Background and aim: Cell death maintains homeostasis and eliminates damaged cells. The role of this cellular process in alcohol consumption and in pathogenesis of alcoholic liver disease (ALD) has not been fully established. Objective: Characterize the cell death of T-CD4, T-CD8, NK and NKT lymphocytes in peripheral blood of patients with different patterns of alcohol consumption and ALD.
Material and methods: Cross-sectional study. Control subjects with alcohol consumption <10g/day (CT); risk alcohol consumption (AUDIT>8) (R); alcohol abuse (A); alcoholism without clinical or biochemical stigmas of liver damage (OH); cirrhosis by alcohol (CiOH) and alcoholic hepatitis (AH). Determination of T-CD4, T-CD8, NK and NKT was performed in peripheral mononuclear fraction. The expression of Fas receptor and ligand (Fas R, Fas L), active caspase 3, early and late apoptosis, necrosis, and cell viability was evaluated by flow cytometry. Statistical analysis: Kruskall-Wallis and U-Mann Whitney, (p<0.05). Protocol approved by the General Hospital of Mexico (HG/DI/16/107/03/082) and UNAM (FMD/DI /15/2019)
Results: 48 participants were included, 14CT, 5R, 5A, 7OH, 6 CiOH y 11AH; the average age was 29±9, 29±10, 26±4, 32±6, 52±11 and 40±10 (p<0.05), respectively. Alcohol consumption per day was higher in ALD groups (292±150, 336±180) (p<0.05). Determination of lymphocyte showed that T-CD8 + cells decrease in AH vs CT (12±1.4 vs 19±2.3%) (p<0.04), while the expression of Fas R, Active Caspase increased. Whereas early Apoptosis and Necrosis increases in AH (p<0.02, p<0.01; p<0.02, p<0.01). The percentage of NK and NKT cells as well as the expression of Fas R and active Caspase 3 increased in HA vs CT (p<0.03, p<0.04; p<0.01, p<0.02).
Conclusions: The results show that according to consumption pattern, expressions of the cell death markers were not high in risk consumption, abuse and alcoholism because these events are still subclinical. While in patients with ALD, T-CD8, NK and NKT cells express a higher percentage of death markers, especially in the alcoholic hepatitis due to the elimination of damaged cells.
Conflict of interests: The authors have no conflicts of interest to declare. This work was partially financed by CONACyT SALUD-2016-272579 and PAPIIT- UNAM TA200515.