SNFGE SNFGE
 
Thématique :
- Foie
Originalité :
Intermédiaire
Solidité :
Très solide
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2017/08  
 
  2017 Aug;66(2):575-590  
  doi: 10.1002/hep.29242.  
 
  Alcohol abstinence ameliorates the dysregulated immune profiles in patients with alcoholic hepatitis: A prospective observational study.  
 
  Li W, Amet T, Xing Y, Yang D, Liangpunsakul S, Puri P, Kamath PS, Sanyal AJ, Shah VH, Katz BP, Radaeva S, Crabb DW, Chalasani N, Yu Q  
  https://www.ncbi.nlm.nih.gov/pubmed/28466561  
 
 

Abstract

Alcoholic hepatitis (AH) develops in only a small proportion of heavy drinkers. To better understand the mechanisms underlying this disparity, we conducted a study to define the relationship between AH development and dysregulated immune responses that might be ameliorated by alcohol abstinence. Sixty-eight AH patients, 65 heavy drinking controls without liver disease (HDC), and 20 healthy controls were enrolled and followed up to 12 months. At baseline, HDC and healthy controls had no significant differences in their plasma levels of 38 inflammatory cytokines/chemokines measured using multiplex immunoassays. However, compared to HDC, AH patients had higher baseline levels of 11 cytokines/chemokines (tumor necrosis factor alpha, interleukin 6 [IL-6], IL-8, interferon gamma-induced protein 10, IL-4, IL-9, IL-10, fibroblast growth factor 2, IL-7, IL-15, and transforming growth factor alpha) but lower levels of the anti-inflammatory macrophage-derived chemokine. AH patients also had more activated yet dysfunctional immune cells as monocytes, T cells, and B cells expressed higher levels of cluster of differentiation 38 (CD38) and CD69 but low levels of human leukocyte antigen DR, CD80, and CD86 at baseline. In addition, CD4 T cells produced less interferon-gamma in response to T-cell stimulation. Up-regulated IL-6, IL-8, CD38, and CD69 and down-regulated macrophage-derived chemokine, human leukocyte antigen DR, CD86, and CD80 correlated positively and negatively, respectively, with disease severity. Longitudinal analysis indicated that levels of IL-6, IL-8, CD38, and CD69 were reduced, whereas levels of macrophage-derived chemokine, human leukocyte antigen DR, CD80, and CD86 were increased in abstinent AH patients. All of the cellular immune abnormalities were reversed by day 360 in abstinent AH patients; however, plasma levels of tumor necrosis factor alpha, IL-8, IL-10, fibroblast growth factor 2, and IL-7 remained higher.

CONCLUSION:

AH patients were in a highly immune-dysregulated state, whereas HDC showed little evidence of immune activation; alcohol abstinence reversed most, but not all, of the immunological abnormalities. (Hepatology 2017;66:575-590).

 

 
Question posée
 
Identifier les relations entre la survenue d’une hépatite alcoolique et les perturbations de la réponse immune étudiée par l’évaluation de taux sériques de cytokines et chémokines et des cellules immunes (HLA DR, CD80, CD86) et pouvant être améliorée par l’arrêt de l’alcool.
 
Question posée
 
Les patients avec hépatite alcoolique ont plus de cellules immunes actives mais dérégulées. Ces fonctions vont se normaliser à long terme avec l’arrêt de l’alcool.
 
Commentaires

Une autre preuve pour justifier, si cela était nécessaire…, l’arrêt de l’alcool en cas de maladie hépatique. 

 
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