lipid-a and Liver-Cirrhosis--Alcoholic

These studies are concerned with detection of circulating antibodies against various defined enterobacterial antigens in patients with chronic inflammatory liver diseases such as chronic hepatitis type B (n = 46), chronic active hepatitis (CAH) of autoimmune type (n = 10), alcoholic cirrhosis (n = 24) and primary biliary cirrhosis (PBC) (n = 24) as well as in healthy individuals (n = 39). Anti-LPS and anti-lipid A were determined by hemolytic and hemagglutination assay. Immunoblot technique was used to investigate the antibody activity against plasmid encoded proteins from Yersinia enterocolitica. Persistent titers of anti-LPS up to serum dilution 1:32.768 were found with hemolytic and hemagglutination assay in patients with alcoholic cirrhosis or PBC and in healthy control. In contrast nearly 50% of patients with chronic hepatitis B had no hemolytic antibodies against the two LPS E. coli serotypes at the time of liver biopsy. Anti-lipid A was detectable in 58% of patients with alcoholic cirrhosis but in low titers in less than 10% in the other groups (p less than 0.001). Alcoholic cirrhosis was also associated with a high frequency of IgG and IgA antibodies against plasmid encoded proteins from Yersinia enterocolitica. The data indicate that the O-polysaccharides as strong antigens are physiologically exposed to the immune system while lipid A and enterobacterial proteins are solely immunogenic under abnormal conditions.

Topics: Adult; Aged; Antibodies, Bacterial; Autoantibodies; Female; Hepatitis, Alcoholic; Hepatitis, Chronic; Humans; Immunoglobulin A; Immunoglobulin G; Lipid A; Lipopolysaccharides; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Longitudinal Studies; Male; Middle Aged; Yersinia enterocolitica

To find out whether the increased immunoglobulin A (IgA) levels commonly reported in patients with alcoholic liver disease (ALD) are part of the immune response to gut-derived endotoxin antigen, an enzyme-linked immunoabsorbent assay was used to measure serum levels of antibodies to lipid A (the shared core of various lipopolysaccharides and the biologically active component of endotoxins) in patients with various diseases and in controls. Of 41 patients with ALD, 35 had significantly raised titres of IgA anti-lipid A. Rises of antilipid A were found in the secretory fraction of IgA as well, and titres of IgG antibody were also consistently increased. IgM titres were high in only 7 of 35 ALD patients tested. Patients with other diseases did not show significantly high titres of IgA antibodies to lipid A even though many had rises in total concentration of their serum IgA.

Topics: Antibodies; Crohn Disease; Enzyme-Linked Immunosorbent Assay; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Lipid A; Liver Cirrhosis, Alcoholic; Liver Cirrhosis, Biliary; Liver Diseases, Alcoholic; Nephelometry and Turbidimetry