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The role of the immune response in both the pathology of liver
disease and in the modulation ofliver injury has been the subject
of intense research. This book aims to present the current
understanding of the involvement of the immune response in liver
disease. The first chapters examine the role of the immune response
in viral infections of the liver. These viruses cause hepatitis of
varying severity and it is thought that many of the mechanisms
responsible for liver cell injury are immunologically mediated. In
addition three of these viruses, hepatitic B, C, and D, are
associated with persistent infection and chronic liver disease. The
role of the immune response in viral persistence is discussed.
Further chapters are devoted to the three major autoimmune liver
diseases which are thought to be the result of loss of tolerance to
autologous liver tissue. There has been much recent research on
cellular immune responses in these diseases but knowledge of the
immunological processes which lead to the breakdown of tolerance
and the mechanisms of tissue damage are limited. Other research has
concentrated on the identification of the antigens which are the
targets of this immune response. Linkage disequilibrium between MHC
alleles and autoimmune diseases has suggested a role for
immunogenetic factors.
The role of the immune response in both the pathology of liver
disease and in the modulation ofliver injury has been the subject
of intense research. This book aims to present the current
understanding of the involvement of the immune response in liver
disease. The first chapters examine the role of the immune response
in viral infections of the liver. These viruses cause hepatitis of
varying severity and it is thought that many of the mechanisms
responsible for liver cell injury are immunologically mediated. In
addition three of these viruses, hepatitic B, C, and D, are
associated with persistent infection and chronic liver disease. The
role of the immune response in viral persistence is discussed.
Further chapters are devoted to the three major autoimmune liver
diseases which are thought to be the result of loss of tolerance to
autologous liver tissue. There has been much recent research on
cellular immune responses in these diseases but knowledge of the
immunological processes which lead to the breakdown of tolerance
and the mechanisms of tissue damage are limited. Other research has
concentrated on the identification of the antigens which are the
targets of this immune response. Linkage disequilibrium between MHC
alleles and autoimmune diseases has suggested a role for
immunogenetic factors.
Howard C. Thomas In normal subjects the regulatory apparatus of the
immune system permits responses to foreign antigens but suppresses
those directed to "self' components. Autoimmune disease occurs as a
failure ofthis system either as a result of a primary defect in the
regulatory apparatus (primary autoimmunization) or because of a
change in the antigenicity of the tissues (secondary
autoimmunization). Autoaggressive reactions are characterised by
the presence of autoantibodies. When these are directed to membrane
displayed antigens (Fig. 1) they are probably of importance in the
lysis of hepatocytes. Those directed to cytoplasmic antigens may be
useful diagnostically but are of unknown pathogenic significance.
When no extrinsic aetiological factor can be identified, the
process is assumed to be the result of a failure ofthe regulatory
system, allowing the spontaneous expansion of a clone of
autoreactive lymphocytes. The defect may be generalised or specific
to certain groups of self-antigens and thus the autoimmune disease
may be either multi- or unisystemic. The recent development of
techniques to enumerate and measure the functional activity of the
suppressor lymphocytes which control the effector limbs of the
immune system has enabled investigators to test whether the various
purported autoimmune diseases do have as their basis a generalised
defect in immunoregu lation. Assessment of antigen-specific
immunoregulatory function is, however, not yet readily available.
liver Membrane I Antigen (LIM) I Liver I HLA, A, B, C,
Sensitisation to Specific -;::!IIIL. .
The 4th edition of Viral Hepatitis covers comprehensively the
entire complex field of infections caused by all of the different
hepatitis viruses, which affect many millions of people throughout
the world with considerable morbidity and mortality. Howard Thomas
and Arie Zuckerman are joined by Anna Lok from the USA and Stephen
Locarnini from Australia as Editors. They have recruited leading
researchers and physicians from many countries, who have produced
an authoritative account of current knowledge and research on this
important infection, including new insights into immune response to
HBV and HCV. The result is a comprehensive account on all aspects
of viral hepatitis, including rapid advances in the diagnosis,
management, treatment and prevention of a complex infection, which
in the case of hepatitis B, C and D may lead to severe
complications including chronic hepatitis, cirrhosis and
hepatocellular carcinoma. The latest edition of Viral Hepatitis
offers an essential resource of current information for
hepatologists, gastroenterologists, infectious diseases specialists
and other clinicians, researchers, public health physicians and
National and International Health Authorities.
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