Lymphocytotoxicity in acute and chronic alcoholic liver disease: In vitro study on effector cells

It has been suggested that alcohol-induced liver lesions would be the consequence of an autoimmune reaction; however, the type of the effector cells remains controversial. In vitro microlymphotoxicity to isolated rabbit hepatocytes was investigated in 29 patients with alcoholic cirrhosis and in 10 patients with acute alcoholic hepatitis. The mean cytotoxicity index was 15.12 ± 14.18 p. 100 (mean ± 2 SD) in patients with alcoholic cirrhosis and was 62.49 ± 16.33 p. 100 in patients with acute alcoholic hepatitis. In order to characterize the effector cells, we studied cytotoxicity either using a T-enriched fraction of peripheral lymphocytes or total lymphocytes after pronase incubation: the lymphocytes used in these studies were obtained from patients with acute alcoholic hepatitis having a high cytotoxicity index; in both experimental situations, cytotoxic activity was abolished. These findings suggest that a) lymphocytes cytotoxic to the hepatocytes are present in acute alcoholic hepatitis but are absent in inactive alcoholic cirrhosis, b) non-T-cells are responsible for the cytotoxicity in the system studied, and c) the immune reaction appears to be of the cell-mediated antibody-dependent type.