Clinical Features Of Autoimmune Hepatitis And FoxP3Expression In Liver Tissue

AIM:To analyze Autoimmune hepatitis in the clinical, laboratory and pathology characteristics and research the expression of FoxP3+, CD4+, CD8+T lymphocytes in liver tissue of AIH patients.Method:The clinical characteristics, biochemical, immunological indexes and part of the histopathologic characteristics of57AIH patients in Tianjin the second people’s hospital were retrospectively analyzed. Using immunohistochemical method,We detected FoxP3+, CD4+, CD8+T lymphocyte in liver tissue of20patients with AIH and FoxP3+T lymphocyte in liver tissue of20CHB patients.Results:1. Most of the AIH patients are female with45to59years old. The first-degree relatives of16patients suffered from autoimmune diseases.2. AIH Patients’liver function is given priority to with elevated ALT and AST, and the increase in AST and ALT levels is more marked than that observed for γGT and ALP. The ANA positive rate (98.00%)was the highest, but7cases (12.28%) patients’ autoantibody were all negative.3. pathological changes of AIH Patients’liver tissue is given priority to with interface of hepatitis (93.02%), followed by collect ymphocytic and plasma cell infiltration (86.05%), and a few rosette sample change (32.56%).4. FoxP3+T lymphocytes were detected slightly in1-3collect abbacy infiltration of part AIH patients(11/20,55.00%), which express mainly in inflammatory cells infiltrating the portal area obviously and accidentally in hepatic sinus. All AIH patients’ liver portal area are all within CD4+, CD8+T lymphocyte infiltration.5. There are no statistical difference in age, the proportion of CD4+/CD8+T lymphocytes in liver tissue, integral of AIH, the serum AST when liver biopsied, yGT, TBIL level and liver tissue Knodell scoreintrahepatic between FoxP3expression positive groups and negative groups in AIH patients(p>0.05). There are significantly statistical difference in the serum ALT when liver biopsied between them(p=0.014).6. FoxP3expression positive ratio in liver tissue of AIH patients is higher than that of CHB patients (11/20vs11/20), but there no statistical difference (P>0.05).Conclusion:1. Most of the AIH patients are middle-aged female. the first-degree relatives of16patients suffered from autoimmune diseases at the same time.so we should pay attention to first-degree relatives with autoimmune disease situation for suspected AIH patients to help to improve AIH diagnostic rate.2. ANA is the most common AIH autoantibodies; For patients whose autoantibodies are all negative we can’t rule out the possibility of AIH, and we should detect autoantibodies at regular intervals or use standardized immunological detection method to assist diagnosis in order to avoid missed diagnosis.3. Interface hepatitis is the most common features of liver tissue pathology change of AIH patients, but not specific change, liver pathologic diagnosis of AIH diagnosis has important significance, but it is not the gold standard of diagnosis.4. There are significantly statistical difference in the serum AST when liver biopsied between FoxP3expression positive groups and negative groups in AIH patients, which hints whether FoxP3+T lymphocytes express in patients with AIH liver tissue may be associated with inflammation, the more obvious inflammation is, the more likely T-regs express in the liver tissue. Expression of T-regs in the liver may be a role of the body to protect itself. In addition, serum AST level of AIH patients with intrahepatic FoxP3positive expression is significantly higher than that in negative group. No statistical difference may be associated with the less sample cases.5. FoxP3express slightly only in part of the portal area of some CHB patients’liver tissue, which is similar to AIH group. It suggests T-regs also may be a protective mechanism of the body of CHB patients. But FoxP3expression positive ratio in liver tissue of AIH patients is higher than that of CHB patients, which means airframe adjustment ability of self-protection of AIH is better than that of CHB when liver inflammation appeared, but more research is needed. The lack of statistical difference may be associated with the less sample cases.6. All AIH patients’liver portal area are all within CD4+, CD8+T lymphocyte infiltration, which verify that liver autoimmune response of AIH patients mainly is mainly mediated by the CD4+, CD8+T cell in further.