MORPHOLOGIC FEATURES OF TISSUE REORGANIZATION PROGRESSION/REGRESSION IN CHRONIC NON-ALCOHOLIC STEATOHEPATITIS AND VIRAL HEPATITIS C

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MORPHOLOGIC FEATURES OF TISSUE REORGANIZATION PROGRESSION/REGRESSION IN CHRONIC NON-ALCOHOLIC STEATOHEPATITIS AND VIRAL HEPATITIS C

Journal Title: Гепатологія - Year 2016, Vol 32, Issue 2

Abstract

Course and prognosis of chronic liver diseases depend on the degree of tissue reorganization that is the main sign of cirrhosis. Recent studies have demonstrated that fi brosis may decrease with time in humans and experimental animals if the disease activity becomes quiescent. Now it is proved that progressive liver reorganization develops in parallel with the opposite process – repair which results in removing of fi brotic tissue and repopulation of parenchyma. Th e aim of the work is to study morphologic features of progression/regression of tissue reorganization in chronic nonalcoholic steatohepatitis and viral hepatitis C Material and methods. Sixty eight autopsy cases of NASH and HCV were enrolled in the study. Viral genesis was proved by serological study (RNA HCV) and morphologic signs of HCV (METAVIR criteria). Diagnosis of NASH was verifi ed by the features of metabolic syndrome and hepatic changes (Brunt criteria). In all cases patients died of extrahepatic diseases (myocardial infarction, stroke, pancreonecrosis et al.). Liver pathology included fi brosis F2-F3 (METAVIR) and absence of liver cirrhosis signs. Pathohistologic analysis is based on the evaluation of progression parameters – ductular reaction, fi brosis and features of regression – perforated delicate septa, isolated thick collagen fi bers, approximation of portal tracts/central veins, aberrant parenchymal vessels. Statistical analysis was performed using Student’s test. P < 0.05 was considered signifi cant. Results and discussion. In chronic steatohepatitis, lobular ductular reaction(31.6±0.4%), associated with mild fi brosis (F2), prevailed. Signs of regression include perforated delicate septa (51.8±0.5%) and aberrant vessels (42.3±0.2%), in the parenchymal compartment. Such fi ndings are the result of lobular “niche regeneration” activation with ductular reaction in the parenchymal compartment. Activation of hepatic precursor cells results in eff ective parenchymal repopulation because of their association with mild fi brosis and signs of septal absorbtion with aberrant vessels. In viral hepatitis the main lesions developed at the interface of parenchymal/ stromal compartments (periportal “niche regeneration” in the area of canals of Hering). Periseptal ductular reaction in these cases (43.4±0.5%) was associated with more prominent fi brosis (F3) (54.3±0.5%) and another set of regression parameters: isolated thick collagen fi bers, approximation of portal tracts/central veins (41.1±0.3%). Likelihood in viral hepatitis activation of periportal “niche regeneration” results not only in parenchymal repopulation but also induces severe fi brosis followed by nodular tissue reorganization typical for cirrhosis. Regression parameters revealed in viral hepatitis C show distinct residual changes caused by incomplete septal absorption and loss of normal balance between the tissue structures. Conclusions. Such combined pathohistologic analysis based on the complex evaluation of ductular reaction and signs of fi brosis progression/regression allows receiving a complete picture of liver tissue reorganization in the individual case and opens new perspectives in the understanding of balance between the repair and fi brosis in chronic liver diseases.

Authors and Affiliations

E Gavrilyuk

Keywords

THE INFLUENCE OF POLYMORPHISM ASP299GLY OF TLR4 GENE AND GLN11LEU OF TLR7 GENE ON THE EFFICIENCY OF ANTIVIRAL THERAPY OF CHRONIC HEPATITIS C

Th e aim of the study was to analyze the infl uence of polymorphism Asp299Gly of TLR4 gene and Gln11Leu of TLR7 gene on the eff ectiveness of antiviral therapy (AVT) of chronic hepatitis C (CHC) with pegylated interfe...

EP ID EP250357
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