肝疾患の免疫血清学的研究

第2編 肝疾患における症候性Macroglobulinemiaの臨床的意義に関する検討

抄録

With patients of liver diseases mainly composed of hepatitis and liver cirrhosis as the subjects of the study, the assay of serum proteins was conducted by immunoelectrophoresis and simultaneously observations were carried out to see the clinical correlation of anti-liver antibody and changes in the quantities of β_2M-globulin. The results were presented as follows.
1. It was noted that β_2A- and β_2M-globulin were increased markedly, especially the latter. Both of them were increased markedly already at the convalescent stage of acute hepatitis, and following this its rate of the increase was in the order of chronic hepatitis, precirrhosis and liver cirrhosis as the disease advanced more chronic.
2. The albumin precipitin arc in the seven cases of liver cirrhosis was shortened, and in one case of lupoid hepatitis complicated with marked hypergammaglobulinemia and, hypoalbuminemia it was strikingly elongated, reaching as far as the β₁-globulin area. In the majority of liver cirrhosis the quantities of α_2-1 or α_2-2 globulin, β_1B, β_1C-globulins were decreased or were totally lacking.
3. In the entire cases with a positive titer of anti-liver antibody β_2M-globulin was increased, whereas in those with a negative titer 23.3 per cent of them proved to be β_2M-globulin negative.
4. Change or aggravation of the clinical coure was greater in those cases with an increase in β_2M-globulin than in those without such an increase. Such a tendency was still more marked in those with appearance of anti-liver antibody.
5. In the liver histologic pictures necrosis of parenchymal cells, stellate cell reaction and infiltration into the interstitium were more maked in the cases with the increase of β_2M-globulin than in those without, but there could be recognized no appreciable difference in between those showing anti-liver antibody and those without it.
6. There could be recognized differences in the values of S-GOT and S-GPT between those with increased β_2M-globulin and those without the increase, and likewise a similar difference could be observed between those with increase of β_2M-globulin accompanied by the appearance of anti-liver antibody and those without anti-liver antibody.
A similar tendency was also observable in the decrease of A/G ratio, in the decreasing tendency of albumin, particularly in the increase of gamma globulin.
7. In the cases having increased β_2M-globulin level accompanied by anti-liver antibody, there could be observed a tendency of decrease in the erythrocyte and leukocyte counts and an increase in lymphocytes.
8. In the observations of change in anti-liver antibody and β_2M-globulin conducted for about three months the quantities of β_2M-globulin were increased in all the cases with persistent appearance of anti-liver antibody and even in those with intermittent appearance of antiliver antibody, and also in those cases whose anti-liver antibody titer proved to be persistently negative. Steroid hormone therapy and splenectomy did not affect these changes.