Effect of corticosteroids on suppressor-cell activity in "autoimmune" and viral chronic active hepatitis

N Engl J Med. 1982 Nov 18;307(21):1301-4. doi: 10.1056/NEJM198211183072102.

Abstract

We detected a severe defect in concanavalin A-induced suppressor-cell activity in 22 patients with "autoimmune" chronic active hepatitis and in 26 patients with hepatitis B surface antigen (HBsAg)-positive chronic active hepatitis, as compared with 20 control subjects (P less than 0.01). Normal values were observed in 21 patients with "autoimmune" hepatitis in whom a remission had been induced and maintained by treatment with prednisolone. When lymphocytes from patients with autoimmune chronic active hepatitis were preincubated with low-dose prednisolone in vitro, suppressor-cell activity was substantially improved (P less than 0.01), but no clear effect of prednisolone was seen in cells from patients with HBsAg-positive chronic active hepatitis. The loss of suppressor-cell activity in chronic active hepatitis may allow liver damage to continue, and the reversal of the defect in the autoimmune form of the disease by administration of low-dose prednisolone provides a plausible explanation for the efficacy of this treatment. The contrasting in vitro responses to prednisolone in autoimmune and HBsAg-positive chronic active hepatitis suggest that the fundamental nature of the suppressor-cell defect may be different in these two forms of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / pharmacology*
  • Adrenal Cortex Hormones / therapeutic use
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / immunology*
  • Chronic Disease
  • Hepatitis / drug therapy
  • Hepatitis / immunology*
  • Hepatitis B / drug therapy
  • Hepatitis B / immunology*
  • Hepatitis B Surface Antigens / analysis
  • Humans
  • Prednisolone / pharmacology
  • T-Lymphocytes, Regulatory / drug effects*
  • T-Lymphocytes, Regulatory / immunology

Substances

  • Adrenal Cortex Hormones
  • Hepatitis B Surface Antigens
  • Prednisolone