[Lymphocytotoxicity in alcoholic hepatitis: evalutation of effector cells].

Alcohol induced liver damage has been recently suggested to occur in some cases as a consequence of a true autoimmune reaction. However the nature of the effector cells is still debated. Microlymphocytotoxicity "in vitro" test against rabbit hepatocytes has been performed in 29 patients with alcoholic cirrhosis and 8 with acute alcoholic hepatitis. The diagnosis has been done on clinical and histological grounds. The mean cytotoxicity index (CI) of subjects with alcoholic cirrhosis was 15.12 +/- 14.18 and with acute alcoholic hepatitis 62.49 +/- 16.33 (normal range: 0 -37.90). To further characterize the effector cells in our system, the test has been performed again either using T-enriched fractions of peripheral lymphocytes or after pronase-induced digestion of SmIg of total lymphocytes in 5 patients with acute alcoholic hepatitis and high CI. In both instances a disappearance of citotoxic activity has been observed. These data suggest: a) autoimmune reaction can occur only in patients with acute alcoholic liver damage; b) non T-cells are responsible for cytotoxicity; c) the immune reaction appears to be of cell-mediated antibody-dependent type.