ABNORMALITIES OF PERIPHERAL-BLOOD T-LYMPHOCYTES AND NATURAL-KILLER-CELLS IN ALCOHOLIC HEPATITIS PERSIST AFTER A 3-MONTH WITHDRAWAL PERIOD

Present information about the behavior of the different lymphoid subse ts in alcoholic hepatitis (AH), including cells displaying cytotoxic a ctivity, is scanty and contradictory. The aim of this study was to gai n further insight into knowledge of the immunological abnormalities in volved in AH and the possible role of ethanol (EtOH) consumption in th ese changes. We analyzed the distribution of a wide range of periphera l blood (PB) lymphoid subsets, both during active EtOH intake and afte r a 3-month withdrawal period, using multiple stainings with monoclona l antibodies and flow cytometry, as well as natural killer (NK) cytoto xic activity. AH patients entering the study were selected strictly; o nly those undergoing their first episode of AH with no other lesions a liver biopsy were enrolled. Regarding the alcohol intake period, the most striking finding was a significant increase of the absolute numbe r of PB T cells affecting both CD4(+) and CD8(+) lymphocytes. These ch anges were associated with a higher expression of T-cell activation an tigens, such as HLA DR and CD11c. Simultaneously, a significant increa se In both NK cells (CD3(-)/ CD56(+)) and the cytotoxic T cells coexpr essing the CD3 and the CD56 molecules together with an increased NK cy totoxic activity were observed. By contrast, the CD19(+)/CD5(+) B-cell subset was significantly decreased. No significant changes were obser ved with EtOH withdrawal except in CD5(+) B lymphocytes, which returne d to normal values. Our results show that, in AH patients, a significa nt expansion of both activated T cells and NK lymphocytes occurs in th e PB, which is associated with an increased NK cytotoxic activity. int erestingly these abnormalities persist during the withdrawal period.