY;93
9.2.6;CONCLUSIONS;95
9.2.7;REFERENCES;96
9.2.8;DISCUSSION;96
9.3;CHAPTER 10. ANTIBODIES TO BILE CANALICULI IN PATIENTS WITH CHRONIC ACTIVE LIVER DISEASE;99
9.3.1;DEFINITION AND THE SERIES EXAMINED;99
9.3.2;DEMONSTRATION OF BILE CANALICULAR ANTIBODY;100
9.3.3;INCIDENCE OF THE BILE CANALICULAR ANTIBODY;102
9.3.4;RELATION TO SERUM ANTIBODIES, BIOCHEMICAL AND CLINICAL CHANGES;103
9.3.5;EXAMINATION FOR BILE CANALICULAR ANTIBODY WITH HUMAN LIVER;107
9.3.6;CONCLUSION;107
9.3.7;DISCUSSION;108
9.4;CHAPTER 11. SERUM TOTAL HAEMOLYTIC COMPLEMENT IN LIVER DISEASE;110
9.4.1;THE COMPLEMENT SYSTEM AND PREVIOUS STUDIES IN LIVER DISEASE;110
9.4.2;TOTAL HAEMOLYTIC COMPLEMENT LEVELS IN PRESENT SERIES;110
9.4.3;POSSIBLE MECHANISMS INVOLVED;113
9.4.4;INCREASED UTILIZATION IN AUTO-IMMUNE LIVER DISEASE;114
9.4.5;CONCLUSION AND FINDINGS AFTER LIVER TRANSPLANTATION;114
9.4.6;REFERENCES;116
9.4.7;DISCUSSION;117
9.5;CHAPTER 12. PROPERTIES OF ANTIBODIES REACTING WITH HOMOLOGOUS AND HETEROLOGOUS LIVER MITOCHONDRIAL FRACTIONS;120
9.5.1;METHODS AND TECHNIQUES;120
9.5.2;RESULTS;121
9.5.3;DISCUSSION;130
9.5.4;REFERENCES;132
9.6;CHAPTER 13. ROUNDTABLE DISCUSSION ON THE OCCURRENCE AND ROLE OF ANTIBODIES;134
10;PART III: CELL MEDIATED RESPONSES AND MANIFESTATIONS OF IMMUNOLOGICAL DAMAGE;140
10.1;CHAPTER 14. THEORETICAL BASIS OF THE LEUCOCYTE MIGRATION TEST;142
10.1.1;DETAILS OF TECHNIQUE AND SIGNIFICANCE OF INHIBITION;142
10.1.2;MECHANISM OF MIGRATION AND INHIBITION;145
10.1.3;STUDIES WITH DIFFERENT CELL PREPARATIONS;145
10.1.4;IMPORTANCE OF AGGLUTINATION IN MECHANISM OF INHIBITION;147
10.1.5;OCCURRENCE OF STIMULATION OF MIGRATION UNDER CERTAIN CONDITIONS;147
10.1.6;INHIBITION OF MIGRATION AND PHAGOCYTIC ACTIVITY;149
10.1.7;SUMMARY;149
10.1.8;REFERENCES;149
10.1.9;DISCUSSION;150
10.2;CHAPTER 15. LEUCOCYTE MIGRATION IN ACTIVE CHRONIC HEPATITIS AND PRIMARY BILIARY CIRRHOSIS;152
10.2.1;LEUCOCYTE MIGRATION TECHNIQUE;152
10.2.2;EFFECT OF TEMPERATURE AND ENZYME INHIBITION ON MIGRATION;152
10.2.3;PREPARATION OF FOETAL LIVER ANTIGEN AND ITS EFFECT ON NORMAL LEUCOCYTES;154
10.2.4;RELATIONSHIP BETWEEN STIMULATION AND INHIBITION OF MIGRATION;154
10.2.5;RESULTS IN LIVER DISEASE;156
10.2.6;RELATION OF MIGRATION INDEX TO TREATMENT AND LIVER FUNCTION;158
10.2.7;CONCLUSIONS AND MODEL OF AUTO-IMMUNE LIVER DISEASE;160
10.2.8;REFERENCES;161
10.2.9;DISCUSSION;161
10.3;CHAPTER 16. THE ANERGIC STATE AND OTHER IMMUNOLOGICAL CHANGES IN PRIMARY BILIARY CIRRHOSIS;164
10.3.1;SKIN TESTING WITH TUBERCULIN OR DNCB;165
10.3.2;LYMPHOCYTE TRANSFORMATION TO PHYTOHAEMAGGLUTININ;166
10.3.3;RELATION OF ANERGY TO CLINICAL AND PATHOLOGICAL GRADE;167
10.3.4;RELATION BETWEEN LYMPHOCYTE TRANSFORMATION, TUBERCULIN AND DNCB TESTING;168
