Expression of bcl-2 in the liver tissue of patients with autoimmune liver diseases and chronic hepatitis C

Abstract

Changes of apoptosis in liver cells are observed in patients with lesions of various etiologies. The aim of this study was a comparative evaluation of the expression of the antiapoptotic factor bcl-2 in liver at CHC and autoimmune liver diseases (AiLD). Immunohistochemical assessment of bcl -2 expression in biliary epithelial cells and non-parenchymal cells were performed in liver biopsies from 33 patients with liver disease (7 – with autoimmune hepatitis (AIH), 10 – with primary biliary cirrhosis (PBC), 6 – overlap syndrome AIH / PBC and 10 – with chronic hepatitis (CHC)). In all groups, the greatest density of bcl-2+ non-parenchymal cells showed in the portal area, moreover, the expression of bcl-2 in non-parenchymal cells at CHC patients was significantly lower than in the other groups. The interrelation between necroinflammatory activity and bcl-2 expression in non-parenchymal liver cells was found (r = 0,35), the relationship with the stage of fibrosis was not found. We were obtained statistically significant differences in bcl-2 expression in biliary epithelial cells by semi-quantitative assessment: in the majority of patients with PBC bcl-2 was expressed over 2/3 of cholangiocytes, at AIH and AIH/PBC patients bcl-2+ reaction was observed in 1/3–2/3 biliary cells, and all CHC patients had bcl-2 expression less than in 1/3 cholangiocytes (p <0.05). Differences between AIH and AIH/PBC of bcl-2 expression in cholangiocytes were not observed. The intensity of bcl-2 expression in biliary epithelial cells can be used as a differential diagnostic marker when necessary to differentiate AIH and CHC in controversial situations and, most importantly, AIH / PBC and PBC.

Keywords

• аутоиммунный гепатит
• первичный билиарный цирроз
• хронический гепатит с
• перекрестный синдром
• апоптоз
• bcl-2
• дифференциальная диагностика