engleski

Immunologic function tests and liver cirrhosis

Infections may cause major problems in patients with cirrhosis, especially of the alcoholic type, and were responsible for about 7% of deaths in well compensated patients. The aim of the study was to determine whether there are any differences in the main immunologic tests between the patients with alcoholic liver cirrhosis and healthy subjects. Thirty-three patients with alcoholic liver cirrhosis and forty-two healthy subjects were included in the study. The inclusion criteria were: alcohol abstinence before hospitalization ; absence of infections, inflammatory or neoplastic diseases ; no therapy with steroids, cytostatics or cimetidine, and negative hepatitis virus serology. Elevated IgG, IgA and IgM were found in patients with alcoholic liver disease, possibly due to constant antigen stimuli and initial hypersecretion of an unknown cause. It was found reduced absolute numbers of CD4 and CD8 lymphocytes in patients, but the CD4/CD8 mean ratio did not differ significantly between the patients and healthy volunteers, suggesting a normal helper/suppresser function of T lymphocytes in the patients. The blastogenic transformation of lymphocytes under all mitogens was diminished in the patients, supporting the hypothesis of changes in lymphocyte reactivity in vitro. Lower values of C3 and C4 complement suggested persistence of an immune process in which the complement cascade was activated both in a classic and alternative way and on the other hand a diminished liver synthesis. The results of our study showed that these patients had changes in their immune status which were not caused by inflammation or infection, but primarily resulted from the liver disease. Testing of the immune status could also help in the recognition of patients at a high risk of infections.

alcoholic liver cirrhosis; CD4 and CD8 lymphocytes; C3 and C4 complement; CD4/CD8 ratio; immune status

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