10.3.5;STUDIES WITH HAEMOCYANIN;168
10.3.6;CONCLUSIONS;169
10.3.7;REFERENCES;169
10.3.8;DISCUSSION;169
10.4;CHAPTER 17. INDUCTION AND TRANSFER OF AUTO-IMMUNE PERIDUCTULAR FIBROSIS IN INBRED RAT STRAINS - WITH EVIDENCE FOR PREDOMINANTLY CELL-MEDIATED PATHOGENESIS;172
10.4.1;DEVELOPMENT OF ANIMAL MODEL;172
10.4.2;HISTOLOGICAL APPEARANCES OF LIVER LESIONS;174
10.4.3;FINDINGS IN ANIMALS IMMUNIZED BY TRANSFER OF SPLEEN CELLS;177
10.4.4;QUANTITATION OF HISTOLOGICAL CHANGES;177
10.4.5;CHANGES IN SKIN REACTIVITY;179
10.4.6;RELATIVE ROLES OF CELLULAR VERSUS ANTIBODY AUTO-IMMUNITY;182
10.4.7;CYTOTOXICITY OF LYMPHOCYTES;182
10.4.8;REFERENCES;183
10.4.9;DISCUSSION;183
10.5;CHAPTER 18. CHARACTERIZATION AND ISOLATION OF LIVER SPECIFIC PROTEINS IN DIFFERENT SPECIES: THEIR IMPORTANCE FOR EXPERIMENTAL MODELS AND IN DIAGNOSIS OF CHRONIC HEPATITIS;186
10.5.1;OCCURRENCE OF LIVER SPECIFIC AUTO-ANTIBODY;186
10.5.2;INDUCTION OF TOLERANCE USING HUMAN LIVER PROTEIN;188
10.5.3;PRODUCTION OF ACTIVE CHRONIC HEPATITIS BY IMMUNIZATION PROCEDURES;192
10.5.4;DEMONSTRATION OF SPECIFICALLY SENSITIZED CELLS IN HUMAN ACTIVE CHRONIC HEPATITIS;193
10.5.5;STUDIES WITH PERFUSED RAT LIVER;196
10.5.6;CONCLUSION;201
10.5.7;DISCUSSION;202
10.6;CHAPTER 19. IMMUNOLOGIC OBSERVATIONS AND ELECTRON MICROSCOPY OF HALOTHANE -INDUCED HEPATIC INJURY;203
10.6.1;CERTAIN HISTOLOGICAL FEATURES;203
10.6.2;TIMING OF ONSET;203
10.6.3;SIGNIFICANCE OF POST-OPERATIVE FEVER;203
10.6.4;OCCURRENCE OF MITOCHONDRIAL ANTIBODIES;204
10.6.5;ELECTRON MICROSCOPY CHANGES;204
10.6.6;LYMPHOCYTE TRANSFORMATION;205
10.6.7;ROLE OF SENSITIZATION;206
10.6.8;ACKNOWLEDGEMENT;207
10.6.9;REFERENCES;207
10.6.10;DISCUSSION;207
10.7;CHAPTER 20. STUDIES ON MULTI-SYSTEM INVOLVEMENT IN ACTIVE CHRONIC HEPATITIS AND PRIMARY BILIARY CIRRHOSIS;211
10.7.1;DEFINITION OF SJÖGREN'S SYNDROME;211
10.7.2;SJÖGREN'S SYNDROME IN AUTO-IMMUNE LIVER DISEASE;212
10.7.3;RENAL TUBULAR ACIDOSIS;214
10.7.4;OTHER SYSTEMIC MANIFESTATIONS;216
10.7.5;REFERENCES;219
10.7.6;DISCUSSION;219
10.8;CHAPTER 21. SOME ASPECTS OF HUMORAL AND DELAYED HYPERSENSITIVITY IN CHRONIC HEPATITIS;221
10.8.1;LYMPHOCYTE TRANSFORMATION IN LIVER DISEASE;221
10.8.2;PATIENTS STUDIED AND TECHNIQUES;222
10.8.3;RESULTS;222
10.8.4;CONCLUSIONS;226
10.8.5;REFERENCES;226
10.9;CHAPTER 22. ROUND TABLE DISCUSSION ON CELL MEDIATED RESPONSES AND MANIFESTATIONS OF IMMUNOLOGICAL DAMAGE;227
11;PART IV: RESULTS OF IMMUNOSUPPRESSIVE THERAPY;232
11.1;CHAPTER 23. PROBLEMS OF MULTI-CENTRE TRIALS, ILLUSTRATED BY THE COPENHAGEN TRIAL OF STEROID THERAPY IN CIRRHOSIS;234
11.1.1;THE RESULTS;234
11.1.2;REGISTRATION AND PROCESSING SYSTEM;238
11.1.3;CONCLUSIONS;239
11.1.4;REFERENCES;243
11.1.5;DISCUSSION;243
11.2;CHAPTER 24. PREDNISOLONE THERAPY IN ACTIVE CHRONIC HEPATITIS;244
