Urinary IgA, secretory IgA and secretory component in women with recurrent urinary tract infections.

Urinary secretory IgA (sIgA), consisting of free secretory component (FSC) and dimeric IgA, is involved in the defense against urinary tract infections (UTI). Recurrent UTIs (rUTI) have been suggested to be associated with a defective excretion of sIgA. Therefore urinary sIgA, FSC and serum-type IgA concentrations were measured by ELISA in 68 normal women, 10 asymptomatic women with rUTIs and no urological abnormality (group A), 8 asymptomatic women with rUTIs and a urological abnormality (B), 4 women with acute UTI (C) and 5 women with a selective serum IgA deficiency (D). Annual UTI rates were increased in groups A, B and C, but normal in group D. In no patient group urinary FSC concentration was different from the normals, while sIgA concentrations were increased in group C, markedly reduced in group D, but normal in groups A and B. Urinary serum-type IgA concentrations were significantly increased in group A and C, markedly reduced in group D and normal in group B. These results demonstrate that the urinary sIgA system participates in the immune response to bacterial infections, but that even a complete failure of the sIgA system does not lead to an increased UTI rate. Furthermore, no association of recurrent UTIs with disturbances of the urinary sIgA excretion could be demonstrated.