간경변증의 조직학적 활성도에 따른 간세포내 HBcAg의 발현율 및 발현양상

Abstract

[한글]

B형 간염바이러스가 간염, 간경변증, 그리고 간세포 암종의 발생에 있어서 중요한 원인이 된다는 사실이 밝혀진 후로 인체 감염시에 나타나는 B형 간염바이러스 표지자들이 점차로 규명되었고 간염의 임상적 진행과정과 표지자들의 연관성을 알아보려는 연구가 이루어져 왔다. Gudat등(1975)에 의해 HBcAg과 HBsAg의 발현여부와 간염의 여러 단계가 비교된 이후부터 최근에 시험관내 microcytotoxicity assay에 의한 실험에서 T 림프구의 표적이 HBsAg보다는 HBcAg이라는 연구 결과가 보고될 때까지 B형 간염바이러스에 대한 체내에서의 면역반응의 표적에 대하여 많은 논란이 있어왔다. 따라서 본 연구에서는 간경변증 환자에서 재생결절의 괴사-염증 활성도에 따른 HBcAg과 HBsAg의 발현양상을 조사하고 활성도와 관계있는 요인을 알아보고자 하였다. 간경변증으로 진단받은 46예를 대상으로 조직학적 활성도에 따른 HBcAg과 HBsAg의 간세포내 발현율과 발현양상을 조사하고 HBeAg의 유무와 결절의 크기를 표지자의 발현양상과 비교하여 다음과 같은 결론을 얻었다.

1. 간경변증 46예 중 조직내 HBcAg은 19예(41.3%)에서, HBsAg은 31예(67.4%)에서 발현하였다.

2. 간경변증의 조직학적 활성도는 조직내 HBcAg, 특히 세포질내의 HBcAg의 발현과 관련이 있었다.

3. 간경변증의 조직학적 활성도가 높을 수록 혈청내 HBeAg의 양성률이 의의 있게 높았다.

4. 간경변증와 조직학적 활성도와 조직내 HBsAg의 발현여부와는 관계가 없었고, 간경변증의 결절 크기와 조직내 HBcAg 및 HBsAg의 발현율/발현양상 사이에도 의의 있는 연관이 없었다.

이상의 결과로 보아 간경변증의 조직학적 활성도를 결정하는 인자는 HBcAg이며 특히 세포질에 발현된 HBcAg이 인체내에서 면역반응을 유발하고 염증반응의 표적이 될 것으로 사료된다.

The expression rate and pattern of HBcAg and HBsAg in the hepatocytes according to

the histologic activity of cirrhosis

Yoon Mi Jeen

Department of Medical science, The Graduate School, Yonsei University

(Directed by Professor Chanil Park)

Since the discovery of hepatitis B virus as the cause of hepatitis, liver

cirrhosis and hepatocellular carcinoma, many hepatitis B viral markers that appear

in infected individuals have been discovered and the efforts to understand the

relationship between the emergence of viral markers and the progression of

hepatitis have been performed. Gudat (1975) compared the expression of HBcAg and

HBsAg in various conditions and stages of hepatitis but the pattern of expression

of viral markers and its significance have not been understood. Recently it was

found by microcytotoxicity assay that HBcAg might be the target of T lymphocyte.

This study was attempted to identify any correlation of the tissue expression rate

and pattern of HBcAg and HBsAg with the histologic activity of 46 cases of liver

cirrhosis. The expression rate and pattern of HBcAg and HBsAg in relation to the

nodular size and positivity of serum HBeAg were also compared.

The result were as follows;

1. The expression rate of HBcAg in the liver was 41.3%(19/46), and that of HBsAg

was 67.4%(31/46).

2. The histologic activity of liver cirrhosis appeared to be correlated with the

expression of HBcAg, especially cytoplasmic HBcAg.

3. The positivity of serum HBeAg was sigfnificantly higher in active liver

cirrhosis.

4. There was no relation between the tissue expression of HBsAg and the

histologic activity of liver cirrhosis. Likewise no relation existed between the

nodular size and expression rate and pattern of HBcAg and HBsAg.

This study suggests that the tissue HBcAg, especially the cytoplasmic HBcAg is

the most likely factor determining the histologic activity of liver cirrhosis, and

that the cytoplasmic HBcAg may be the ultimate cause and target of host immune

response.

[영문]

Since the discovery of hepatitis B virus as the cause of hepatitis, liver cirrhosis and hepatocellular carcinoma, many hepatitis B viral markers that appear in infected individuals have been discovered and the efforts to understand the relationship between the emergence of viral markers and the progression of hepatitis have been performed. Gudat (1975) compared the expression of HBcAg and HBsAg in various conditions and stages of hepatitis but the pattern of expression of viral markers and its significance have not been understood. Recently it was found by microcytotoxicity assay that HBcAg might be the target of T lymphocyte. This study was attempted to identify any correlation of the tissue expression rate and pattern of HBcAg and HBsAg with the histologic activity of 46 cases of liver

cirrhosis. The expression rate and pattern of HBcAg and HBsAg in relation to the nodular size and positivity of serum HBeAg were also compared.

The result were as follows;

1. The expression rate of HBcAg in the liver was 41.3%(19/46), and that of HBsAg was 67.4%(31/46).

2. The histologic activity of liver cirrhosis appeared to be correlated with the expression of HBcAg, especially cytoplasmic HBcAg.

3. The positivity of serum HBeAg was sigfnificantly higher in active liver cirrhosis.

4. There was no relation between the tissue expression of HBsAg and the histologic activity of liver cirrhosis. Likewise no relation existed between the nodular size and expression rate and pattern of HBcAg and HBsAg.

This study suggests that the tissue HBcAg, especially the cytoplasmic HBcAg is the most likely factor determining the histologic activity of liver cirrhosis, and that the cytoplasmic HBcAg may be the ultimate cause and target of host immune response.