Hoerner M, Behrens U J, Worner T M, Blacksberg I, Braly L F, Schaffner F, Lieber C S
Alcohol Research and Treatment Center, Veterans Administration Medical Center, Bronx, New York 10468.
Hepatology. 1988 May-Jun;8(3):569-74. doi: 10.1002/hep.1840080322.
We recently presented preliminary data indicating the presence of antibodies against acetaldehyde adducts in sera of over 70% of alcoholic patients. To assess the respective roles of liver disease and alcohol consumption as well as the specificity of this immune response, 141 patients in various stages of alcoholic and nonalcoholic liver diseases were tested by a hemagglutination assay. Sixty-three (73%) of 86 alcoholics had antibody titers above control levels (p less than 0.0001). Alcohol consumption of these individuals was significantly higher (p less than 0.001) than that of those alcoholics with normal titers. Twenty-two patients (39%) with nonalcoholic liver diseases also had elevated levels of antibodies against acetaldehyde adducts (p less than 0.0005); of these, 8 had primary biliary cirrhosis (7 in Stages III and IV), 9 had chronic active hepatitis (6 with cirrhosis) and 5 had acute (virus- or drug-induced) hepatitis. Antibody titers did not correlate with levels of transaminase or alkaline phosphatase activity, nor with bilirubin, and albumin. However, in 52 alcoholics and in nonalcoholic patients with biopsy-confirmed liver disease, the highest titers were seen in the more advanced stages of liver damage. Thus, in addition to alcohol consumption, severity of liver disease may play a role in the appearance of circulating antibodies against acetaldehyde adducts.
我们最近公布的初步数据表明，超过70%的酒精性肝病患者血清中存在针对乙醛加合物的抗体。为了评估肝脏疾病和酒精摄入各自的作用以及这种免疫反应的特异性，我们采用血凝试验对141例处于酒精性和非酒精性肝病不同阶段的患者进行了检测。86例酒精性肝病患者中有63例（73%）抗体滴度高于对照水平（p<0.0001）。这些个体的酒精摄入量显著高于抗体滴度正常的酒精性肝病患者（p<0.001）。22例（39%）非酒精性肝病患者针对乙醛加合物的抗体水平也升高（p<0.0005）；其中，8例患有原发性胆汁性肝硬化（7例处于III期和IV期），9例患有慢性活动性肝炎（6例伴有肝硬化），5例患有急性（病毒或药物性）肝炎。抗体滴度与转氨酶或碱性磷酸酶活性水平、胆红素及白蛋白均无相关性。然而，在52例酒精性肝病患者以及经活检确诊为肝病的非酒精性患者中，在肝损伤较严重阶段观察到最高滴度。因此，除了酒精摄入外，肝脏疾病的严重程度可能在针对乙醛加合物的循环抗体出现中起作用。
