Expression of HLA-DR antigens on bile duct
epithelium in primary sclerosing cholangitis
RW Chapman, PM Kelly, A Heryet, DP Jewell and
KA Fleming
Department of Gastroenterology, (University of Oxford), John Radcliffe
Hospital.
Gut, Vol 29, 422-427
The expression of HLA class I (HLA-A, B, C)
and class II (HLA-DR) antigens on the biliary epithelium of 10 patients
(nine men) with primary sclerosing cholangitis (PSC) was investigated
using an immunoperoxidase technique on cryostat sections. Five patients
were staged as grade II and five grade III on hepatic histology.
None were cirrhotic. as grade II and five grade III on hepatic histology.
None were cirrhotic. Controls were nine patients with primary biliary
cirrhosis (PBC), five with extra hepatic biliary obstruction, 15
with other forms of chronic liver disease and six with normal livers.
Bile ducts from the normal subjects and patients with chronic liver
disease did not express HLA-DR antigens. In contrast, all 10 of
the PSC biopsies showed varying degrees of HLA-DR staining of the
biliary epithelium. Expression of DR antigens was also found on
the bile ducts of all five patients with extra hepatic biliary obstruction
and in six of nine patients with PBC. Expression of HLA class I
antigens was seen on the biliary epithelium of all the biopsies
examined. Increased numbers of helper and suppressor T-cells were
seen in the portal tracts of all the PSC patients. This study has
confirmed that aberrant expression of HLA-DR may occur on the biliary
epithelium of some, but not all, patients with PBC. In addition,
the study has shown that aberrant expression of HLA-DR always occurs
in PCS at an early stage of histological liver damage. |