LONG-LASTING IMMUNOLOGICAL EFFECTS OF ETHANOL AFTER WITHDRAWAL

The aim of the present study was to analyze on chronic alcoholic patie nts the effect of ethanol (EtOH) withdrawal on the immune system throu gh the investigation of the distribution of PB lymphoid subsets, using multiple-stainings with monoclonal antibodies and flow cytometry. For this purpose a group of 20 patients with active alcoholism without li ver disease, negative for hepatitis virus, and without malnutrition wa s analyzed and followed for 9 months after alcohol consumption had bee n discontinued. Twenty-five age- and sex-matched healthy volunteers we re included in the study. The following panel of monoclonal antibodies combinations (FITC/PE/PerCP or PE-Cy5) was used: TCR alpha beta/CD3/H LA DR, CD25/CD56/CD3, TCR gamma delta/CD3/HLA DR, CD45RA/CD45R0/CD4, C D3/CD8, CD19/CD5, and CDB/CD11c. Analysis was performed an at least 1, 500 events/tube at flow cytometry using the Lysys II software program. During the alcohol intake period, the mast striking findings were a s ignificant (P < 0.05) expansion of the CD8+ T-lymphocyte subset, which coexpresses the activation associated antigens HLA DR and CD11c, as w ell as a significant increase in both NK-cells (CD3-/CD56+) and the T- cell subset with NK activity coexpressing CD3 and CD56 (P < 0.05 and P < 0.01, respectively). In addition, a decrease in the CD5+ B-cells (P < 0.05), associated with reduced serum gamma-globulin levels, was als o observed. During alcohol withdrawal, a rapid decrease towards normal values of activated CD8+/HLA DR+ and CD11c + T-lymphocytes was observ ed as well as a normalization of CD19+/CD5+ B-cells and gamma-globulin serum levels; these changes might be directly related to EtOH suppres sion. Surprisingly, however, new immunological imbalances emerged in s pite of the absence of alcohol intake. Thus, a progressive and signifi cant expansion (P < 0.05) of CD4+ T-cells associated with an increased expression of the CD25 activation-related antigen and a preferential use of the CD45R0 isoform by CD4+ T-cells were observed. In parallel, there was an even more evident increase (P < 0.01) in the number of PB NK-cells. Our results show that EtOH consumption induces changes in t he immune system, its effects persisting or even becoming more evident after suppression of EtOH intake for a 9 month period. (C) 1996 Wiley -Liss, Inc.