Immune complexes in the portal and systemic circulation of patients with alcoholic liver disease

Abstract

Fifty-two patients with alcoholic liver disease (ALD) were studied for the presence of circulating immune complexes. “Mixed” type of cryoglobulins consisting of immunoglobulins and complement components were found in 61% of 67 sera specimens tested. The C1q binding test was positive in 56% of 66 sera tested. Serum autoantibodies especially antinuclear and antiskeletal muscle antibodies were more prevalent in ALD patients than control subjects. The serum titer of IgG antibody to E. coli was higher in ALD patients compared to controls. However, we found no evidence to implicate autoantibodies or antibacterial antibodies in the formation of immune complexes. Immune complexes were detected by the C1q binding test in serum specimens obtained concomitantly from the portal vein, hepatic vein, and peripheral vein in seven of nine ALD patients. When the level of immune complexes in the portal vein was compared to that of the hepatic vein, the concentration remained unchanged in seven patients, increased in one, and decreased in another patient. The lack of concentration gradient of the immune complexes between the portal vein and hepatic vein cannot be explained by the magnitude of intrahepatic vascular shunts. This suggests that the capacity of the liver to clear immune complexes in patients with alcoholic cirrhosis may be saturated or impaired.