Immunoglobulin and complement depositions in the liver of chronic hepatitis patients.

Background/aims: Liver biopsy is a cornerstone in the management of chronic hepatitis patients. In biopsy, liver cell damage as well as severity of inflammatory cell infiltration in the parenchyma and portal tracts are evaluated. There are some other inflammatory markers such as complements (C) and immunoglobulins (Ig), which are involved in the pathogenesis of inflammation. This study was carried out to investigate the status of Ig and C depositions in the liver of chronic hepatitis cases.

Methodology: Two biopsy samples were taken from patients who were scheduled for liver biopsy for chronic hepatitis. The acetone fixed sections were incubated with fluorescin-conjugated anti human IgG, IgA, IgM, C3 and C4. Ten samples of non-hepatitis control cases were provided during elective cholecystectomy.

Results: Deposition of IgG, IgM, and Cs were seen in the parenchyma in HBV, HCV and non viral hepatitis cases. The parenchyma of control liver did not show any deposition of IgG, IgM, and Cs. IgA was found in the parenchyma of 3 control cases. C3 deposition in the parenchyma had significant association with enzyme rising in HCV (p=0.001) and non viral groups (p=0.004). C4 deposition in the parenchyma was also associated with enzyme rising in HCV cases (p=0.01). There was an association between ALT elevations with the presence of IgM in the parenchyma in HBV (p=0.01) and HCV (p=0.03) groups. Mantel-Haenszel chi2 test (for evaluation of the effects of stage and grade) confirmed that the depositions of C3 and C4 in HCV and C3 in nonviral hepatitis have positive association with enzyme rising.

Conclusions: Presence of IgM, IgG, C3, and C4 in the liver parenchyma is abnormal and may be helpful in histological evaluation in chronic hepatitis. Parenchymal (but not portal) depositions of C3 and C4 in HCV and non-viral hepatitis cases show close association with elevation of liver enzymes.