Elevated intracellular IFN-gamma levels in circulating CD8+ lymphocytes in patients with fulminant hepatitis.
OBJECTIVE
Fulminant hepatitis usually takes a rapidly progressive course, terminating in death within a short period. Experimental studies have demonstrated that immunological mechanisms play an important role, especially those involving virus-specific CD8+ cytotoxic T lymphocytes and their production of interferon-gamma (IFN-gamma). However, there are no immunological markers for prediction of the development of fulminant hepatitis in man.


METHODS
Peripheral blood lymphocytes from four patients with fulminant hepatitis, six with acute hepatitis and 11 healthy volunteers as normal controls were analyzed. Intracellular IFN-gamma production in both CD8 positive and negative T lymphocytes was assessed by flow cytometry.


RESULTS
Populations of CD8+ IFN-gamma+ T lymphocytes were significantly increased in patients with fulminant hepatitis, as compared with those with acute hepatitis and normal controls. Production of IFN-gamma in CD8+ T lymphocytes of patients with fulminant hepatitis was also elevated, furthermore significantly correlating with the prothrombin time (r=-0.64, p<0.01).


CONCLUSIONS
The capacity for IFN-gamma production by CD8+ lymphocytes is up-regulated in fulminant hepatitis, and this may be important for the development of fulminant hepatitis.
Kimura
K
K
First Department of Internal Medicine, Gifu University School of Medicine, Japan.
Ando
K
K
Tomita
E
E
Ohnishi
H
H
Ishikawa
T
T
Kakumu
S
S
Muto
Y
Y
Moriwaki
H
H
D000328:Adult; D000368:Aged; D000954:Antigens, Surface / Q000097:blood; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D006501:Hepatic Encephalopathy / Q000097:blood* / Q000821:virology; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D007425:Intracellular Membranes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
D000954:Antigens, Surface; D007371:Interferon-gamma