ALTERED HUMORAL AND CELL-MEDIATED IMMUNITY IN CHRONIC ALCOHOLICS:Its Relation to the Development of Liver Injury

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Humoral and cell-mediated immunity in ninety four patients with chronic alcoholics were studied. IgA were significantly elevated (40%) in chronic alcoholics without cirrhosis but IgM, IgA and IgG levels were all elevated in patients with cirrhosis. Furthermoreseventy six percent of the chronic alcoholics failed to develop a delayed hypersensitivity reaction to DNCB skin test. The number of T cell were significantly decreased in thirty four percent of the chronic alcoholics. DNCB test was abnormal in seventy seven percent of the chronic alcoholics without liver injury, therfore suggesting that abnomal cellular immunity appears to exist in chronic alcoholics irrespective of the presence of liver disease.Leucocyte migration inhibition test (LMIT) was significantly demonstrated in fifty percent of the chronic alcoholics when both ethanol and liver specific antigen (LSA) were added to the medium. The patients with positive LMIT showed abnomral liver function and this finding was observed more frequently in patients with alcoholic hepatitis. Therefore, this finding suggests that once liver damage occurs, ethanol itself might play a role as hapten and combine with LSA resulting in antigens an contribute to the development and perpetuation of the alcoholic liver damage. HBs antigen was positive in only 2.1 percent of 94 chronic alcoholics, whereas anti HBs was detected in 44% of 50 patients. This finding shows that there was no significant difference in the incidence between controls and chronic alcoholics suggesting that HBs antigen is not involved in the developmet of alcoholic iver injury at least as a primary factor.
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ALTERED HUMORAL AND CELL-MEDIATED IMMUNITY IN CHRONIC ALCOHOLICS:Its Relation to the Development of Liver Injury

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