Serum amyloid A immunohistochemical staining patterns in hepatitis.

Histopathology

Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA.

Published: December 2016

AI Article Synopsis

  • Serum amyloid A (SAA) is an important protein produced by the liver in response to inflammation and is useful in assessing liver conditions, but studies on its expression in hepatitis are limited.
  • Researchers conducted immunostaining for SAA on 160 liver biopsy samples, including cases of hepatitis C, hepatitis B, steatohepatitis, and autoimmune hepatitis, to see how it correlates with disease activity and stage.
  • The results showed that SAA staining was more prevalent in early-stage liver disease and less fibrosis, suggesting that it may play a role in the progression of liver conditions.

Article Abstract

Aims: Serum amyloid A is an acute phase reactant that is produced by hepatocytes in response to either inflammatory or neoplastic conditions. Because inflammatory adenomas produce this protein, serum amyloid A immunohistochemistry has been used in the evaluation of hepatocellular neoplasms. However, studies evaluating the expression of this protein in hepatitis are lacking. The aim of this study was to perform serum amyloid A immunostains on medical liver biopsy specimens of patients with common chronic liver diseases and correlate them with disease activity and stage.

Methods And Results: We performed serum amyloid A immunostains on 160 medical liver biopsies, including 100 cases of hepatitis C virus infection at different stages (20 cases of each) and 20 cases each of hepatitis B viral infection, steatohepatitis and autoimmune hepatitis. The extent and location of staining was recorded and correlated with grade, stage and laboratory values (transaminases, bilirubin and viral load). Data were analysed using the Cochran-Mantel-Haenszel χ test for trend. Serum amyloid A staining was present in 130 (81%) cases and was limited to zone 3 perivenular hepatocytes in 66 (41%). Biopsy specimens with less fibrosis and/or mild portal inflammation showed significantly more staining than those with cirrhosis (P < 0.001), or at least moderate inflammatory activity (P < 0.001). There was no significant association between lobular inflammation (P = 0.06), bilirubin levels or viral load and immunohistochemical staining for serum amyloid A.

Conclusions: Our results show that liver biopsy specimens with mildly active chronic hepatitis, early fibrosis and normal serum transaminases show more serum amyloid A immunopositivity compared with cases with more inflammatory activity, fibrosis or transaminitis. These findings indicate that serum amyloid A is expressed primarily in the early phases of disease and might influence progression and/or response to treatment.

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http://dx.doi.org/10.1111/his.13016DOI Listing

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