Phytohaemagglutinin-induced lymphocyte transformation and histologic findings in patients with chronic aggressive hepatitis before and during immunosuppressive therapy

In vitro lymphocyte transformation (14C-thymidine incorporation rate following stimulation by PHA) was studied in 19 patients with histologically proven chronic aggressive hepatitis. In the majority of the cases measurements were performed prior to and during a combined (azathioprine/corticosteroid) immunosuppressive therapy. In comparison to normal controls, the majority of the patients showed a significantly reduced lymphocyte transformation before the treatment started. During the immunosuppressive therapy there was a normalization of PHA-responsiveness in most of the patients, or an improvement, at least. Bioptic control seems to be the most reliable parameter to prove a therapeutic effect, since the histologic criteria for a decrease of the inflammatory activity were the last to occur. After transient cessation of the therapy, in 4 out of 6 cases a decrease of lymphocytic PHA-responsiveness was developed again, paralleled by histologic activation of the process where biopsy could be performed. This observation favours a long-term therapy for at least several years.