SERUM SECRETORY IGA AND SECRETORY COMPONENT IN PATIENTS WITH NONCIRRHOTIC ALCOHOLIC LIVER-DISEASES

Elevated levels of secretory IgA in serum have been demonstrated in se veral liver dysfunctions such as hepatic cytolysis and cholestasis, Ho wever, these possible alterations at an early stage of liver diseases have not yet been investigated, We studied a cohort of chronic alcohol ic patients without cirrhosis in order to assess the changes in serum secretory IgA and other forms of secretory component, the split produc t of the polymeric Ig-receptor of epithelial cells, The possible diagn ostic value of these measurements in the assessment of alcoholic disea se was compared to that of serum gamma-glutamyl transpeptidase activit y. Serum levels of secretory IgA and IgM and free secretory component, were quantified by an enzyme-linked immunosorbent assay in 71 patient s with chronic alcoholic liver disease without cirrhosis and in 45 hea lthy controls, Patients were divided into two groups according to the severity of the liver abnormalities, In addition, the reversibility of serum secretory IgA, IgM and free secretory component abnormalities a fter alcohol withdrawal was evaluated in 15 patients. Serum levels of the three molecular forms of secretory component were significantly hi gher than those measured in control subjects, both in the whole popula tion of patients and in the two groups of alcoholic patients without c irrhosis, In all groups, serum secretory IgA levels were correlated to free secretory component but not to total IgA levels, Serum secretory IgA levels were as discriminative as gammaglutamyl transferase activi ty in distinguishing between chronic alcoholic patients without cirrho sis and non-alcoholic subjects, The abnormalities of serum secretory I gA concentrations were reversible after alcohol withdrawal. The result s of this study demonstrate that serum secretory IgA and free secretor y component levels are significantly increased in patients with chroni c alcoholic liver disease, even at a very early stage of the disease, and decrease after alcohol withdrawal. Serum secretory IgA could there fore be used as an additional marker of mild liver abnormalities in ch ronic alcoholic subjects, and of the effectiveness of alcohol withdraw al, Release of polymeric Ig-receptor into the serum could share a simi lar physiopathological mechanism with gamma-glutamyl transpeptidase.