Cunningham-Rundles C, Brandeis W E, Safai B, O'Reilly R, Day N K, Good R A
Am J Med. 1979 Nov;67(5):883-90. doi: 10.1016/0002-9343(79)90749-6.
We have previously shown that a selective absence of serum and secretory immunoglobulin A (IgA) may lead to the development of circulating immune complexes which appear to contain bovine milk antigens. We report here that high levels of circulating immune complexes were found in the serum of a child who was treated for severe combined immunodeficiency by bone marrow transplantation but in whom the IgA-producing cells subsequently failed. As increasing amounts of complexes appeared over a two year period, the child had a parallel progression of an apparent chronic graft versus host disease including a Sjögrens syndrome and scleroderma. Very large amounts of complexes were eventually formed but the level fell 77 per cent after milk was excluded from the diet. Chemical studies on the complexes showed that the majority of complexes did contain bovine milk proteins, and fluorescence antibody staining of skin biopsy samples showed the presence of dense deposits of bovine casein in the dermis. The relationship between bovine protein-antigen antibody complexes and the chronic graft reaction remains uncertain.
我们之前已经表明，血清和分泌型免疫球蛋白A（IgA）的选择性缺乏可能导致循环免疫复合物的形成，这些复合物似乎含有牛乳抗原。我们在此报告，一名接受骨髓移植治疗严重联合免疫缺陷的儿童血清中发现了高水平的循环免疫复合物，但随后其产生IgA的细胞功能衰竭。在两年时间里，随着复合物数量的不断增加，该儿童出现了明显的慢性移植物抗宿主病的平行进展，包括干燥综合征和硬皮病。最终形成了大量的复合物，但在饮食中排除牛奶后，复合物水平下降了77%。对复合物的化学研究表明，大多数复合物确实含有牛乳蛋白，皮肤活检样本的荧光抗体染色显示真皮中有密集的牛酪蛋白沉积物。牛蛋白 - 抗原抗体复合物与慢性移植反应之间的关系仍不确定。
