Lours KATER
Patients with alcoholic liver disease frequently reveal an increase in IgA =rum concentration and IgA deposits in a continuous pattern along hepatic sinusoids. We in-ve&igaW whether the hepatic IgA deposits are a pas- sive reflection of changes in concentration or composition of IgA in the circulation, or represent a distinct effect of alcohol on the liver. Forty-one patients with alcoholic liver disease (daily alcohol intake at least 50 gm for more than five consecutive years) were compared with 41 patients with nonalcoholic liver disease. Patients in both groups were matched for serum IgA and hbtopathological changes in the liver biopsy. IgA deposits in the liver were found in 78% of the alcoholic patients and in 12% of the nonalcoholic patients. The presence of deposits was not related to histopathological changee in the liver or to the serum IgA concentration.
In serum IgA subclass distribution, alcoholic patients differed from nonalcoholic patients by a slight but significant shift to IgA2; in contrast, the hepatic IgA dew in alcoholic patients were almost of the IgAl subclass. Serum secretory component (which is an equivalent of -rum secretory IgA) was elevated in both alaoholic and nonalcoholic patients; patients with a liver biopsy revealing hepatitis showed the highest level. In contrast, the hepatic deposits did not contain secretory component. We conclude that the continuous deposits of IgA along liver sinueoids are not a paseive reflection of c h a n m in concentration or composition of circulating IgA, but may represent a distinct effect of alcohol on the liver related to the role of this organ in IgA metabolism.
Patients with alcohol-induced liver disease (ALD) reveal deposits of IgA in a continuous staining pattern along sinusoids in the liver (1, 2). This phenomenon is a useful adjunct to the diagnosis of ALD. Two mechanisms may be involved in the origin of these IgA deposits. First, the deposits reflect changes in the concentration and/or properties of IgA in the circulation. This mechanism is considered to be involved because serum IgA levels are ~~~ ~