Cirrhosis immune response

The immunological disorders of Indian childhood cirrhosis and of tropical splenomegaly syndrome, where there are disturbances of the immunoglobulin synthesis as well as defects of cellular immune responses, may be the results of a combination of infections and perhaps certain types of unusual autoimmune phenomena—or even to vitamin deficiencies. 

This section is confined to the disturbance of the serum immunoglobulins in an unusual type of liver disease Indian childhood cirrhosis or infantile cirrhosis is one of the major causes of mortality in Indian children and the disease is uniformly fatal. Its etiology is unknown, but recent studies strongly suggest that there is a disturbed immunological process, probably involving both the humoral and cellular aspects of the immune response. 

Causes The following causes are seen as being responsible for an acquired immune deficiency syndrome in liver cirrhosis (B.A. Runyon, 1995) (i.) hypofunction of the RES (a decrease in the filter or clearance function and phagocytosis capacity as well as reduced formation of immune modulators) (s. p. 65), (2.) reduction in hepatic synthesis of opsonins (s. p. 66), (3.) compromised function of leucocytes, (4.) impaired proliferation and activation of T lymphocytes, and (5.) increased mucosa permeability to bacteria. Both bacteria and bacterial lipopolysaccharides enter the organism in large numbers. They are responsible for increased serum levels of the cytokines (e. g. interleukins 1 and 6, TNF, y-interferon), and there is increased production of these substances together with their reduced breakdown in the cirrhotic liver. Cytokines are formed in the monocytes of blood and in the mononuclear cells of various organs (above all in ascites). 

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