臨牀消化器内科 Vol.14 No.10(4)


特集名 B型肝炎 --最近の知見
題名 B型慢性肝炎の肝細胞障害とその制御
発刊年月 1999年 09月
著者 鈴木 義之 虎の門病院消化器科
著者 熊田 博光 虎の門病院消化器科
【 要旨 】 本邦における肝疾患患者の大半を占め,放置すれば肝硬変,肝癌へと進展していく慢性肝疾患の代表的なものであるB,C型慢性肝炎は,ウイルスそのものによる肝障害よりも宿主の免疫応答による肝障害がその主体をなしている.急性増悪の際にはCTLを中心とする細胞性免疫が関わっているのみならず,CD4陽性のhelper T(Th)細胞,TNF-αのようなサイトカインを含む液性免疫の関与も認められた.さらに,ウイルスの排除の際にはCTL,Thが重要な役割を演じ,これにB細胞やマクロファージから産生されるTNF-αが関わっていた.これらに加え,sFasLを含めた免疫応答の解析は重症化の指標となる可能性が示され,ステロイドによる肝炎鎮静化の過程にはFas-FasLを介した系が関与していると考えられた.
Theme Hepatitis B-Current Topics
Title Mechanism of Hepatocyte Injury from Viral Hepatitis
Author Yoshiyuki Suzuki Depertment of Gastroenterology, Toranomon Hospital
Author Hiromitsu Kumada Depertment of Gastroenterology, Toranomon Hospital
[ Summary ] Chronic B type hepatitis is a typical chronic liver disease which will progress to cirrhosis or hepatoma, if not treated. The majority of Japanese liver patients have this disease. Hepatocyto injuries from the immune response of the host are the main compose the main hepatocyto injury caused by viruses. Cellular immunity, which was caused by CTL affected cases of schub. It was also recognaized that CD4 intervented in humoral immunity. These contained cytokines, which seemed to be positive helper T cells, as was TNF. Furthermore, CTL and Th play important roles in cases of elimination of viruses. TNF-alpha which is produced from B cells and macrophages affected this. In addition to these, analysis of immune response which was able to contain FasL became the index of severe hepatitis suggesting the analysis of immune response, which was able to contain FasL. Fas-FasL was regarded as the series which participated in the healing of hepatitis through use of steroids.
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