Antiphospholipid antibodies in alcoholic liver disease are influenced by histological damage but not by alcohol consumption

Abstract

Antiphospholipid antibodies (aPL) have been detected in various liver diseases, particularly cirrhosis. The role of alcoholic consumption per se has been suggested. The aim of our study was to assess the prevalence of aPL in patients with alcoholic liver disease at various states and to correlate the presence of aPL with both liver injury and alcoholic consumption.

Three groups were prospectively included. Group A: 74 controls (age-and sex-matched); group B: 46 patients with alcoholic steatosis; group C: 28 patients with alcoholic cirrhosis. For each patient, lupus anticoagulant, anticardiolipin antibodies and anti-j32-glycoprotein I antibodies were tested.

The prevalence of aPL (presence of at least one positive test) was 5% in group A, 20% in group B and 50% in group C (P < 0.04). No correlation appeared between aPL and Child Pugh score in group C. No correlation was found between the presence of aPL and alcohol intake in patients with either steatosis or cirrhosis. Our study confirms that aPL positivity is more frequently encountered in patients with alcoholic liver disease than in controls. Their prevalence increases with the degree of histological damage but not with the level of alcoholic intake.

Keywords

antiphospholipid antibodies anticardiolipin antibodies anti-fl2-glycoprotein I antibodies alcoholic liver disease alcohol consumption

Get full access to this article

View all access options for this article.

References

1 McNeil HP , Chesterman CN , Krillis SA . Immunological and clinical importance of antiphospholipid antibodies . Adv Immunol 1991; 49: 193-281 .

2 Koskela P , Vaarala O , Makitalo R . Significance of false positive syphilis reactions and anticardiolipin antibodies in a nation-wide series of pregnant women . J Rheumatol 1988; 15: 70-73 .

3 Schved JF , Dupuy-Fons C , Biron C , Quere I , Janbon C. A prospective epidemiological study on the occurrence ofantiphospholipid antibody: the Montpellier antiphospholipid study . Haemostasis 1994; 24: 175-182 .

4 Hugues GRV , Harris EN , Gharavi AE . The anticardiolipin syndrome . J Rheumatol 1986; 13: 486-489 .

5 Piette JC . 1996 diagnostic and classification criteria for the antiphospholipid/cofactors syndrome: a ‘mission impossible’? Lupus 1996; 5: 354-363 .

6 Harris EN , Baguley E , Asherson RA , Hugues GRV . Clinical and serological features of the ‘antiphospholipid syndrome’ . Br J Rheumatol 1987; 26(Suppl 2): 19-19 .

7 Mackworth-Young CG , Loizou S , Walport MJ . Antiphospholipid antibodies and disease . Q J Med 1989; 72: 767-767 . Antiphospholipid antibodies in alcoholic liver disease P Perney et al

8 McNeil P , Chesterman CN , Krilis SA . Anticardiolipin antibodies and lupus anticoagulants comprise separate antibody subgroups with different phospholipid binding characteristics . Br J Haematol 1989; 73: 506-513 .

9 Chedid A , Mendenhall CL , Hammond JB et al. Phospholipid antibodies in alcoholic liver disease . Hepatology 1994; 20: 1465-1471 .

10.

10 Gervais A , Czernichow B , Grunebaum L et al. Anticorps seriques anticardiolipidiques chez les malades atteints de cirrhose alcoolique . Gastroenterol Clin Biol 1996; 20: 736-742 .

11.

11 Barbare JC et al. Prevalence and isotype of antiphospholipid and anti-f2-glycoprotein I antibodies in alcoholic disease . Hepatology 1998; 28: 197A-197A (abstract 139).

12.

12 Biron C , Lalloyer N , Tonnelot JL , Larget D , Gris JC , Schved JF . Anticardiolipin antibodies and acute alcoholic intoxication . Lupus 1995; 4: 486-490 .

13.

13 Sherlock S , Dooley J . Alcohol and the liver. In: Sherlock S , Dooley J (ed) Diseases of the Liver and Biliary System (9th edn). Blackwell Scientific: Oxford , 1992, pp 370-389.

14.

14 Pugh RN , Murray-Lyon IM , Dawson JL , Pietroni MC , Williams R . Transection of the oesophagus for bleeding oesophageal varices . Br J Surg 1973; 60: 646-649 .

15.

15 Brandt JT , Triplett DA , Alving B , Scharrer I . Criteria for the diagnosis of lupus anticoagulants: an update. On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the International Society of Thrombosis and Hemostasis . Thromb Haemost 1995; 74: 1185-1190 .

16.

16 Harris EN , Ghavari AE , Hugues GRV . The anti-cardiolipin assay. In: Harris EN , Exner T , Hugues GRV , Asherson RA (ed). Phospholipid-Binding Antibodies. Boca Raton, FL: CRC Press , 1991, pp 175-187.

17.

17 Biron C , Andreani H , Blanc P et al. Prevalence of antiphospholipid antibodies in patients with chronic liver disease related to alcohol or hepatitis C virus: correlation with liver injury . J Lab Clin Med 1998; 131: 243-250 .

18.

18 Quintarelli C , Ferro D , Valesini G , Basili S , Tassone G , Violi F . Prevalence of lupus anticoagulant in patients with cirrhosis: relationship with beta-2-glycoprotein I plasma levels . J Hepatol 1994; 21: 1086-1091 .

19.

19 Prieto J , Yoste JR , Beloqui O et al. Anticardiolipin antibodies in chronic hepatitis C: implication of hepatitis C virus as the cause of the antiphospholipid syndrome . Hepatology 1996; 23: 199-204 .

20.

20 Munoz-Rodriguez FJ et al. Prevalence of hepatitis C virus infection in patients with antiphospholipid syndrome . J Hepatol 1999; 30: 770-773 .

21.

21 Zetterman RK . Autoimmunity and alcoholic liver disease . Am J Med 1990; 89: 127-128 .

22.

22 McFarlane IG . Autoimmunity and hepatotropic viruses . Semin Liver Dis 1991; 11: 223-233 .

23.

23 Devaux PF . Static and dynamic lipid asymmetry in cell membranes . Biochemistry 1991; 30: 1163-1173 .

24.

24 Kerr JFR , Wyllie AH , Currie AR . Apoptosis: a basic biological phenomenon with wide-ranging implications in tissue kinetics . Br J Cancer 1972; 26: 239-257 .

25.

25 Verhoven B , Schlegel RA , Williamson P . Mechanism of phosphatidylserine exposure, a phagocyte recognition signal, on apoptotic T lymphocytes . J Exp Med 1995; 182: 1597-1601 .

26.

26 Fadok V , Voelker DR , Campbell PA , Cohen JJ , Bratton DL , Henson PM . Exposure of phosphatidylserine on the surface of apoptotic lymphocytes triggers specific recognition and removal by macro phages . J Immunol 1992; 148: 2207-2216 .

27.

27 Hunt J , Krilis S . The fifth domain of,B2-glycoprotein I contains a phospholipid binding site (Cys 281-Cys 288) and a region recognised by anticardiolipin antibodies . J Immunol 1994; 152: 653-659 .

28.

28 McNeil H , Simpson R , Chesterman C , Krilis S . Anti-phospholipid antibodies are directed against a complex antigen that includes a lipid-binding inhibitor of coagulation: beta 2-glycoprotein I (apolipoprotein H) . Proc Nati Acad Sci USA 1990; 87: 4120-4124 .

29.

29 Eschwege V , Laude I , Toti F , Pasquali JL , Freyssinet JM. Detection of bilayer phospholipid-binding antibodies using flow cytometry . Clin Exp Immunol 1996; 103: 171-175 .