CLINICAL CYTOLOGY OF LIVER: CUPFFER'S CELLS

Introduction. Kupffer cells (tissue macrophages, mononuclear phagocytes) are the key cellular components of the intrahepatic innate immune system and play a key role in eliminating liver inflammation, maintaining the orderliness of cellular and noncellular structures and in the metabolic liver homeostasis. The goal is to present the structural and functional characteristics of Kupffer cells based on the results of the cytological identification of intravital biopsy specimens of the liver with its various lesions. Material and methods. Liver biopsy was obtained by performing a liver aspiration biopsy in HIV-infected patients and with chronic hepatitis C (CHC), from which written informed consent was obtained. Histological sections were stained with hematoxylin and eosin, picrofuxin according to Van Gison, Masson, per hemosiderin by Perls. Semi-thin sections (1 μm thick) were successively stained with azur II, the main magenta. Micrographs were obtained using a digital video camera (Leica FC 320, Germany). Electron microscopic preparations were studied in an electron microscope JEM-1011 (JEOL, Japan) at magnifications of 10,000-60000 with an accelerating voltage of 80 kW. To take pictures, we used a set of OlympusMegaView III digital camera (Germany) and iTEM image processing software (Olympus, Germany). Results. The structural and functional characteristics of Kupffer cells, structural features, polymorphism depending on the phagocytic activity for monoinfections of CHC, HIV infection and HIV / CHC co-infection are presented in detail on the material. The illustrations show specific intracellular structures and the involvement of Kupffer cells in lysis of infected hepatocytes with and without the involvement of cytotoxic lymphocytes. The presence of different populations of hepatic macrophages differing in phenotypes suggests that they perform various functions in the liver and homeostasis, in general, which is important for diagnosis and monitoring of therapy for liver diseases. Conclusions. Conducting morphological studies of the liver biopsy with simultaneous use of various methods of cellular identification significantly expands the possibilities of intravital diagnostics of liver lesions of various origin and allows to clarify pathogenetic and morphological mechanisms of liver lesions. In CHС in HIV-infected patients a special phenotype of Kupffer cells is formed, characterized by a sharp increase in intracellular inclusions in the form of granules of various sizes, which indicates high functional activity of Kupffer cells.