THE ROLE AND SIGNIFICANCE OF IMMUNE DISORDERS IN THE PATHOGENESIS OF ACUTE AND CHRONIC LIVER LESIONS

Аннотация

Recent immunological and immunomorphological studies over the past three decades have significantly transformed our understanding of the pathogenesis of both acute and chronic liver diseases. It has been established that immune dysfunction plays a central role in the progression of liver pathology to chronic forms, primarily through the development of autoimmune reactions and destructive inflammatory processes. In viral hepatitis types B and C, notable shifts in T- and B-cell immunity are observed, including T-helper deficiency, altered helper/suppressor ratios, and excessive antibody production. Circulating immune complexes (CICs) contribute to hepatocyte injury and microcirculatory disturbances. Experimental models such as heliotrine-induced and autoimmune hepatitis closely replicate the immunopathology seen in clinical cases, including lymphoid tissue atrophy and immune imbalance. Despite advances, the role of thymus-spleen interactions in the immune response to hepatic injury remains insufficiently explored. Understanding these mechanisms is crucial for the development oftargeted diagnostics and immunomodulatory therapies for chronic liverdiseases. Keywords:Chronic hepatitis, immune disorders, T-lymphocytes, B-lymphocytes, autoimmune reactions, circulating immunecomplexes,spleen, thymus, liver cirrhosis, heliotrinemodel Аннотация:Иммунологические и иммуноморфологические исследования последних трёх десятилетий существенно изменили представления о патогенезе острых и хронических заболеваний печени. Установлено, что иммунные нарушения играют ведущую роль в хронизации патологического процесса в печени, способствуя развитию аутоиммунных реакций и деструктивных воспалительных изменений. При вирусных гепатитах В и С наблюдаются выраженные изменения в Т- и В-звеньях иммунитета: дефицит Т-хелперов, нарушение соотношения хелперы/супрессоры, гиперпродукция антител. Циркулирующие иммунные комплексы (ЦИК) усугубляют повреждение гепатоцитовимикроциркуляторные расстройства.Экспериментальные модели гепатитов, такие как гелиотриновая и аутоиммунная, достоверно воспроизводят иммунопатологические процессы, выявляемые у пациентов, включая атрофию лимфоидной ткани и иммунный дисбаланс. Несмотря на достигнутый прогресс, роль взаимодействий между тимусом и селезёнкой при поражениях печени остаётся недостаточно изученной. Углублённое понимание этих механизмов имеет решающее значение для разработки новых диагностических и терапевтических подходов при хронических заболеванияхпечени. page1397 INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE ISSN:2692-5206,ImpactFactor:12,23 AmericanAcademicpublishers,volume05,issue05,2025 Journal: https://www.academicpublishers.org/journals/index.php/ijai Ключевые слова:Хронический гепатит, иммунные нарушения, Т-лимфоциты, В- лимфоциты, аутоиммунные реакции, циркулирующие иммунные комплексы, селезёнка, тимус,циррозпечени,гелиотриновая модель. Immunological and immunomorphological studies conducted over the past three decades have significantly altered our understanding of the pathogenesis of both acute and chronic hepatitis [1,2,17,82,161,163,184,201,251,269]. It has been established that immune disorders in the body play a leading role in the transition of liver pathology to a chronic form, contributing to the development of autoimmune reactions and the progression of inflammatory-destructive changes intheliver [3,4,7,11,18,53,65,98,106,160,214,256]. Numerous studies on the immune status in hepatitis of various etiologies have revealed profound alterations in the T- and B-cell systems of immunity [10,12,44,49,69,83,97,187,273,275]. Immunological indicators have been, and continue to be, widely used in the differential diagnosis of various liver diseases [57,121,122,123,163,218,251,273]. A marked reduction in T-lymphocytes has been observed in severe forms and prolonged courses of acute viral hepatitis as well as in chronic hepatitis [11,18,49,53,100,171]. During remission or convalescence phases, both absolute and relative T-lymphocyte counts increased, although they did not reach normal baseline levels. The number of B-lymphocytes increased during the acute stage of the disease and especially during recovery; similar patterns were seen inprolonged cases ofhepatitis B and Cand in chronic activehepatitis [69,184,253]. The content of regulatory T-cell subpopulations varied widely across different forms of viral hepatitis B. According to several authors [12,17,40,49,84], T-helper levels decrease during acute phases. This deficiency increases as the disease becomes protracted, while the number of T-suppressors remains largely unchanged, even in severe forms of acute viral hepatitis B. In mild to moderate forms where a decrease in T-suppressors is observed, the hepatitis tends to progress into aprolonged course [163]. In cases where hepatic inflammation progresses to a chronic form, a significant decrease in T- suppressors is noted alongside a slight decline in T-helpers, especially evident in chroni