Jejunal immunoglobulin secretion in alcoholic patients with and without cirrhosis

Alcoholic liver diseases are associated with an elevation of serum immunoglobulin A (IgA). This could be the result of increased IgA production by the intestinal mucosa. Serum and jejunal immunoglobulin, albumin and orosomucoid were measured in 13 alcoholic patients with (n = 6) and without (n = 7) cirrhosis and compared to 11 controls. Jejunal secretions were obtained by segmental perfusion under an occluding balloon. High levels of serum monomeric and polymeric IgA were only found in patients with cirrhosis. Alcoholics with and without cirrhosis had normal monomeric and polymeric IgA jejunal secretion rates. Jejunal clearances of albumin, orosomucoid and immunoglobulin G were significantly higher in both non-cirrhotic and cirrhotic patients than in controls. These findings indicate normal jejunal IgA secretion and increased permeability to plasma proteins, such as albumin and immunoglobulin G in alcoholics.