LYMPHOCYTE PROFILE ON PATIENTS WITH CHRONIC AND ACUTE ALCOHOL CONSUMPTION

Introduction and Objectives

Several mechanisms participate in the physiopathology of chronic alcohol consumption and Alcoholic Liver Disease (ALD), such as deregulation in the immune system.

Aim

To analyze the lymphocyte subpopulations from patients with chronic and acute alcohol consumption.

Material and methods

A Cross-sectional study that included: G1: Controls with alcohol consumption <10g/day (CT); G2: Alcoholism, without clinical or biochemical stigma of liver damage (OH); G3: Patients with cirrhosis by alcohol (CiOH) and G4: Patients with Alcoholic Hepatitis (AH). Determination of T-CD3, T-CD4, T-CD8, NK and NKT lymphocytes from peripheral blood was performed by flow cytometry. Statistical analysis was performed by U-Mann Whitney test, p<0.05 was considered significant.

Results

570 participants were included, the mean of age was: 29.5±10.8, 31±12.6, 47.6± 7.7 y 41.2±9.2 years for CT, OH, CiOH and AH respectively (p<0.001). Alcohol consumption was higher in CiOH 240(320,120) and AH 320(480,160) (p<0.001, p<0.05). Liver function test showed alterations in patients with CiOH and AH, AST 49.5 (75.3,38) for CiOH and 155 (177,121) for AH (p<0.001, p<0.001); ALT 32.5 (47.3,24) in CiOH and 49 (75,35.3) in AH (p<0.001, p<0.001), whereas GGT was 91.5 (191.8, 48) for CiOH, and 224 (525.5, 104) for AH (p<0.001, p<0.001). Cell percentages are described in Table 1.

Data expressed as the median and quartiles (Q3-Q1). a) Alcoholism vs. Control; b) Cirrhosis vs. Control; c) Alcoholic Hepatitis vs. Control; d) Alcoholism vs. Cirrhosis; e) Alcoholism vs. Alcoholic Hepatitis; f) Cirrhosis vs. Alcoholic Hepatitis.

Discussion

Changes in the proportion of innate cells affect their ability to repair tissues, which can be exacerbated when damage is perpetuated and chronic inflammation is established. To compare CiOH vs. CT groups we found the suppression of adaptive response and increase in innate population. Furthermore, when CiOH was compared vs. OH increased CD4+ cells and decreased the cytotoxic population, which could be explained due to factors such as active alcohol consumption or advanced cirrhosis. In AH, the innate responses are suppressed compared to other groups. When we compare acute damage (AH) vs. alcoholism (OH) cytotoxic populations decrease, while CD4+ cells increase. However, during acute damage (AH) vs chronic damage (CiOH) increase T and CD8+ cells.

Conclusions

The immunological abnormalities that occur during alcoholism, cirrhosis and alcoholic hepatitis are different, the most significant changes were observed in CD4+, CD8+, NK and NKT cells promoting an imbalance that could be related to progression of liver damage.

The authors declare that there is no conflict of interest.

This work was partially financed by CONACyT SALUD-2016-272579 y PAPIIT-UNAM TA200515.