Sung J J, Leung J C, Tsui C P, Chung S S, Lai K N
Departments of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong.
Gastrointest Endosc. 1995 Nov;42(5):439-44. doi: 10.1016/s0016-5107(95)70047-1.
Immunoglobulin A is the predominant immunoglobulin in the bile. Data on the effects of biliary obstruction on IgA secretion are few.
The serum and bile IgA levels in patients with common duct stones (n = 27) or with malignant obstructive jaundice (n = 20) were collected by insertion of nasobiliary catheters. Single samples of common duct bile from patients with gallstones (n = 24) were collected as controls. Bile samples collected were measured for total IgA, secretory IgA, and free secretory component levels by sandwich enzyme-linked immunosorbent assays.
Bile total IgA, secretory IgA, and free secretory component in the common duct stones group (82.7 +/- 11.4 microgram/ml, 18.4 +/- 1.7 microgram/ml, 0.74 +/- 0.15 microgram/ml) and the malignant obstructive jaundice group (81.6 +/- 10.7 microgram/ml, 18.2 +/- 2.4 microgram/ml, 0.57 +2- 0.12 microgram/ml) were found to be significantly lower than those of the control gallstone patients (104.8 +/- 3.4 microgram/ml, 33.2 +/- 2.9 microgram/ml, 1.03 +/- 0.12 microgram/ml) (P < 0.05). Serum secretory IgA levels in the common duct stones (26.53 +/- 1.75 microgram/ml) and malignant obstructive jaundice groups (26.03 +/- 3.48 microgram/ml) were significantly higher than the gallstone group (18.45 +/- 4.56 microgram/ml). The bile-to-serum concentration ratio of total IgA, secretory IgA, and free secretory component levels rose significantly within 48 hours after relief of obstruction.
Biliary obstruction secondary to both calculus or malignancy of the hepatobiliary system causes suppression of bile IgA secretion and elevated serum level of secretory IgA. Bile secretory IgA secretion recovers with endoscopic drainage of the obstructed system.
免疫球蛋白A是胆汁中的主要免疫球蛋白。关于胆道梗阻对IgA分泌影响的数据很少。
通过插入鼻胆管收集胆总管结石患者（n = 27）或恶性梗阻性黄疸患者（n = 20）的血清和胆汁IgA水平。收集胆结石患者（n = 24）的胆总管胆汁单一样本作为对照。采用夹心酶联免疫吸附测定法测量收集的胆汁样本中的总IgA、分泌型IgA和游离分泌成分水平。
胆总管结石组（82.7±11.4微克/毫升、18.4±1.7微克/毫升、0.74±0.15微克/毫升）和恶性梗阻性黄疸组（81.6±10.7微克/毫升、18.2±2.4微克/毫升、0.57±0.12微克/毫升）的胆汁总IgA、分泌型IgA和游离分泌成分显著低于对照胆结石患者（104.8±3.4微克/毫升、33.2±2.9微克/毫升、1.03±0.12微克/毫升）（P < 0.05）。胆总管结石组（26.53±1.75微克/毫升）和恶性梗阻性黄疸组（26.03±3.48微克/毫升）的血清分泌型IgA水平显著高于胆结石组（18.45±4.56微克/毫升）。梗阻解除后48小时内，总IgA、分泌型IgA和游离分泌成分水平的胆汁与血清浓度比显著升高。
肝胆系统结石或恶性肿瘤继发的胆道梗阻导致胆汁IgA分泌受抑制，血清分泌型IgA水平升高。梗阻系统经内镜引流后，胆汁分泌型IgA分泌恢复。
