LOSS OF THE CD5(-CELL SUBSETS IN ALCOHOLICS() AND CD45RA(HI) B)

Chronic alcoholics are frequently immunodeficient, have polyclonal hyp ergammaglobulinaemia, and often have autoantibodies. Recent work in ot her diseases has shown that functional distinctions of possible releva nce 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 subset s 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 patie nts and 29 controls revealed a sharp decrease in the percentage of alc oholics' B cells which were CD5(+), 37.6% versus 16.3%, P < 0.00001; a bsolute CD5(+) B cell numbers were similarly reduced (58.9 cells/mu 1 versus 20.9; P = 0.0012). In addition to the loss of CD5 + B cells, th ere was a reduction in the percentage of B cells which are CDS(-)CD45R A(hi) leaving many patients with a B cell profile which was predominan tly CD19(+)CD5(-)CD45RA(lo). This subset appears phenotypically simila r to the IgM-producing CD5(-)CD45RA(lo) subset described by others, an d may be enriched for auto antibody-producing cells. One outlier patie nt was an ALD with 61% of B cells which were CD5(+), which also is a p rofile consistent with increased autoantibody production.