Immunoglobulin allotypes and immunoreactivity in chronic liver disease.

The immunoglobulin allotypes Gm (a; x; f) and Km 1 have been estimated in 194 patients with chronic liver disease, and compared with the frequency distribution of a representative reference group (Gm : n = 2171; Km : n = 2179). In relation to the Gm phenotypes we have investigated the cell-mediated immunoreactivity by the E rosette test, lymphocyte transformation test and migration inhibition test. Virus-induced chronic liver disease showed significantly higher prevalence of the phenotypes Gm a+x-f+ and Gm a+x+f+ as well as of the marker Km + 1 (p less than or equal to 5%; chi 2-test). In auto-immune chronic liver disease we observed a decrease in the phenotype Gm a+x-f+ while the factor Km + 1 was significantly multiplied. Patients with cryptogenic and alcoholic hepatopathy showed no differences in comparison with the reference group. In the progressive forms of the chronic liver disease (chronic active hepatitis, liver cirrhosis) Gm a+x+f+ was significantly more frequent. The investigations concerning cell-mediated immunity in different Gm allotypes generally showed a trend to increased reactivity in Gm a+x+ in comparison with Gm a-x- in non-alcoholic liver disease. It is possible to presume different genetic and immunologic situations in the various liver diseases as endogenous factors promoting the disease.

[Whipple's disease, an example of interactions between gastrointestinal flora and the macroorganism?]. / Morbus Whipple, ein Beispiel für Wechselwirkungen zwischen Gastrointestinalflora und Makroorganismus?

Morbus Whipple is known as a systemic disease caused by bacteria and inducing the formation of mucopolysaccharides which is absorbed by macrophages. In a mucosal bioptate of a 60 years old patient suffering from this disease we could prove numerous rod-shaped bacteria (Propionibacterium) by electronmicroscopy. In the duodenal secretion aerobic and strictly anaerobic bacteria were to be found. Therapy with tetracycline was followed by a fast and distinct improvement of the clinical symptoms of the absorption disturbances but not so clear of the histological findings.

Haptoglobin type and liver disease.

The haptoglobin phenotype has been estimated in patients suffering from chronic liver disease (n = 222) and acute hepatitis (n = 59) in comparison with the haptoglobin pattern of a normal population (n = 1726). The frequency of Hp 1-1 was significantly increased in non-alcoholic chronic liver disease (p = 5%; chi 2-test) in contrast to alcoholic disease. The highest incidence of Hp 1-1 occurred in cryptogenic cases (p = 1%). The follow-up of patients suffering from acute hepatitis failed to indicate any relationship between the haptoglobin phenotype and the course of hepatitis. The results suggest that Hp 1-1 is a genetic marker of special kinds of chronic liver diseases.

[Comparative in vitro studies of cell-mediated immunity in chronic liver diseases]. / Vergleichende in-vitro-Untersuchungen zur zellvermittelten Immunität bei chronischen Lebererkrankungen.

Reactions of cell-mediated immunity are investigated in 32 healthy controls and 134 patients with chronic liver diseases (E-rosette-forming cells, lymphocyte transformation test, leucocyte migration inhibition test using the T-cell-mitogens Phytohaemagglutinin and Concanavalin A). The number of E-rosette-forming cells is significantly decreased in chronic active hepatitis, alcoholic hepatitis and cirrhosis. The 3H-thymidine uptake in the lymphocyte transformation test by use of PHA and Con A is markedly reduced especially in active and progressed liver diseases. PHA caused a significant higher inhibition of leucocyte migration in patients with alcoholic hepatitis and cirrhosis than in healthy controls. A dependency between the results of the two tests is not detectable (Chi 2-test). We found in individual cases of groups with liver diseases serum inhibition factors by MIT, but not correlations with other immunological or clinical-chemical parameters. The pathogenetical value of the used methods in cases with chronic liver diseases is questionable.

[Changes in phagocytic performance of neutrophilic granulocytes in chronic liver diseases of various etiologies]. / Veränderungen der Phagozytoseleistung neutrophiler Granulozyten bei chronischen Lebererkrankungen verschiedener Atiologie.

The phagocytic functions and the nitroblue-tetrazolium (NBT)-reduction of heat inactivated Saccharomyces cerevisiae blastospores by polymorphnuclear leukocytes in 92 patients with chronic liver diseases and 21 normal human subjects was investigated. The percentage of phagocytizing leukocytes and the number of phagocytized yeast particles/100 leukocytes was only significantly reduced in active alcoholic cirrhosis. A relationship between this findings and highly enhanced sIgA levels of this group is discussed. The NBT-reduction is impaired in all groups with liver disease, the decrease is significant in chronic persistent hepatitis and all groups with alcoholic etiology. The detection of a positive correlation to unspecific stimulation of lymphocytes by PHA and negative correlation to leukocyte migration inhibition by PHA suggested the implication of reactions of cell mediated immunity in NBT-reaction. No relations between phagocytosis, NBT-reaction and autologous serum factors was estimated.

[Acetaldehyde-induced leukocyte migration inhibition in alcoholic liver diseases]. / Azetaldehydinduzierte Leukozytenmigrationshemmung bei alkoholischen Lebererkrankungen.

Acetaldehyde in non-toxic doses (15.6 micrograms per start) causes in the inhibition test of the migration of leucocytes an inhibition of the migration in 6/13 of the patients with alcoholic hepatitis, a stimulation of the migration in 6/11 of alcohol cirrhoses. Healthy (n = 16) persons, patients with alcoholic fatty degeneration of the liver (n = 3) as well as non-alcoholic liver diseases (chronic persisting hepatitis, n = 11; chronic active hepatitis, n = 8, cirrhosis, n = 7) did not show this cellular immune reagibility. The inhibition of the migration and the stimulation of the migration, respectively, might develop by hapten autoantigen complexes (altered cytoskeleton?) with release of the factors of inhibition of migration and stimulation of migration, in which case the role of a hapten belongs to acetaldehyde. The results of the tests did not correlate with functional and histological findings of the liver, with the actual consumption of alcohol and also not with haptoglobin phaenotypes. When it is postulated that by acetaldehyde also the release of further lymphokines is mediated, origin and progression of alcoholic hepatitis and alcoholic cirrhosis might be explained immunopathogenetically.

[Acute and subchronic experiments on the effects of microcrystalline cellulose on various pharmacological and biochemical parameters in mongrel rabbits]. / Beeinflussung verschiedener pharmakologischer und biochemischer Parameter am Bastardkaninchen durch mikrokristalline Cellulose im akuten und subchronischen Versuch.

The subchronic intravenous application of microcrystalline cellulose (MCC), in a dose of 5 mg/kg twice weekly for 10 weeks, resulted in servere crystal embolism in the lungs of the animals. The clinical parameters were either unchanged (erythrocyte and leucocyte counts, differential blood picture, osmotic resistance of the erythrocytes, total serum bilirubin, serum protein and serum protein fractions) or slightly pathological (hemoglobin content, hematocrit, GOT and GPT). The results from tests of the liver function (by means of bromosulphthaleine clearance) and of the renal function as well as the ophthalmologic examination were not indicative of damaged parenchyma or disturbed microcirculation. Intra-arterial infusions of MCC affected the peripheral muscular blood supply, blood pressure and heart rate.