In vitro evidence for B cell dysfunction in patients with chronic liver disease.

Patients with chronic liver disease have been reported to have multiple immunologic abnormalities. We evaluated immune function in 40 such patients. The patient group had a decreased proportion of CD3 positive cells compared to controls (54.2 +/- 13.2 vs 67.9 +/- 5.7, p less than 0.01), CD4 positive cells (38.4 +/- 10.0 vs 44.3 +/- 4.9, p less than 0.01) and CD8 positive cells (17.7 +/- 8.2 vs 26.3 +/- 3.9, p less than 0.05). B cells were increased over controls (8.3 +/- 4.0 vs 6.0 +/- 1.9, p less than 0.01). In vitro immunoglobulin synthesis studies demonstrated decreased production in both IgM (632 +/- 482 ng/ml vs 2,050 +/- 1,720 ng/ml, p less than 0.01) and IgG synthesis (726 +/- 640 ng/ml vs 1,117 +/- 1,012 ng/ml, p less than 0.05) by patients as compared to controls. Coculture of fractionated populations of lymphocytes indicated that the patients had adequate T helper cell activity and no evidence for enhanced T suppressor cell activity. B cells of patients with chronic liver disease appear to have an impaired capacity to produce immunoglobulin in vitro.

Duke Scholars

Author John Wiley Williams Jr. Medicine, General Internal Medicine