Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?

Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections.<0.001, OR:2.02) by Cox-regression analysis.The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies

Summary of Cox model: factors affecting time to first severe bacterial infection.

<p><i>p</i> value: level of significance; 95% CI: 95% confidence interval.</p

Anti-microbial serological markers in cirrhotic patients according to the absence or presence of ascites.

<p>*<i>p</i><0.01,</p>#<p><i>p</i><0.001 between cirrhotic patients with or without ascites by χ²-test with Yates correction and linear-by-linear association for serological responses.</p

Anti-microbial serological markers in patients with liver cirrhosis according to the disease severity depicted by Child-Pugh stages.

<p>*<i>P</i><0.001 for both by linear-by-linear association.</p><p>Child-Pugh stage were not available for 7 patients.</p

Logistic regression: Predictive factors for severe bacterial infection in patients with liver cirrhosis.

<p>The coefficient is equivalent to the natural log of the OR; <i>p</i> value: level of significance;</p><p>OR: odds ratio; 95% CI: 95% confidence interval.</p

Anti-microbial serological markers in patients with chronic liver diseases and healthy controls.

<p>AIH = autoimmune hepatitis, HCV = viral hepatitis C, PBC = primary biliary cirrhosis, PSC = primary sclerosing cholangitis.</p><p>*<i>p</i><0.001 between liver cirrhosis and chronic HCV, autoimmune liver diseases, healthy controls.</p>#<p><i>p</i><0.001 between chronic HCV patients and autoimmune liver diseases, healthy controls.</p>&<p><i>p</i> = 0.04 between PSC and healthy controls.</p>φ<p><i>p</i><0.001 between PSC and chronic HCV.</p>⊥<p><i>p</i><0.01 between PSC and chronic HCV.</p><p>by using Fisher's exact test or χ²-test with Yates correction if appropriate.</p

Anti-microbial antibody levels in patients with cirrhosis with various levels of severity, as depicted either by Child-Pugh stages (A) or MELD score (B).

<p><b>A</b>. Individual values are shown by black spots. Mean values with standard error bars are indicated in blue. Cut-off values for positivity are 25 Units for all antibodies. <i>P</i><0.001 between all groups by ANOVA post hoc Scheffe for ASCA IgA and anti-OMP Plus™ IgA <i>P = NS</i> for ASCA IgG. <b>B</b>. MELD Q1-Q4 represent the groups of patients broken down by quartile: quartile1 patients have the lowest severity up to quartile4, representing patients with the highest level of severity. <i>P</i><0.001 between all groups by ANOVA post hoc Scheffe for ASCA IgA and anti-OMP Plus™ IgA <i>P = NS</i> for ASCA IgG.</p