CIRCULATING IGA ANTIBODY AGAINST A 65 KDA HEAT-SHOCK PROTEIN IN ACUTEALCOHOLIC HEPATITIS

Heat shock proteins are known to be immunogenic in a number of diverse conditions and can be induced by hypoxia, tumour necrosis factor and alcohol - all potential triggers in patients with acute alcoholic hepa titis. In the present study, sera from 23 patients with acute alcoholi c hepatitis, 18 liver disease controls, ten patients with inactive alc oholic liver disease and six alcoholics without liver damage were scre ened for the antibody to a 65 kDa heat shock protein using an ELISA te chnique. IgA antibody was found to be closely associated with alcoholi c hepatitis; 20/23 patients were seropositive compared to 5/18 liver d isease controls and 4/10 with inactive alcoholic cirrhosis. IgM and Ig G antibodies to the 65 kDa heat shock protein were less closely associ ated with alcoholic hepatitis and were positive in nine and eight of t he 23 patients, respectively, compared with six and seven of 18 liver disease controls. Neither antibody was detected in alcoholics without liver damage or normal controls. These data indicate that an IgA immun e mediated response to the 65 kDa heat shock protein is characteristic of patients with acute alcoholic hepatitis and may be one mechanism u nderlying observed persistence of liver damage after cessation of alco hol consumption. (C) Journal of Hepatology.