CD40、HLA-DR在自身免疫性肝病Kupffer细胞的表达变化

Expression of CD40 and HLA-DR in Kupffer Cells of Autoimmune Liver Disease

目的研究自身免疫性肝病Kupffer细胞抗原呈递分子的表达变化。方法按照自身免疫性肝炎、原发性胆汁性胆管炎的诊断标准进行分组,脂肪肝作为对照组。入选患者的肝穿石蜡切片进行CD40、HLA-DR免疫组化染色,随机选取10个显微镜高倍视野(×400倍),观察染色情况,并统计CD40+、HLA-DR+细胞数目。结果 CD40在自身免疫性肝病组的阳性细胞数低于对照组。CD40免疫组化阳性产物呈棕褐色或棕黄色颗粒状着色,主要位于细胞膜,少部分位于细胞质。分别计算自身免疫性肝炎、原发性胆汁性胆管炎和脂肪肝3组肝穿标本中的CD40阳性的kupffer细胞数绝对值,结果显示:3组间CD40阳性的kupffer细胞的计数绝对值比较具有统计学意义(P=0.04,P<0.05)。AIH与PBC组比较无统计学差异(P=0.428,P>0.05);AIH与脂肪肝组比较具有统计学意义(P=0.02,P<0.05)。免疫组化中,HLA-DR在自身免疫性肝病组的阳性细胞数低于对照组,HLA-DR免疫组化染色阳性产物呈棕褐色颗粒,主要位于细胞膜。分别统计AIH、PBC和脂肪肝3组的HLA-DR阳性的kupffer细胞计数的绝对值,结果显示3组比较其结果具有统计学意义(P=0.015,P<0.05),AIH与脂肪肝组比较具有统计学意义(P=0.017,P<0.05)。CD40、HLA-DR结果与肝功能、凝血功能化验检查结果进行相关性分析,结果显示具有相关性。结论自身免疫性肝病患者组的肝穿石蜡切片免疫组化染色显示CD40及HLA-DR表达较脂肪肝组数量减少,且CD40、HLA-DR与自身免疫性肝病的转氨酶变化相关,提示自身免疫性肝病可能存在kupffer细胞抗原呈递功能减弱,是导致自身免疫性肝病肝损害的原因之一。

Objective To study the expression changes of Kupffer cell antigen presenting molecules in autoimmune liver disease.Methods Patients were divided into autoimmune hepatitis（AIH）group,primary biliary cholangitis（PBC）group,while fatty liver l hepatitis as a control group.Immunohistochemical staining of CD40 and HLA-DR were performed,random selection of 10 high-power mirror field of vision（400 times）,then compare the differences with variance analysis.Results The number of the positive cells in the autoimmune liver disease group was lower than that in the control group.The positive product is brown granular or brown stain,mainly located in the cell membrane,little part is located in the cytoplasm.The results showed that there was statistical significance（P=0.04,P 0.05）among the three groups.There was no significant difference between the AIH group and the PBC group（P=0.428,P〉0.05）.There was significant difference between AIH and NALD（P=0.02,P〈0.05）.（3）HLA-DR in autoimmune hepatitis group,the positive cells was lower than the control group,the staining positive products were brown particles,mainly located in the cell membrane.The absolute value of HLA-DR positive Kupffer cell count was calculated and the results showed that the 3 groups had statistical significance（P=0.015,P〈0.05）,There was no statistically significant between AIH and NALD（P=0.017,P〈0.05）.（4）CD40 and HLA-DR showed a positive correlation.（5）CD40,HLADR showed correlation withALT/AST in AIH.Conclusion CD40 and HLA-DR in patients with autoimmune liver disease was less than that of non autoimmune liver disease,and CD40,HLA-DR and liver function damage is correlated.It suggested that autoimmune liver disease may be weakened by Kupffer cell antigen presenting function,which is one of the causes of liver damage in autoimmune liver diseases.