LETTERS
Letters that report new clinical or laboratory observations, cases of unusual importance, and new developments in medical care will be considered for publication in this section. Manuscripts must be typed doubles paced. Text length must not exceed 750 words; no more than five references and one figure or table can be used. See "Information for Authors" on page 1-6 for form of references. Manuscripts should include an abstract of length not exceeding 100 words. Letters will be reviewed by consultants when, in the opinion of the editors, such review is needed. The Editor reserves the right to shorten letters and to make changes that accord with our style. T Cells and B Cells in HBsAg-Positive Patients with Chronic Persistent Hepatitis and Asymptomatic Carriers HUMAN LYMPHOCYTES in the peripheral blood that form rosettes spontaneously with sheep erythrocytes (E rosettes) are thymus-derived. Bone marrow-derived lymphocytes (B cells), can bind antigen-antibody-complement complex by using the presence of receptors for the third factor of complement on the cell surface (EAC cells). Wybran and Fudenberg (1) suggested several hypotheses to explain the mechanism of depressed E rosettes in viral diseases, namely, that [1] viruses sterically hinder the receptors for sheep erythrocytes or may turn off the synthesis of such receptors; [2] viruses alter the lymphocyte metabolism so that modifications of the lymphocyte membrane prevent rosette formation with sheep erythro-
cytes; [3] viral diseases increase the number of B cells; and [4] certain viral diseases with defects in cellular immunity reflect a decrease in the number of functional thymusderived lymphocytes (T cells). Decreased T cells and increased B cells in the peripheral blood were already reported in a number of patients with chronic hepatitis who were not divided into definite groups, and their deviation was not associated with relative degrees of lymphocytotoxic antibody ( 2 ) . In our present study, the percentages of E rosette and EAC rosette in the peripheral blood lymphocytes were detected by the method of Jondal and co-workers (3) to study normal subjects and hepatitis B surface antigen (HBsAg)-positive patients with chronic persistent hepatitis, who were diagnosed by liver biopsy and HBsAg asymptomatic carriers. Their HBsAg-positive findings were determined with single radial immunodiffusion. As shown in Table 1, 10 healthy subjects had percentages of E rosette between 33.0 and 50.5 (mean, 41.6 ± 5.5) and percentages of EAC rosette between 24.5 and 37.0 (mean, 30.6 ± 3.5). In five HBsAg asymptomatic carriers, percentages of E rosette were from 35.9 to 47.1 (mean, 42.2 ± 5.1), and percentages of EAC rosette were from 20.8 to 37.4 (mean, 30.2 ± 5.6). The normal percentages of both cells in two HBsAg asymptomatic carriers were similar to those described by DeHoratius, Strickland, and Williams ( 2 ) . In their patients who were carriers, the number of E rosettes did not diminish, but the number of EAC rosettes
Table 1 . Findings in Patients with Chronic Persistent Hepatitis, Asymptomatic Carriers, and Normal Subjects
Patient
Age
Sex
yrs Patients with chronic persistent hepatitis 1 2 3 4 5 Mean ISD
P Asymptomatic hepatitis B surface antigen carriers 6 7 8 9 10 Mean 1 SD P Normal subjects, n = 10 Range Mean 1 SD
E-Rosette
no./mm*
EAC-Rosette %
26 25 31 27 47 (31.2) 8.2 NS*
M M M M M
1820 1640 1750 1760 1860 (1766) 60
Letters that report new clinical or laboratory observations, cases of unusual importance, and new developments in medical care will be considered for publication in this section. Manuscripts must be typed doubles paced. Text length must not exceed 750 words; no more than five references and one figure or table can be used. See "Information for Authors" on page 1-6 for form of references. Manuscripts should include an abstract of length not exceeding 100 words. Letters will be reviewed by consultants when, in the opinion of the editors, such review is needed. The Editor reserves the right to shorten letters and to make changes that accord with our style. T Cells and B Cells in HBsAg-Positive Patients with Chronic Persistent Hepatitis and Asymptomatic Carriers HUMAN LYMPHOCYTES in the peripheral blood that form rosettes spontaneously with sheep erythrocytes (E rosettes) are thymus-derived. Bone marrow-derived lymphocytes (B cells), can bind antigen-antibody-complement complex by using the presence of receptors for the third factor of complement on the cell surface (EAC cells). Wybran and Fudenberg (1) suggested several hypotheses to explain the mechanism of depressed E rosettes in viral diseases, namely, that [1] viruses sterically hinder the receptors for sheep erythrocytes or may turn off the synthesis of such receptors; [2] viruses alter the lymphocyte metabolism so that modifications of the lymphocyte membrane prevent rosette formation with sheep erythro-
cytes; [3] viral diseases increase the number of B cells; and [4] certain viral diseases with defects in cellular immunity reflect a decrease in the number of functional thymusderived lymphocytes (T cells). Decreased T cells and increased B cells in the peripheral blood were already reported in a number of patients with chronic hepatitis who were not divided into definite groups, and their deviation was not associated with relative degrees of lymphocytotoxic antibody ( 2 ) . In our present study, the percentages of E rosette and EAC rosette in the peripheral blood lymphocytes were detected by the method of Jondal and co-workers (3) to study normal subjects and hepatitis B surface antigen (HBsAg)-positive patients with chronic persistent hepatitis, who were diagnosed by liver biopsy and HBsAg asymptomatic carriers. Their HBsAg-positive findings were determined with single radial immunodiffusion. As shown in Table 1, 10 healthy subjects had percentages of E rosette between 33.0 and 50.5 (mean, 41.6 ± 5.5) and percentages of EAC rosette between 24.5 and 37.0 (mean, 30.6 ± 3.5). In five HBsAg asymptomatic carriers, percentages of E rosette were from 35.9 to 47.1 (mean, 42.2 ± 5.1), and percentages of EAC rosette were from 20.8 to 37.4 (mean, 30.2 ± 5.6). The normal percentages of both cells in two HBsAg asymptomatic carriers were similar to those described by DeHoratius, Strickland, and Williams ( 2 ) . In their patients who were carriers, the number of E rosettes did not diminish, but the number of EAC rosettes
Table 1 . Findings in Patients with Chronic Persistent Hepatitis, Asymptomatic Carriers, and Normal Subjects
Patient
Age
Sex
yrs Patients with chronic persistent hepatitis 1 2 3 4 5 Mean ISD
P Asymptomatic hepatitis B surface antigen carriers 6 7 8 9 10 Mean 1 SD P Normal subjects, n = 10 Range Mean 1 SD
E-Rosette
no./mm*
EAC-Rosette %
26 25 31 27 47 (31.2) 8.2 NS*
M M M M M
1820 1640 1750 1760 1860 (1766) 60
