Sopeña B, Fernández-Rodríguez C M, Martínez Vázquez C, Méndez M X, de la Fuente J, Freire M, Arnillas E, Outon A
Servicio de Medicina Interna, Complejo Hospitalario Xeral-Cies, Vigo, Pontevedra.
An Med Interna. 1998 Apr;15(4):189-93.
Contribution of cellular immunity to the onset and perpetuation of alcohol-induced liver damage remains controversial. The aim of this work was to know whether T-cells participate in the pathogenesis of alcoholic liver injury by measuring the serum levels of sIL-2R in alcoholic patients with different degree of hepatic damage.
Fifty two patients and eighteen healthy subjects (Control group) were included. All patients were active drinkers of at least 100 grams/day of ethanol over a ten-years period. Serum sIL-2R was determined by ELISA. Liver biopsy was performed in all patients and liver function tests, serum immunoglobulins and complement proteins C3 and C4 were measured in all participants. The relationship between the sIL-2R and the severity of liver disease was studied.
Circulating sIL-2R was higher in the group of patients than in the control (2.388 +/- 275.7 U/ml vs. 795.7 +/- 48.7 IU/mL; p < 0.001). There were not increased circulating sIL2R in those patients with alcoholic hepatitis. However, patients with cirrhosis showed increased serum sIL-2R regardless of the presence of alcoholic hepatitis. Furthermore, serum levels of sIL-2R inversely correlated with hepatic function test (r = -0.69; p < 0.001 for serum albumin; and r = -0.73; p < 0.001 for the prothrombin time) and were highest in those patients of the Child-Turcotte's class C.
Circulating sIL-2R increases in alcoholic cirrhosis. However, our data do not support a contributory role of the cellular immunity, as assessed by circulating sIL-2R levels to the alcoholic liver damage. The increased serum sIL-2R in cirrhosis may result from defective heptic clearance of this molecule.
细胞免疫对酒精性肝损伤的发生和持续存在的作用仍存在争议。本研究的目的是通过检测不同肝损伤程度的酒精性患者血清中可溶性白细胞介素-2受体(sIL-2R)水平,了解T细胞是否参与酒精性肝损伤的发病机制。
纳入52例患者和18名健康受试者(对照组)。所有患者均为活跃饮酒者,在十年期间每天至少饮用100克乙醇。采用酶联免疫吸附测定法(ELISA)检测血清sIL-2R。所有患者均进行肝活检,并检测所有参与者的肝功能、血清免疫球蛋白以及补体蛋白C3和C4。研究sIL-2R与肝病严重程度之间的关系。
患者组循环sIL-2R水平高于对照组(2.388±275.7 U/ml对795.7±48.7 IU/mL;p<0.001)。酒精性肝炎患者循环sIL-2R水平未升高。然而,肝硬化患者无论是否存在酒精性肝炎,血清sIL-2R均升高。此外,sIL-2R血清水平与肝功能检查呈负相关(血清白蛋白r=-0.69;p<0.001;凝血酶原时间r=-0.73;p<0.001),在Child-Turcotte C级患者中最高。
酒精性肝硬化患者循环sIL-2R升高。然而,我们的数据不支持通过循环sIL-2R水平评估的细胞免疫对酒精性肝损伤起作用。肝硬化患者血清sIL-2R升高可能是由于肝脏对该分子的清除功能缺陷所致。