Acidophil bodies in nonalcoholic steatohepatitis

Summary The significance of the quantity of acidophil bodies (AB) in nonalcoholic steatohepatitis (NASH) is not certain. We quantified AB in liver biopsies and examined the association with the diagnosis of NASH and other histologic features. We reviewed 157 liver biopsies from the NASH Clinical Research Network Database collected in 2006. One hundred twenty-seven biopsies were from adult patients. Diagnoses were 94 definite NASH, 40 borderline NASH, and 23 definitely not NASH. The total length and average width of the core biopsies were measured, and the biopsy areas were calculated (mm²). Total AB were counted, and mean AB count per mm² was calculated (AB/mm²) to derive acidophil body index (ABI). ABI was 0.04 (±0.08) in definite NASH and 0.02 (±0.05) in borderline/definitely not NASH groups combined (P =.02) in all 157 biopsies; similar findings were present in the 127 adult-only biopsies (0.04 ± 0.05 and 0.02 ± 0.05, respectively; P =.05). In all 157 biopsies, increased ABI was associated with greater lobular inflammation (P =.01) and many ballooned hepatocytes (P =.048). There was a positive relationship between ABI and high nonalcoholic fatty liver disease activity scores, but this association was not statistically significant. There was no association between ABI and steatosis or fibrosis stage either in the entire cohorts or in the subset of adult patients. In conclusion, the density of AB is associated with lobular inflammation, ballooned hepatocytes, and the diagnosis of NASH in adult and pediatric liver biopsies, suggesting the implication of the apoptotic pathway in NASH-associated liver cell injury.