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Ativa??o das c?lulas hep?ticas estreladas e fibrose hep?tica em crian?as portadoras de hepatite autoimune tipo 1: estudo imuno-histoqu?mico de bi?psias hep?ticas pareadas antes do tratamento e ap?s a remiss?o cl?nica

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Previous issue date: 2009-12-03 / The activation of hepatic stellate cells (HSC) is considered the most important event in hepatic fibrogenesis. The precise mechanism of this process is unknown in autoimmune hepatitis (AIH), and more evidence is needed on the evolution of fibrosis. The aim of this study was to assess these aspects in children with type 1 AIH. We analyzed 16 liver biopsy samples from eight patients, paired before treatment and after clinical remission, performed an immunohistochemical study with anti-actin smooth muscle antibody and graded fibrosisand inflammation on a scale of 0:4 (Batts and Ludwig scoring system). We observedthere was no significant reduction in fibrosis scores after 24? 18 months (2.5 ? 0.93 vs. 2.0? 0.53, P = 0.2012). There was an important decrease in inflammation: portal (2.6 ?0.74 vs. 1.3? 0.89, P = 0.0277), periportal/periseptal (3.0 ?0.76 vs. 1.4 ? 1.06, P = 0.0277), and lobular (2.8 ? 1.04 vs. 0.9? 0.99, P =0.0179). Anti-actin smooth muscle antibodies
were expressed in the HSC of the initial biopsies (3491.93 ?2051.48 lm2), showing a significant reduction after remission (377.91 ?439.47 lm2) (P = 0.0117). HSC activation was demonstrated in the AIH of children. The reduction of this activation after clinical remission, which may precede a decrease in fibrosis, opens important perspectives in the follow-up of AIH. / A ativa??o das c?lulas hep?ticas estreladas (CHE) ? considerada o evento mais importante na fibrog?nese hep?tica. Na hepatite autoimune (HAI) este mecanismo ? desconhecido e maiores evid?ncias s?o necess?rias quanto ? evolu??o da fibrose. O
objetivo desse estudo foi avaliar a ativa??o das CHE e a evolu??o da fibrose hep?tica em crian?as portadoras de HAI tipo 1. Foram analisadas 16 bi?psias hep?ticas pareadas de oito pacientes, antes do tratamento e ap?s a remiss?o cl?nica atrav?s de estudo imuno-histoqu?mico com anticorpo anti-??-actina de m?sculo liso e realizada a grada??o da fibrose e da inflama??o empregando-se o sistema de escores de Batts e Ludwig (0-4). N?o houve significante redu??o nos escores de fibrose ap?s intervalo de tempo de 24? 18 meses entre as bi?psias (2,5 ? 0,93 vs.
2,0? 0,53, P = 0,2012). Observou-se redu??o significante na inflama??o: portal (2,6?0,74 vs. 1,3? 0,89, P = 0,0277), periportal/perisseptal (3,0 ?0,76 vs. 1,4 ? 1,06, P =0,0277) e lobular (2,8 ? 1,04 vs. 0,9? 0,99, P =0,0179). A -actina de m?sculo liso nas CHE foi expressa em bi?psias hep?ticas iniciais (3491,93 ?2051,48 ?m2) e mostrou significante redu??o ap?s a remiss?o cl?nica (377,91 ?439,47 ?m2) (P = 0,0117). A ativa??o de CHE foi demonstrada em crian?as portadoras de HAI tipo 1.
A redu??o de sua ativa??o ap?s remiss?o cl?nica, a qual pode preceder a redu??o da fibrose, abre importantes perspectivas no follow-up da HAI

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/18540
Date03 December 2009
CreatorsMaia, Jussara Melo de Cerqueira
ContributorsCPF:04045599487, http://lattes.cnpq.br/2365612055067945, Porta, Gilda, CPF:68900279815, http://lattes.cnpq.br/1640218138018173, Motta, Maria Eug?nia Farias Almeida, CPF:60325569487, http://lattes.cnpq.br/8403651529107146, Cavalcanti J?nior, Geraldo Barroso, CPF:10861203453, http://lattes.cnpq.br/0091662650633339, Jatob?, Carlos Andr? Nunes, CPF:67567045400, http://lattes.cnpq.br/8755924262557104, Ramos, Ana Maria de Oliveira
PublisherUniversidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, UFRN, BR, Ci?ncias da Sa?de
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Formatapplication/pdf
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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