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Expansion of intrahepatic lymphocytes expressing PD-1 and bcl-2 in chronic hepatitis C

correlation with the disease progression

Sultan, Mervat M.a; El-Refaie, Ahmeda; Abdallah, Ayat R.b; Abdelsameea, Emanc; El-Sabaawy, Maha M.c

Egyptian Journal of Pathology: July 2018 - Volume 38 - Issue 1 - p 105–109
doi: 10.1097/01.XEJ.0000542232.60893.db

Background Programmed death-1 (PD-1) plays an important role in balancing antiviral immunity. Recently, PD-1 has been shown to induce immune exhaustion of T cells in chronic hepatitis C (CHC). Immune exhaustion and apoptosis are responsible for viral persistence. Little information is available regarding the correlation between PD-1 and antiapoptotic proteins, such as bcl-2.

Aim The purpose of this study was to investigate the relationship between PD-1 and bcl-2 in liver tissue of patients with CHC infection and histological characteristics of disease progression.

Methods This study was conducted on 91 CHC patients and 20 healthy control participants. Immunohistochemistry was performed on liver tissue sections using antibodies against PD-1 and bcl-2. Immunohistochemical results were correlated with demographic, laboratory, and histopathological findings.

Results Age and sex did not reveal significant association with either PD-1 or bcl-2. Transaminases, platelets, and prothrombin time showed significant association with PD-1 and bcl-2. PD-1, and bcl-2 demonstrated significant correlation with necroinflammatory activity (P<0.000 and <0.000, respectively) and fibrosis (P=0.001 and <0.000, respectively). Neither PD-1 nor bcl-2 has shown significant correlation with steatosis. There was a strong significant negative correlation between PD-1 and bcl-2 (r=0.723, P≤0.000).

Conclusion Intrahepatic PD-1 is conversely inter-related to bcl-2 with a pivotal role in disease severity and progression.

Departments of aPathology

bEpidemiology and Preventive Medicine

cHepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt

Correspondence to Mervat M. Sultan, MD, Department of Pathology, National Liver Institute, Menoufia University, Yassin Abdel Gaffar Street, 32511 Shebeen El-Kom, Egypt Tel: +20 482 223 216; fax: +20 482 234 586; e-mail:

Received September 5, 2017

Accepted October 5, 2017

©2018Egyptian Journal of Pathology
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