[Intrahepatic cholestasis: modulation by immunological factors?].

The mechanism of intrahepatic cholestasis in active liver disease has not yet been elucidated. Recent investigations in type II drug-induced hepatitis have suggested that lymphocytes produce a cholestatic factor. The authors' studies on lymphocyte cultures of patients with alcoholic hepatitis and acute viral hepatitis suggest that cellular immune phenomena may be of general significance in the pathogenesis of intrahepatic cholestasis. Supernatants of cultured lymphocytes of patients with alcoholic and acute viral hepatitis reduced bile flow and bile acid excretion in a rat model, provided that the lymphocytes had been previously stimulated by the appropriate antigen. An identical cholestatic effect was seen using sera of these patients. The pathogenetic mechanism of this lymphocytic factor is still unknown.