Accumulation of macrophages in primary sclerosing cholangitis

Objectives: To determine what changes are occurring in patients with primar y sclerosing cholangitis PSC by examining perisinusoidal macrophages (Kupff er cells) in liver biopsies; 2-to measure transforming growth factor beta ( TGF beta) as a marker of fibrosis in these patients. Design and methods: Transmission electron microscopy and immunohistochemist ry of 15 PSC, 26 primary biliary cirrhosis (PBC), 30 alcoholic liver diseas e (ALD) and 51 with normal histology was used. Five PSC, 30 ALD and 120 nor mal volunteers were sampled for serum levels of TGF beta. Results: There was a threc-fold increase in relative numbers of Kupffer cel ls in PSC compared to PBC and to patients whose livers had normal histology . In PSC there was an accumulation of perisinusoidal macrophages, which was not associated with focal necrosis or with cholestasis. The levels of TGF beta in PSC were 54 +/- 2 in cirrhotic versus 34 +/- 5 in non-cirrhotic pat ients (p < 0.005). Conclusion: Ile persistent activation of these macrophages may lead to the chronic release of TGF beta and contribute to chronic inflammation, fibrosi s and cirrhosis. (C) 2001 The Canadian Society of Clinical Chemists. All ri ghts reserved.