Journal of Viral Hepatitis
Volume 12 Issue 5 Page 507 - September 2005
doi:10.1111/j.1365-2893.2005.00626.x


Flow cytometry of fine-needle-aspiration biopsies: a new method to monitor
the intrahepatic immunological environment in chronic viral hepatitis

D. Sprengers1, R. G. van der Molen1, J. G. Kusters1, J. Kwekkeboom1, L. J.
W. van der Laan1, H. G. M. Niesters2, E. J. Kuipers1, R. A. De Man1, S. W.
Schalm1 and H. L. A. Janssen1

Summary. Information about the character and grade of the intrahepatic
immune response in viral hepatitis is important for the evaluation of
disease stage and effect of therapy. Complications like haemorrhage limit
the frequent performance of tissue-needle biopsies (TB), and the cells of
peripheral blood have to be used as surrogate markers instead.
Fine-needle-aspiration biopsy (FNAB) of the liver represents a safe and
atraumatic method that allows frequent cytological sampling. Our aim was to
investigate whether flow cytometry of FNAB specimens allows co-analysis of
phenotype, function and specificity of key populations of liver-infiltrating
lymphocytes (LIL). In 20 consecutive patients with chronic viral hepatitis
[10 hepatitis B virus (HBV), 10 hepatitis C virus (HCV)], flow cytometry was
performed on FNAB cytology, and simultaneously on lymphocytes isolated from
a TB and peripheral blood mononuclear cells (PBMC). The ratio of CD8+/CD4+
lymphocytes in FNAB correlated well with LIL from TB (r =0.78, P < 0.05) but
differed from PBMC (mean ratio: 2.6, 2.1 and 0.7, respectively). Similarly,
a correlation was observed for percentage CD56+ natural killer (NK) cells
(mean %: 29.9, 32.3 and 14.5, respectively; r = 0.69, P < 0.05). The
percentage of interferon (IFN)--producing CD3+ lymphocytes in both FNAB and
TB was higher than in PBMC (mean %: 41, 44 and 22, respectively; P < 0.05).
Furthermore, tetrameric complexes allowed analysis of HBV-specific T cells
in FNAB specimens. In conclusion, flow cytometry of FNAB allows easy,
atraumatic and reliable analysis of lymphocytes obtained from the
intrahepatic compartment. Therefore, the FNAB is a valuable tool in the
study of the immunopathology of viral hepatitis, and it may contribute to
the improved clinical evaluation of chronic viral liver disease.




Sandra Tara Balduf (Ane)

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