Miller H F, Legler K, Thomssen R
Infect Immun. 1983 May;40(2):542-7. doi: 10.1128/iai.40.2.542-547.1983.
The marked increase in the total serum immunoglobulin M (IgM) is a characteristic feature of acute hepatitis A. To study the nature of this IgM, we assayed serial titers of IgM antibodies against various antigens during and after acute hepatitis A. The antibodies against blood group antigen remained unchanged throughout the observation period. Thus, the production or metabolism of IgM was not nonspecifically altered. The IgM antibody against hepatitis A antigen decreased and finally disappeared during convalescence as expected. However, its time course did not correlate quantitatively with the concentration of the total serum IgM. In contrast, IgM antibodies against gut bacteria Bacteroides fragilis and Streptococcus faecalis were considerably elevated in all patients at the onset of the disease, and they normalized similarly to the total IgM during convalescence. IgM antibodies against Escherichia coli were elevated only in some of the patients. The data suggest that the amount of IgM antibodies against gut bacteria contributes significantly to the increase in the total serum IgM in acute hepatitis A.
血清总免疫球蛋白M（IgM）显著增加是甲型肝炎的一个特征。为了研究这种IgM的性质，我们检测了甲型肝炎急性期及恢复期针对各种抗原的IgM抗体的系列滴度。针对血型抗原的抗体在整个观察期内保持不变。因此，IgM的产生或代谢并未发生非特异性改变。正如预期的那样，针对甲型肝炎抗原的IgM抗体在恢复期下降并最终消失。然而，其时间进程与血清总IgM浓度在数量上并无关联。相比之下，针对肠道细菌脆弱拟杆菌和粪肠球菌的IgM抗体在所有患者发病时均显著升高，并且在恢复期与总IgM一样恢复正常。针对大肠杆菌的IgM抗体仅在部分患者中升高。这些数据表明，针对肠道细菌的IgM抗体量对甲型肝炎患者血清总IgM的增加有显著贡献。
