T-cell subsets in peripheral blood and ascitic fluid of patients with alcoholic liver cirrhosis

Soluble CD8 and soluble CD4 antigens in viral hepatitis and alcoholic cirrhosis

Serum levels and production of soluble CD8 and soluble CD4 antigens by peripheral blood mononuclear cells were determined in patients with alcoholic cirrhosis and acute or chronic viral hepatitis. Patients with chronic viral hepatitis had significantly increased soluble CD8 serum levels (n = 18; 734 +/- 143 U/ml) (mean +/- SD) compared to healthy controls (n = 80; 312 +/- 141 U/ml; p < 0.001) and patients with alcoholic cirrhosis (n = 12; 505 +/- 256 U/ml; p = 0.006), whose soluble CD8 concentrations were also higher than controls (p < 0.001). In contrast, soluble CD4 antigen serum levels were similar in all groups. In addition, patients with chronic hepatitis showed an increased production of soluble CD8, but not soluble CD4, after mitogenic stimulation of their peripheral blood mononuclear cells compared to controls or patients with alcoholic cirrhosis. Patients with acute viral hepatitis, studied within the first 2 weeks after onset of jaundice, showed markedly elevated serum concentrations of soluble CD8 (n = 4; 807 +/- 379 U/ml; p < 0.001 vs. controls), but not soluble CD4. In addition, nine patients with chronic hepatitis C were studied during and after treatment with alpha interferon. Soluble CD8 serum concentrations of six treatment responders were not found to be different from the low levels seen in controls, whereas three non-responders had increased soluble CD8 levels which were similar to levels in untreated patients with chronic hepatitis C. After interferon-alpha therapy ended, a significant elevation of soluble CD8 serum concentrations was observed in four relapsing patients, which paralleled the serum ALT increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchoalveolar lavage in alcoholic liver cirrhosis. T-lymphocyte subsets and immunoglobulin concentrations

The purpose of this study was to determine the phenotype profiles of immune effector cells and the concentrations of immunoglobulins in the lower respiratory tract of non-smoking patients with alcoholic liver cirrhosis (ALC). Nine nonsmoking patients with liver biopsy-proved ALC (grade B or C cirrhosis in Child's classification), free of clinical pulmonary symptoms, and with normal chest roentgenogram were included in the study. The control group included 12 healthy nonsmokers. Each patient had fiberoptic bronchoscopy with bronchoalveolar lavage (BAL). The number of T cells and of lymphocyte subpopulations was determined by immunofluorescence studies using monoclonal antibodies that were specific for CD3, CD4, and CD8 markers. Patients with ALC exhibited a dramatically increased percentage of CD8+ cells in BAL that induced a low CD4/CD8 ratio (0.96 +/- 0.15 vs 1.8 +/- 0.12 in healthy controls). Further characterization of lymphocyte subsets' dual immunofluorescence analysis demonstrated that most of the CD8+ alveolar lymphocytes had a phenotype of cytotoxic cells (CD8+ CD11b-; 48 percent +/- 13 in ALC vs 10 percent +/- 5 in controls). ALC was associated with an appreciable alveolar-capillary "leak" as demonstrated by a significant increase in BAL fluid albumin. In addition, the concentrations of immunoglobulins in BAL fluid were significantly greater in ALC than in controls. However, the relative (to albumin) coefficient of excretion of IgG, A, and M in and alpha 2-macroglobulin BAL fluid was not significantly different between controls and ALC. Our results indicate that increased proportions of CB8+ and especially of CD8+ CD11b- cells are a common feature in the lower respiratory tract of nonsmoking patients with ALC. These changes may be of potential functional importance in the regulation of the local pulmonary immune response in ALC.

Helper-inducer and suppressor-inducer lymphocyte subsets in alcoholic cirrhosis

Peripheral blood lymphocytes from patients with alcoholic cirrhosis, alcohol-induced fatty liver, and healthy controls were analyzed for helper-inducer (CD4+CD29w+) and suppressor-inducer (CD4+CD45R+) T lymphocytes. In confirmation of earlier reports, patients with alcoholic cirrhosis were found to have a significantly reduced absolute number of peripheral lymphocytes (p = 0.03), an elevated relative percentage of CD3+ cells (median, 76% versus 68%; p = 0.0004) and CD4+ T cells (median, 56% versus 51%; p = 0.0011), and a reduced percentage of CD8+ T lymphocytes (median, 11% versus 20%; p = 0.0007) as compared with the control group. No difference in lymphocyte subsets was observed between controls and patients with alcohol-induced fatty liver. Within the CD4+ T-cell population a change in the relative proportion of two complementary lymphocyte subsets (CD4+CD29+ helper-inducer and CD4+CD45R+ suppressor-inducer T cells) was observed in patients with alcoholic cirrhosis: a higher percentage of CD4+CD29w+ helper-inducer T cells were circulating in their peripheral blood than in healthy controls (median, 33% versus 28%; p = 0.0036), whereas the CD4+CD45R+ suppressor-inducer T-cell subset did not differ (median, 21% versus 21%) between the two groups. Owing to the reduction of lymphocyte counts in cirrhotic patients the absolute number of CD4+CD29w+ cells was not different from that of control individuals; however, CD4+CD45R+ T cells in peripheral blood (p = 0.0063) were absolutely reduced. More CD4+ cells were simultaneously CD29w+ in cirrhotic patients (61%) than in controls (52%), whereas a lower percentage of CD4+ lymphocytes was also CD45R+ in these patients (33%) as compared with controls (40%).(ABSTRACT TRUNCATED AT 250 WORDS)