Inverse association between hepatic stellate cell apoptosis and fibrosis in chronic hepatitis C virus infection.

Perisinusoidal hepatic stellate cells (HSC) are the principal fibrogenic cells in the liver. In animal models, HSC apoptosis is the predominant clearance mechanism of activated HSC, although data evaluating whether the same processes occur in humans are limited. We conducted a cross-sectional study to evaluate the association between HSC apoptosis and fibrosis stage in subjects with chronic hepatitis C virus (HCV) infection (n = 44) and HCV-negative controls with normal liver histology (n = 9). We used immunohistochemical techniques to identify activated (alpha-smooth muscle actin+), proliferative (Ki-67+) and apoptotic (terminal deoxynucleotidyl transferase [TdT]-mediated dUTP nick end-labelling+) HSC in liver biopsy specimens from all subjects. The same pathologist enumerated positive cells per high-power field (HPF, x 200) in 20 periportal/lobular areas. HSC apoptosis was decreased in HCV-positive subjects compared with controls (median 0.4, range 0.0-3.1 vs 1.1, 0.2-3.5 cells/HPF, P = 0.02). Among HCV-positive subjects, HSC apoptosis was decreased in those with moderate to advanced fibrosis (P = 0.04) compared with those with mild fibrosis. By multivariate analysis, HSC apoptosis decreased by an average of 0.14 cells/HPF (95% confidence interval 0.01-0.28 cells/HPF) per increase in fibrosis stage (P = 0.04). While the number of activated and proliferative HSC was significantly increased in HCV-infected subjects compared with that in uninfected controls, the numbers of these cells did not differ between HCV-infected subjects with mild vs moderate/advanced fibrosis. In conclusion, the number of apoptotic HSC was significantly decreased in HCV-infected subjects with advanced fibrosis. In chronic HCV infection, inhibition of HSC apoptosis may be one mechanism by which fibrosis progresses.

Tissue distribution of the non-polymorphic major histocompatibility complex class I-like molecule, CD1d.

The CD1 gene family is composed of five distinct molecules: CD1a, b, c, d and e. CD1a, b and c are primarily expressed thymically with limited extrathymic expression. Preliminary studies have shown that CD1d is primarily expressed extrathymically in gastrointestinal epithelial cells, renal tubular epithelial cells and B cells. This report characterizes the expression of CD1d in a variety of human tissues by immunohistochemistry using two anti-human CD1d monoclonal antibodies (mAb). CD1d was found in a wide range of tissues including the intestine, liver, pancreas, skin, kidney, uterus, conjunctiva, epididymis, thymus and tonsil. Within those tissues CD1d was mainly present in epithelial cells, vascular smooth muscle cells and parenchymal cells. Therefore, the tissue distribution of CD1d is distinct from CD1a-c and classical major histocompatibility complex (MHC) proteins implicating a unique role for CD1d in the immune system.