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- Title
Correlation of Infiltration by T Cells and Macrophages with the Severity of Liver Damage in Drug-Induced Liver Injury: Implications in Responsiveness to Steroid Therapy.
- Authors
Hyun Yang; Pil Soo Sung; Jae Jun Lee; Hee Chul Nam; Jeong Won Jang; Eun Sun Jung; Si Hyun Bae; Jong Young Choi; Seung Kew Yoon
- Abstract
Background/Aims Drug-induced liver injury (DILI) is liver injury caused by the interplay between drugs, their metabolites and host immune response. The aim of this study is to characterize liver infiltrating immune cells in DILI and to evaluate the correlation between infiltrating immune cells and clinical outcome. Methods From January 2017 to February 2019, 23 patients with DILI were prospectively enrolled in this study. Diagnosis of DILI was based on patient medication history after exclusion of other etiology (virus, alcohol, autoimmune, ischemic hepatitis or extrahepatic obstruction of the bile duct). Liver biopsy was performed, and immunohistochemical stain for CD3, CD68, CD20, and CD38 was done. Experienced pathologist confirmed the pathologic and immunohistochemical findings. Results The causes included health foods or dietary supplements (n=8, 34.8%), folk remedies (n=6, 26.1%), medications (n=4, 17.4%), herb (n=3, 13.0%). Eighteen patients (78.3%) treated with steroid. Two patients progressed to hepatic failure and recovered after steroid treatment. All patients were completely recovered from DILI at 1 month after diagnosis, whether they were treated with steroid or not. The frequency of infiltrated T cells, macrophages, and B cells was quantified by immunohistochemistry. The amounts of T cells, showed linearly ascending correlation with total bilirubin (r=0.370, p=0.030) and Model for End-Stage Liver Disease (MELD) score (r=0.340, p=0.047). The amounts of macrophages showed linearly ascending correlation with total bilirubin (r=0.401, p=0.020), aspartate aminotransferase (r=0.445, p=0.010), and MELD score (r=0.402, p=0.020). Conclusions In this study, we found the positive correlation between the amounts of T cells and macrophages infiltrations and deterioration of liver function in DILI. Favorable responses to steroid therapy suggest that vigorous innate and adaptive immune responses play critical roles in DILI.
- Subjects
T cells; LIVER injuries; MACROPHAGES; SEEPAGE; ASPARTATE aminotransferase
- Publication
Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p26
- ISSN
1976-2283
- Publication type
Article