Clonal accumulation of V beta 5.1-positive cells in the liver of a patient with autoimmune cholangiopathy

Liver. 1997 Feb;17(1):7-12. doi: 10.1111/j.1600-0676.1997.tb00771.x.

Abstract

We describe a 43-year-old woman with clinical features compatible with autoimmune cholangiopathy recently reported by Ben Ari et al. She was negative for anti-mitochondrial antibody, positive for high titer anti-nuclear antibody with homogeneous pattern, high levels of serum immunoglobulin G and nearly normal levels of serum immunoglobulin M for more than five years. In the early stages of the disease, the elevations of serum transaminase, alkaline phosphatase and gamma-glutamyl transpeptidase were well controlled by the administration of ursodeoxycholic acid. After five years of follow-up, she showed the second exacerbation of liver function tests, which then rapidly improved by prednisone administration. To analyze the antigen diversity recognized by T-cells in the liver, T-cell receptor repertoire was examined by immuno-histochemistry. The liver biopsy obtained in the early stage showed clonal accumulation of V beta 5.1-positive cells in portal areas, which was found in patients neither with primary biliary cirrhosis nor autoimmune hepatitis. In conclusion, these data suggest that T-cell response in autoimmune cholangiopathy is different from those two autoimmune liver diseases, which may imply a distinct entity of the disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Antinuclear / metabolism
  • Autoimmune Diseases / immunology*
  • Biopsy
  • Cholangitis / immunology*
  • Female
  • Hepatitis / immunology
  • Humans
  • Immunoglobulin G / metabolism
  • Immunoglobulin M / metabolism
  • Immunohistochemistry
  • Liver / immunology*
  • Liver Cirrhosis, Biliary / immunology
  • Prednisone / therapeutic use
  • Receptors, Antigen, T-Cell, alpha-beta / metabolism*
  • T-Lymphocytes / metabolism*
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Antibodies, Antinuclear
  • Immunoglobulin G
  • Immunoglobulin M
  • Receptors, Antigen, T-Cell, alpha-beta
  • Ursodeoxycholic Acid
  • Prednisone