11.2.1;PATIENTS STUDIED AND BASE-LINE BIOCHEMICAL DATA;244
11.2.2;CLINICAL COURSE AND MORTALITY;248
11.2.3;CHANGES IN BIOCHEMICAL INDICES;249
11.2.4;REFERENCES;249
11.2.5;DISCUSSION;250
11.3;CHAPTER 25. A LONG-TERM STUDY OF IMMUNOSUPPRESSIVE THERAPY IN ACTIVE CHRONIC HEPATITIS;251
11.3.1;SELECTION OF PATIENTS;251
11.3.2;RESULTS TO-DATE;253
11.3.3;OVERALL BENEFIT AND TOXICITY;253
11.3.4;REFERENCES;253
11.3.5;DISCUSSION;259
11.4;CHAPTER 26. TREATMENT OF CHRONIC HEPATITIS WITH AZATHIOPRINE AND PREDNISONE COMBINED;260
11.4.1;SELECTION OF PATIENTS;260
11.4.2;RESULTS OF THERAPY;261
11.4.3;DETAILS OF THERAPEUTIC SCHEDULE;261
11.4.4;DISCONTINUATION OF THERAPY;264
11.4.5;REFERENCE;266
11.5;CHAPTER 27. A CONTROLLED TRIAL OF PREDNISONE AND AZATHIOPRINE IN ACTIVE CHRONIC HEPATITIS;267
11.5.1;DESCRIPTION OF TRIAL AND SELECTION OF PATIENTS;267
11.5.2;COMPARABILITY OF CONTROL AND TREATED GROUPS;267
11.5.3;CRITERIA FOR IMPROVEMENT;269
11.5.4;RESPONSE TO TREATMENT;269
11.5.5;CONCLUSIONS;272
11.5.6;ADDENDUM;272
11.5.7;DISCUSSION;273
11.6;CHAPTER 28. EXPERIENCE WITH AZATHIOPRINE IN PRIMARY BILIARY CIRRHOSIS;275
11.6.1;SELECTION OF PATIENTS;275
11.6.2;DURATION OF TRIAL;275
11.6.3;OVERALL RESULTS;276
11.6.4;CONCLUSIONS;277
11.6.5;DISCUSSION;278
11.7;CHAPTER 29. ROUND TABLE DISCUSSION ON RESULTS OF IMMUNO-SUPPRESSIVE THERAPY;280
12;PART V: SOME ASPECTS OF THE IMMUNOLOGY OF LIVER TRANSPLANTATION;286
12.1;CHAPTER 30. RESULTS WITH RELATION TO TISSUE TYPING AND RECURRENCE OF PRIMARY HEPATOMA;288
12.1.1;IMMEDIATE RESULTS;288
12.1.2;DETAILS OF TWO LONG TERM SURVIVORS;289
12.1.3;THE OVERALL RESULTS;290
12.1.4;OCCURRENCE OF JAUNDICE;291
12.1.5;RELATION BETWEEN REJECTION AND TISSUE TYPING;292
12.1.6;RECURRENCE OF HEPATOMA AFTER TRANSPLANTATION;294
12.1.7;SUMMARY;294
12.1.8;ACKNOWLEDGEMENT;295
12.1.9;REFERENCES;295
12.1.10;DISCUSSION;295
12.2;CHAPTER 31. THE LEUCOCYTE MIGRATION TEST IN ASSESSMENT OF REJECTION;297
12.2.1;EARLY REJECTION EPISODES;297
12.2.2;LATER CHANGES;300
12.2.3;CONFLICTING FINDINGS IN ONE PATIENT;303
12.2.4;CONCLUSIONS;303
12.2.5;REFERENCES;303
12.2.6;DISCUSSION;304
12.3;CHAPTER 32. ASSAY OF SERUM IMMUNOSUPPRESSIVE ACTIVITY AFTER LIVER TRANSPLANTATION;306
12.3.1;THE TEST SYSTEM;306
12.3.2;SERUM LEVELS AFTER TRANSPLANTATION;308
12.3.3;SERUM ASSAY RELATED TO TYPE OF DISTURBED LIVER FUNCTION;311
12.3.4;CONCLUSIONS;313
12.3.5;REFERENCES;313
12.3.6;DISCUSSION;313
12.4;CHAPTER 33. IMMUNOLOGICAL ASPECTS OF ORGAN GRAFTING IN THE PIG;315
12.4.1;PROLONGED SURVIVAL OF LIVER ALLOGRAFTS IN THE PIG;315
12.4.2;PROTECTIVE EFFECT OF A LIVER GRAFT;316
12.4.3;STUDIES WITH ANTIGEN EXTRACTS;317
12.4.4;APPLICATION OF FINDINGS TO OTHER SPECIES;318
12.4.5;DISCUSSION;319
13;INDEX;324