Emmrich J, Seyfarth M, Conradi P, Plath F, Sparmann G, Löhr M, Liebe S
Department of Internal Medicine, University of Rostock, Germany.
Gut. 1998 Mar;42(3):436-41. doi: 10.1136/gut.42.3.436.
The predominance of secretory IgA (S-IgA) in intestinal secretions compared with blood is well established, but concentrations of this protein in pancreatic juice and its origin, especially in chronic pancreatitis, are unknown.
To investigate the role of S-IgA in chronic pancreatitis.
Twenty one patients with chronic pancreatitis (group I), three patients with proven malignancies (group II), and 12 patients without pancreatic disease (group III).
Pure human pancreatic juice was collected endoscopically in four fractions after consecutive stimulation with secretin and cholecystokinin (CCK). Samples were analysed for S-IgA, protein, trypsinogen, and proteolytic activity.
The S-IgA level was significant increased in fraction 1 of pancreatic juice of group I (1210 (1411) ng/ml) compared with controls (33 (70) ng/ml). Protein concentrations and trypsinogen content were lower in group I than in the other groups. Proteolytic activity could be observed in 53% of all 133 pancreatic juice samples, but in 87% of fraction 1. In pancreatic tissue of three patients with chronic pancreatitis both IgA and secretory component were detected by immunohistology. Expression of the secretory component by human pancreatic epithelial cells was increased in patients with chronic pancreatitis compared with normal controls. The concentration of S-IgA in pancreatic juice did not correlate with the serum S-IgA level. In contrast, serum levels of S-IgA were decreased in patients with chronic pancreatitis.
There are high levels of S-IgA in human pancreatic juice following chronic inflammation and a protective role is suggested for this immunoglobulin.
与血液相比，分泌型IgA（S-IgA）在肠道分泌物中占优势已得到充分证实，但这种蛋白质在胰液中的浓度及其来源，尤其是在慢性胰腺炎中的情况尚不清楚。
研究S-IgA在慢性胰腺炎中的作用。
21例慢性胰腺炎患者（I组）、3例确诊为恶性肿瘤的患者（II组）和12例无胰腺疾病的患者（III组）。
在内镜下，连续用促胰液素和胆囊收缩素（CCK）刺激后收集四份纯人类胰液。对样本进行S-IgA、蛋白质、胰蛋白酶原和蛋白水解活性分析。
与对照组（33（70）ng/ml）相比，I组胰液第1份中的S-IgA水平显著升高（1210（1411）ng/ml）。I组的蛋白质浓度和胰蛋白酶原含量低于其他组。在所有133份胰液样本中，53%可观察到蛋白水解活性，但在第1份中为87%。通过免疫组织学在3例慢性胰腺炎患者的胰腺组织中检测到了IgA和分泌成分。与正常对照组相比，慢性胰腺炎患者的人胰腺上皮细胞分泌成分表达增加。胰液中S-IgA的浓度与血清S-IgA水平无关。相反，慢性胰腺炎患者的血清S-IgA水平降低。
慢性炎症后人类胰液中存在高水平的S-IgA，提示这种免疫球蛋白具有保护作用。
