In vitro effect of prednisolone on peripheral blood suppressor T cell activity in patients with alcoholic hepatitis.

An immunological process is suggested to play some role in the pathogenesis of alcoholic hepatitis; however, its nature has not been clarified. In the present study, we examined, in 30 patients with alcoholic liver disease, an in vitro effect of prednisolone on suppressor T cell activity to see whether an altered cellular immunoregulatory mechanism is affected by corticosteroid. Suppressor T cell activity, which was induced by concanavalin A (Con A), was assessed by inhibition of phytohemagglutinin-stimulated blast transformation of autologous lymphocytes, and prednisolone (10 micrograms/ml) was added when suppressor T cells were induced. Low suppressor T cell activity was found in alcoholic patients with hepatic fibrosis, alcoholic hepatitis, and cirrhosis with hepatitis; these reductions recovered to a normal range when lymphocytes were incubated in vitro with prednisolone, suggesting an improvement in the altered immunoregulation by prednisolone. Although immunotherapy is shown to be of no benefit in the treatment of alcoholic hepatitis, we propose a need to elucidate further the therapeutic modalities for correction of the immunoregulatory abnormalities in such patients.