Review Article

Immune Dysfunction and Albumin-Related Immunity in Liver Cirrhosis

Table 1

Key studies on antibodies directed against albumin.

ReferencePatient cohortMethod of detectionReported resultComment

Hauptman et al. (1974)18 patients with Laennec’s cirrhosis and history of alcoholic abuseAffinity purification of cirrhotic sera by adsorption over albumin-loaded column followed immunoelectrophoresis and immunoblot7 out of 18 patients had detectable IgA antibodies against albuminPts. with antialbumin antibodies showed marked hypoalbuminemia and hypergammaglobulinemia

Hellstrom et al. (1989)8 patients with hepatitis B (all HbsAgpos, 4 pts. anti-HBepos/HBV-DNAneg)Ex vivo stimulation of isolated B-cells; supernatants were then assayed by ELISAIn all patients, antialbumin IgG was found in the supernatant

Louzir et al. (1992)56 patients with HBV-related liver disease (50 pts HBsAg pos, 6 HBsAgneg, and anti-Hbcpos)Patients’ sera were measured by ELISAIn 69.3, 64.5, and 24.2% of the pts, antialbumin antibodies of the IgG, IgA, or IgM class were detected

Lenkei et al. (1980)275 hepatic patients (“mostly with acute hepatitis”)Sera were tested by antialbumin (AA) agglutination51 HbsAgneg pts. with high AA-agglutination titreAntigen: polymerized albumin

Lindstrom et al. (1978)19 pts, nine pts with prolonged nitrofurantoin therapy and tailing albumin phenomenon (TA), control sera from ten patients without TASera were tested by ELISAPatients with TA phenomenon showed higher IgG antialbumin levels (measured as absorbance) compared to patients without TAFollow-up of one patient with TA and nitrofurantoin available: IgG antialbumin levels decreased after cessation of nitrofurantoin

Onica et al. (1983)8 healthy individuals, 25 patients with various liver disease (14 pts acute viral hepatitis, 8 pts chronic hepatitis, and 3 pts liver cirrhosis)Affinity purification of sera by adsorption over albumin-loaded column followed radioimmunoassay and immunodiffusion3 healthy individuals showed antialbumin antibodies (IgG/IgM/no IgA); 10 patients harbored antialbumin antibodies (IgG/IgM/no IgA)Antigen: polymerized albumin

Tamura et al. (1982)54 healthy controls, 77 patients with liver disease (8 acute hepatitis, 15 chronic persistent hepatitis, 14 chronic active hepatitis without liver cirrhosis (LC), 16 alcoholic LC, 9 nonalcoholic LC, and 15 hepatocellular carcinoma)Antibodies in sera or protein fractions were detected with microhaemagglutination assayAntibodies to human albumin were found in 22% of the patients, antibodies to bovine serum albumin in 48% of the patients

Brown et al. (1985)Four groups; group I: 19 healthy individuals who never received immunotherapy or exogenous albumin. Group II: 8 individuals who had received exogenous albumin in the past but no immunotherapy; group III: 26 patients who had received immunotherapy not containing albumin and no exogenous albumin
Group IV: 215 patients who had received immunotherapy containing albumin
Antibodies were detected in sera by ELISAIndividuals exposed to albumin did not harbor increased antialbumin titres compared to individuals who were never exposed to albumin

Bosse et al. (2005)500 healthy individuals received repeated intramuscular injections in weekly intervals; 30 healthy subjects received intravenous albumin infusionsAntialbumin antibodies were assayed by ELISA from seraTreatment did not change or increase antibody titresDouble-blind, randomized trial

Mangili et al. (1988)29 patients with diabetes type 1; 20 healthy individualsAntialbumin antibodies were assayed by ELISA from seraAntibodies (IgG/IgM) against modified (glucitol-albumin, ketoamin-albumin) and unmodified albumin were found in both diabetic and healthy individuals; higher titres were more common in diabetic patients

Raghav et al. (2017)50 patients with type 1 diabetes, 50 patients with type 2 diabetes, 50 patients with gestational diabetes, 50 patients with type 2 diabetes and chronic kidney disease, and 50 healthy controlsAntialbumin antibodies were assayed by ELISA from seraPatients with type 1 and type 2 diabetes showed increased levels of antibodies directed against glycated albumin