PHOSPHOLIPID ANTIBODIES IN ALCOHOLIC LIVER-DISEASE

Alcoholic liver injury has been reported to be directed preferentially against the proteins of the cell membrane, sparing the phospholipids. However, antiphospholipid antibodies against certain cell membrane ph ospholipids are known to be associated with a variety of diseases. We undertook this investigation to determine whether antiphospholipid ant ibodies were present in the serum of patients with alcoholic liver dis ease. We investigated seventy long-term alcoholic patients (>80 gm eth anol/day for > 1 yr) and 8 normal nonalcoholic controls by means of en zyme-linked immunosorbent assay to determine whether serum antibodies were generated against the following membrane phospholipids: phosphati dylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidy lglycerol, diphosphatidylglycerol (cardiolipin) and phosphatidic acid. Group 1 comprised alcoholic patients with normal liver function (n = 13), group 2 comprised alcoholic patients with abnormal liver function (n = 16), group 3 comprised patients with alcoholic hepatitis or cirr hosis (n = 41) and group 4 comprised nonalcoholic controls (n = 8). Th e antibody prevalence was 15% in group 1, 31% in group 2, 81% in group 3 and 0% in group 4. In group 3, 20 of 41 patients had antibodies aga inst several cell membrane phospholipids (i.e., phosphatidylethanolami ne, phosphatidylserine, phosphatidylglycerol, phosphatidic acid, cardi olipin and phosphatidylinositol). The antiphosphatidylethanolamine iso type was IgA or IgM in 25 of 41 of these patients. Both IgA (p < 0.01) and IgM (p < 0.008) antiphosphatidylethanolamine correlated significa ntly with disease severity. Antiphospholipid antibodies in alcoholic p atients seem to reflect disease progression and correlate significantl y with disease severity.