10.25298/2616-5546/HepatoGastro.2021

Abstract

Background. Basically, there are two mechanisms of hepatocyte death in liver damage: non-programmed and programmed. The most studied and widely represented in the illustrations are the changes in the liver associated with unprogrammed hepatocyte death. Visualization of the main types of programmed hepatocyte death is lacking. Objective. To present morphological characteristics of the main subprograms of hepatocyte death according to light and electron microscopy of intravital liver bioptates in chronic hepatitis C (CHC). Material and methods. The liver bioptates were obtained by aspiration liver biopsy from 18 patients with CHC. Some visualization methods were used: light and electron microscopy, including examination of semi-thin sections, various methods of fxation and staining. Results. Currently, all types of programmed cell death can be subdivided into external, triggered by signals from the outside of the cell, and internal, caused by disturbances in the functioning of cells. The review provides illustrations and a description of the main types of programmed hepatocyte death in CHC. Morphological signs of internal apoptosis are illustrated by the changes occurring in the mitochondria of hepatocytes (typical and atypical). The participants of the external mechanism of apoptosis associated with the activation of death receptors, are represented by different populations of lymphocytes (cytotoxic, Pit cells). Visualization of lysosomedependent autophagy is represented by illustrations reflecting the main stages and variants of its development (macro-,micro- and chaperone-dependent, mitophagy). Conclusion. Comprehensive morphological diagnostics comprising original methods of fxation and staining of bioptates allows for more accurate visualization of the changes in hepatocytes associated with different variants of programmed cell death and helps to establish the most characteristic pathological and morphological signs for CHC.