Cook R T, Waldschmidt T J, Cook B L, Labrecque D R, McLatchie K
Department of Pathology, Veterans Affairs Medical Centre, Iowa City, IA, USA.
Clin Exp Immunol. 1996 Feb;103(2):304-10. doi: 10.1046/j.1365-2249.1996.d01-621.x.
Chronic alcoholics are frequently immunodeficient, have polyclonal hypergammaglobulinaemia, and often have autoantibodies. Recent work in other diseases has shown that functional distinctions of possible relevance to autoimmunity and immunodeficiency can be found among the B cell subsets defined by differential expression of the surface markers CD5 and CD45RA. Therefore, we have evaluated the CD5, CD45RA B cell subsets of both chronic alcoholics without evidence of active liver disease (AWLD), and alcoholics admitted for acute alcoholic liver disease (ALD). Mean B cell numbers were normal in AWLD, but significantly reduced in ALD. Analysis of B cells by three-colour flow cytometry in 20 patients and 29 controls revealed a sharp decrease in the percentage of alcoholics' B cells which were CD5+, 37.6% versus 16.3%, P < 0.000 01; absolute CD5+ B cell numbers were similarly reduced (58.9 cells/microliters versus 20.9; P = 0.0012). In addition to the loss of CD5+ B cells, there was a reduction in the percentage of B cells which are CD5- CD45RAhi, leaving many patients with a B cell profile which was predominantly CD19+ CD5- CD45RAlo. This subset appears phenotypically similar to the IgM-producing CD5- CD45RAlo subset described by others, and may be enriched for autoantibody-producing cells. One outlier patient was an ALD with 61% of B cells which were CD5+, which also is a profile consistent with increased autoantibody production.
慢性酗酒者常常存在免疫缺陷，有多克隆高丙种球蛋白血症，且常出现自身抗体。近期针对其他疾病的研究表明，在由表面标志物CD5和CD45RA差异表达所定义的B细胞亚群中，可发现与自身免疫和免疫缺陷可能相关的功能差异。因此，我们评估了无活动性肝病证据的慢性酗酒者（AWLD）以及因急性酒精性肝病（ALD）入院的酗酒者的CD5、CD45RA B细胞亚群。AWLD患者的B细胞平均数量正常，但ALD患者的B细胞平均数量显著减少。对20例患者和29例对照进行三色流式细胞术分析B细胞发现，酗酒者CD5 + B细胞的百分比急剧下降，分别为37.6%和16.3%，P < 0.000 01；CD5 + B细胞的绝对数量也同样减少（58.9个细胞/微升对20.9个；P = 0.0012）。除了CD5 + B细胞减少外，CD5 - CD45RAhi B细胞的百分比也降低，使得许多患者的B细胞表型主要为CD19 + CD5 - CD45RAlo。该亚群在表型上似乎与其他人描述的产生IgM的CD5 - CD45RAlo亚群相似，并且可能富含产生自身抗体的细胞。有一名异常患者是ALD患者，其61%的B细胞为CD5 +，这一表型也与自身抗体产生增加一致。
