J.Jpn. Surg. Soc.. 93(4): 400-412, 1992

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Original article

ETIOLOGY OF IDIOPATHIC PORTAL HYPERTENSION (IPH)
-THE ROLE OF IMMUNOLOGICAL MECHANISM IN IPH-

The pathogenesis of IPH is not yet clear, but immunological mechanism is suspected to play an etiologic role in IPH. In this study, we investigated immunological abnormalities in human IPH and attempted to produce experimental models of IPH in rabbits sensitized with extract of IPH or normal rabbit spleen. We examined the role of the spleen in this disease. In the peripheral blood of human IPH, we found a reduction in suppressor T lymphocyte activity, increase in the Leu3a/Leu2a or OKT4/OKT8 ratio and some autoantibodies, e.g., antinuclear antibody or antilymphocyte antibody. After splenectomy, these immunological abnormalities tended to normalize. Furthermore, we have experienced some IPH cases with autoimmune diseases. In animal experiment, we succeeded in producing models in rabbits resembling human IPH by repeat injection of IPH or normal rabbit spleen-extract and found elevation factors of the portal vein pressure in the mitochondrial and microsomal fractions of the fixed cells of the spleen.
From these results, IPH may be etiologically associated with an immunological mechanism and the spleen may play an important role in this disease.

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