New insights into an old paradigm: why IgA accumulates in alcoholic liver disease and what could be its role

Alcoholic liver disease (ALD) is the most prevalent cause of chronic liver disease in western countries with highly morbid complications, such as alcohol-associated hepatitis and limited therapeutic options.1 The pathogenesis of ALD is highly influenced by the gut-liver axis1 and some of the key features of ALD include dysbiosis (bacterial, fungal and viral), increased intestinal permeability and translocation of bacterial ligands that activate inflammatory pathways in the liver (figure 1). In this context, the defence mechanism especially at the intestinal level are essential for the control of bacterial translocation. Among these mechanisms, secretory immunoglobulins are essential for the protection of the mucosal surface by binding and neutralising harmful pathogens. However, patients with ALD have increased systemic IgA levels2 and IgA deposits in hepatic sinusoids. While these observations were made decades ago, their cause and role in ALD pathogenesis remained unknown. In...
Source: Gut - Category: Gastroenterology Authors: Tags: Gut Commentary Source Type: research