Friman V, Quiding M, Czerkinsky C, Nordström I, Larsson L, Ericson D, Björkander J, Theman K, Kilander A, Holmgren J
Department of Infectious Diseases, University of Göteborg, Sweden.
Clin Exp Immunol. 1994 Feb;95(2):222-6. doi: 10.1111/j.1365-2249.1994.tb06514.x.
In search for a possible explanation for the different susceptibility to mucosal infections in IgA-deficient (IgAd) individuals, the frequency of total immunoglobulin-secreting cells (ISC) and vaccine-specific antibody-secreting cells (ASC) in intestinal mucosa and peripheral blood was determined by the enzyme-linked immunospot (ELISPOT) assay before and after peroral vaccination with a B subunit-whole cell cholera vaccine. Two groups of IgAd individuals, frequently infected and non-infected respectively, and normal controls were studied. Before cholera vaccination there were significantly higher frequencies of total IgM and IgG ISC in the gut, but not in the blood, in the IgAd individuals than in the controls. However, there were no significant differences between healthy and infection-prone IgAd individuals in this respect. In response to oral cholera vaccination, intestinal cholera toxin (CT)-specific IgG and IgM ASC were significantly more abundant among the IgAd individuals with a history of frequent infections than among the healthy IgAd individuals and controls. A similar difference in IgG and IgM ASC, although not significant, was also noted in blood. In IgAd individuals with frequent infections the vaccine induced variable anti-CT IgM ASC responses in the gut, ranging from no increase to a few strikingly high responses. In the controls, the CT-specific responses were dominated by IgA ASC. The data show that oral cholera vaccination evoked strong CT-specific IgG ASC responses, and in some cases also strong IgM ASC responses in the intestinal mucosa of IgAd patients with a history of frequent infections. The healthy IgAd individuals unexpectedly responded with lower numbers of CT-specific IgG ASC and did not show any increase of CT-specific IgM ASC in the intestinal mucosa. Thus, inability to mount a mucosal immune response to an oral antigen cannot in itself explain recurrent infections among many IgAd individuals.
为了寻找对IgA缺陷（IgAd）个体黏膜感染易感性不同的可能解释，在用B亚单位-全细胞霍乱疫苗进行口服疫苗接种前后，通过酶联免疫斑点（ELISPOT）试验测定了肠道黏膜和外周血中总免疫球蛋白分泌细胞（ISC）和疫苗特异性抗体分泌细胞（ASC）的频率。研究了两组分别为频繁感染和未感染的IgAd个体以及正常对照。在霍乱疫苗接种前，IgAd个体肠道中总IgM和IgG ISC的频率显著高于对照组，但血液中并非如此。然而，在这方面，健康的和易感染的IgAd个体之间没有显著差异。口服霍乱疫苗后，有频繁感染史的IgAd个体中，肠道霍乱毒素（CT）特异性IgG和IgM ASC明显比健康的IgAd个体和对照组丰富。血液中IgG和IgM ASC也有类似差异，尽管不显著。在有频繁感染的IgAd个体中，疫苗在肠道中诱导了可变的抗CT IgM ASC反应，从无增加到少数显著高反应不等。在对照组中，CT特异性反应以IgA ASC为主。数据表明，口服霍乱疫苗在有频繁感染史的IgAd患者的肠道黏膜中引发了强烈的CT特异性IgG ASC反应，在某些情况下还引发了强烈的IgM ASC反应。健康的IgAd个体出乎意料地以较少数量的CT特异性IgG ASC做出反应，并且在肠道黏膜中未显示CT特异性IgM ASC有任何增加。因此，无法对口服抗原产生黏膜免疫反应本身并不能解释许多IgAd个体中的反复感染。
