CLINICAL MORPHOLOGY OF THE LIVER: HEPATOCYTES, ENDOMEMBRANE SYSTEM
Abstract
Background. One of the main structural and functional elements of hepatocytes ensuring the proper functioning of the body's systems is the endomembrane cytoplasm system (EMMS) represented by the endoplasmic reticulum, Golgi complex, lysosomes and other organelles. In clinical practice, EMMS components imaging in chronic hepatitis C (CHC) is insufficiently presented.Objective of the study is to present the morphological characteristics of the EMMS of hepatocytes in viral lesions of the liver.
Materials and methods. Liver bioptates were obtained using fine-needle aspiration biopsy from 18 patients (having given written informed consent) with chronic hepatitis C and co-infection of chronic hepatitis C and HIV. The morphological changes in liver biopsy specimens were described using light microscopy of semi-thin sections based on the improved method of fixation and electron microscopy of ultrathin sections. The pictures were taken with the help of a set from Olympus Mega View III digital camera (Germany) and the iTEM image processing software (Olympus, Germany).
Results. Detailed descriptive and imaging characteristics of the structural features of all components of the EMMS: the rough and smooth endoplasmic reticulum, the Golgi apparatus, lysosomes and peroxisome in CHC and HCV /HIV co-infection are presented. Particular attention is paid to the imaging of the EMMS structures responsible for the replication of HCV in case of co-infection. The pictures of primary and secondary lysosomes, structural features of heterolysosomes, autolysosomes, telolysosomes, peroxisomes are presented.
Conclusion. The morphological characteristics of changes in the EMMS of hepatocytes are most accurately presented by the imaging of all components of the EMMS using electron microscopy. The imaging of virus-induced membrane changes in the EMMS of hepatocytes reveals the peculiarities of cytopathic effects of HCV and the co-infection of HCV + HIV on various structures of the EMMS of hepatocytes responsible for the processes of detoxification, metabolism and replication of hepatotropic viruses. Changes in all structures of the EMMS of hepatocytes are not isolated, but characterized by a set of specific ultrastructural signs interrelated with each other and united by the apoptogenic mechanism of the pathogenesis of HCV infection. Further research is needed to clarify the role of HCV / HIV in the formation of replication "airfields" and "factories", to develop methods for their identification in order to uncover new mechanisms for the progression of HCV infection and the transformation of the infectious process into fibrogenic and oncogenic ones.
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