Circulating IgA antibody against a 65 kDa heat shock protein in acute alcoholic hepatitis

Heat shock proteins are known to be immunogenic in a number of diverse conditions and can be induced by hypoxia, tumour necrosis factor and alcohol--all potential triggers in patients with acute alcoholic hepatitis. In the present study, sera from 23 patients with acute alcoholic hepatitis, 18 liver disease controls, ten patients with inactive alcoholic liver disease and six alcoholics without liver damage were screened for the antibody to a 65 kDa heat shock protein using an ELISA technique. IgA antibody was found to be closely associated with alcoholic hepatitis; 20/23 patients were seropositive compared to 5/18 liver disease controls and 4/10 with inactive alcoholic cirrhosis. IgM and IgG antibodies to the 65 kDa heat shock protein were less closely associated with alcoholic hepatitis and were positive in nine and eight of the 23 patients, respectively, compared with six and seven of 18 liver disease controls. Neither antibody was detected in alcoholics without liver damage or normal controls. These data indicate that an IgA immune mediated response to the 65 kDa heat shock protein is characteristic of patients with acute alcoholic hepatitis and may be one mechanism underlying observed persistence of liver damage after cessation of alcohol consumption.