Schneider T, Zippel T, Schmidt W, Pauli G, Wahnschaffe U, Chakravarti S, Heise W, Riecken E O, Zeitz M, Ullrich R
Department of Gastroenterology, Free University of Berlin, Germany.
Gut. 1998 Mar;42(3):357-61. doi: 10.1136/gut.42.3.357.
Secretory immunity is a major defence mechanism against infections at mucosal surfaces which are common in HIV infected patients.
To analyse intestinal immunoglobulin production in HIV infection in comparison with that in saliva and serum.
Immunoglobulin G (IgG), A (IgA), and M (IgM) concentrations were determined in supernatants of short term cultured duodenal biopsy samples, serum, and saliva from HIV infected patients (n = 28) and controls (n = 14) by radial immunodiffusion.
IgG was increased in the supernatants of short term cultured biopsy samples and saliva from HIV infected patients compared with controls (p < 0.01), but IgA and IgM levels were normal. In contrast, both IgG and IgA concentrations in serum were higher in HIV infected patients than in controls (p < 0.002). No correlation was found between IgA produced by duodenal biopsy specimens and serum IgA.
Abnormalities in mucosal immunoglobulin production in HIV infection were surprisingly small, indicating that specific secretory immunity rather than quantitative immunoglobulin production may be impaired. However, increased production of IgG could contribute to mucosal inflammation by complement activation. Our findings of normal mucosal IgA production and the lack of correlation between serum and mucosal IgA argues against an intestinal origin for the increased serum IgA levels in HIV infected patients.
分泌性免疫是抵御黏膜表面感染的主要防御机制,而黏膜表面感染在HIV感染患者中很常见。
分析HIV感染患者肠道免疫球蛋白的产生情况,并与唾液和血清中的情况进行比较。
通过放射免疫扩散法测定HIV感染患者(n = 28)和对照组(n = 14)短期培养的十二指肠活检样本、血清和唾液上清液中的免疫球蛋白G(IgG)、A(IgA)和M(IgM)浓度。
与对照组相比,HIV感染患者短期培养活检样本和唾液上清液中的IgG升高(p < 0.01),但IgA和IgM水平正常。相比之下,HIV感染患者血清中的IgG和IgA浓度均高于对照组(p < 0.002)。十二指肠活检标本产生的IgA与血清IgA之间未发现相关性。
HIV感染中黏膜免疫球蛋白产生的异常出人意料地小,表明特异性分泌性免疫而非免疫球蛋白的定量产生可能受损。然而,IgG产生增加可能通过补体激活导致黏膜炎症。我们关于黏膜IgA产生正常以及血清和黏膜IgA缺乏相关性的发现,反对HIV感染患者血清IgA水平升高源于肠道的观点。