Immunological Abnormalities Associated with liver Disease: Cause or Effect?

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Abstract
Immunological abnormalities are demonstrable in patients with various types of liver damage. These may be non-specific and unrelated to pathogenesis, e.g., autoantibodies such as anti-nuclear factor; specifically directed against liver antigens but not pathogenetic, cell mediated immune (CMI) reactions to liver antigen as seen in experimental CCl4 poisoning; of such a nature as to modify the pathology produced by hepatotoxic agents, hepatitis B virus or alcohol; primarily responsible for hepatic pathology, in idiopathic chronic active hepatitis. The latter 2 possibilities remain unproven although there is growing evidence that immune responses do play some role in the pathogenesis of acute and chronic hepatitis B and possibly also in the pathogenesis of alcoholic liver disease. It seems much less likely that primary abnormalities of the immune systems are responsible for any type of liver disease. Immune reactions may develop as a consequence of liver damage and only in certain circumstances do these reactions play a role in the development and continuation of hepatic pathology.