Immune response to lipopolysaccharide in primary biliary cirrhosis and autoimmune diseases.
A bacteriological aetiology is suspected to be the triggering factor in primary biliary cirrhosis. We studied lipid A, the toxic and immunogenic moiety of gram-negative bacteria lipopolysaccharide, which accumulates abnormally in Kupffer cells, hepatocytes, and biliary epithelial cells in primary biliary cirrhosis patients. Anti-lipid A antibody levels from serum samples from 36 primary biliary cirrhosis patients, drawn before and after ursodeoxycholic acid treatment, were compared to those from patients with other liver diseases (n=236), non-hepatic diseases (n=249), and healthy subjects (n=75). In primary biliary cirrhosis patients, the prevalence of IgM anti-lipid A antibodies was higher before than after ursodeoxycholic acid therapy (64% vs 22%, respectively; P<0.001). Patients with anti-lipid A antibodies had significantly higher IgM levels than those without antibodies (8.7+/-1.1 g/l vs 4.4+/-0.8 g/l, P<0.02). Total IgM levels were correlated with anti-lipid A antibody levels (r=0.65, P<0.02). After therapy, the serum IgM levels decreased significantly (P<0.03). These results indicate that bacterial antigens may participate in the observed increase of serum IgM levels, and support an aetiological role of a gut-derived endotoxin antigen in the pathogenesis of primary biliary cirrhosis.
Ballot
Eric
E
Service d'Immunologie, Hôpital Saint-Antoine, AP-HP, 184 rue du faubourg Saint-Antoine, 75012 Paris, France.
Bandin
Olivia
O
Chazouilleres
Olivier
O
Johanet
Catherine
C
Poupon
Raoul
R
D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000097:blood / Q000276:immunology; D001327:Autoimmune Diseases / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007109:Immunity; D007075:Immunoglobulin M / Q000097:blood* / Q000276:immunology; D008070:Lipopolysaccharides / Q000276:immunology*; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D000942:Antigens, Bacterial; D007075:Immunoglobulin M; D008070:Lipopolysaccharides; C082161:lipopolysaccharide A; D014580:Ursodeoxycholic Acid