Serum Secretory IgA Levels Research Articles

The level of serum secretory IgA of patients with IgA nephropathy is elevated and associated with pathological phenotypes

Mucosal infection associated episodic macroscopic haematuria is observed in many patients with IgA nephropathy (IgAN), however, the mechanism has not been elucidated. Recent study suggested that secretory IgA (SIgA) might play an important role in the pathogenesis of IgAN. The aim of this study is to investigate the level of serum SIgA and the deposition of SIgA in glomeruli in IgAN patients with different pathological phenotypes. The levels of serum SIgA were detected in 57 patients with IgAN and 48 normal controls. The associations between the levels of SIgA and the pathological phenotypes of IgAN as well as clinical parameters were investigated. Frozen renal sections from 34 of the 57 patients without IgM deposition were immunofluorescence stained and examined by confocal microscopy to detect the co-deposition of IgA and secretory component (SC). The association between deposition of SIgA and the level of serum SIgA was analysed. The level of serum SIgA in patients with IgAN was significantly higher than that of normal controls. The level of serum SIgA in patients with focal proliferative sclerosing IgAN (fpsIgAN) was much higher than that in patients with mild mesangial proliferative IgAN (mIgAN) (P<0.001). The level of serum SIgA correlated with the level of serum creatinine (R=0.509, P<0.001), degree of proteinuria (R=0.643, P<0.001) and creatinine clearance (R= -0.454, P=0.002) in patients with IgAN. Significant co-deposition of SC and IgA were found in 11 of the 34 patients. Although the level of serum SIgA in patients with SC deposits was higher than those without SC deposits, the difference was not significant. It was concluded that mesangial IgA, at least partly, was originated from mucosal immune sites. The levels of serum SIgA were significantly increased in patients with IgAN and were closely associated with pathological phenotypes.

Biliary IgA secretion in obstructive jaundice: The effects of endoscopic drainage

Background: Immunoglobulin A is the predominant immunoglobulin in the bile. Data on the effects of biliary obstruction on IgA secretion are few. Methods: 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. Results: Bile total IgA, secretory IgA, and free secretory component in the common duct stones group (82.7 ± 11.4 μg/ml, 18.4 ± 1.7 μg/ml, 0.74 ± 0.15 μg/ml) and the malignant obstructive jaundice group (81.6 ± 10.7 μg/ml, 18.2 ± 2.4 μg/ml, 0.57 ± 0.12 μg/ml) were found to be significantly lower than those of the control gallstone patients (104.8 ± 3.4 μg/ml, 33.2 ± 2.9 μg/ml, 1.03 ± 0.12 μg/ml) (P < 0.05). Serum secretory IgA levels in the common duct stones (26.53 ± 1.75 μg/ml) and malignant obstructive jaundice groups (26.03 ± 3.48 μg/ml) were significantly higher than the gallstone group (18.45 ± 4.56 μg/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. Conclusions: 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. (Gastrointest Endosc 1995;42:439-44.)

Serum secretory IgA and secretory component in patients with non-cirrhotic alcoholic liver diseases

Elevated levels of secretory IgA in serum have been demonstrated in several liver dysfunctions such as hepatic cytolysis and cholestasis. However, these possible alterations at an eary stage of liver diseases have not yet been investigated. We studied a cohort of chronic alcoholic patients without cirrhosis in order to assess the changes in serum secretory IgA and other forms of secretory component, the split product of the polymeric Ig-receptor of epithelial cells. The possible diagnostic value of these measurements in the assessment of alcoholic disease was compared to that of serum gamma-glutamyl transpeptidase activity.Serum levels of secretory IgA and IgM and free secretory component, were quantified by an enzyme-linked immunosorbent assay in 71 patients with chronic alcoholic liver disease without cirrhosis and in 45 healthy controls. Patients were divided into two groups according to the severity of the liver abnormalities. In addition, the reversibility of serum secretory IgA, IgM and free secretory component abnormalities after alcohol withdrawal was evaluated in 15 patients.Serum levels of the three molecular forms of secretory component were significantly higher than those measured in control subjects, both in the whole population of patients and in the two groups of alcoholic patients without cirrhosis. In all groups, serum secretory IgA levels were correlated to free secretory component but not to total IgA levels. Serum secretory IgA levels were as discriminative as gammaglutamyl transferase activity in distinguishing between chronic alcoholic patients without cirrhosis and non-alcoholic subjects. The abnormalities of serum secretory IgA concentrations were reversible after alcohol withdrawal.The results of this study demonstrate that serum secretory IgA and free secretory component levels are significantly increased in patients with chronic alcoholic liver disease, even at a very early stage of the disease, and decrease after alcohol withdrawal. Serum secretory IgA could therefore be used as an additional marker of mild liver abnormalities in chronic alcoholic subjects, and of the effectiveness of alcohol withdrawal. Release of polymeric Ig-receptor into the serum could share a similar physiopathological mechanism with gamma-glutamyl transpeptidase.

Secretory immunoglobulins in serum from human immunodeficiency virus (HIV)-infected patients.

Infection by the human immunodeficiency virus is associated with polyclonal B cell activation and increased levels of serum IgA. In order to characterize the molecular species of serum IgA, we have measured total IgA, IgA1, and IgA2 in sera from 60 HIV-1-infected patients and 40 healthy controls. In addition, secretory IgA (S-IgA), secretory IgM (S-IgM), free immunoreactive secretory component (SC), and the distribution of monomeric and polymeric IgA were determined. The data confirm the elevation of total serum IgA levels in HIV-1-infected patients, and both IgA1 and IgA2 concentrations are elevated. Furthermore, the data show a substantial increase in serum levels of both monomeric and polymeric IgA. Serum S-IgA levels were significantly increased in CDC group II patients versus controls and more frequently elevated in CDC group IV patients. The highest S-IgA levels were found among patients with the lowest blood CD4+ cell counts. Serum S-IgA levels were not correlated with serum levels of either total IgA or polymeric IgA. Serum S-IgM levels were also increased in HIV-1-infected patients and positively correlated with serum S-IgA levels. Conversely, serum levels of free SC were not altered. An increase in serum S-IgA was not related to human hepatitis B virus infection and/or to hepatic dysfunction or to diarrhea or overt intestinal infection. The data indicate that secretory Ig (S-IgM and S-IgA), which are likely to be produced at mucosal sites, increase in the serum of HIV-1-infected patients.

Serum and bile secretory immunoglobulins and secretory component during the early postoperative course after liver transplantation

Secretory component was assayed in serum and bile from 34 patients within 40 days after a first or a second (three cases) liver transplantation. Levels of serum secretory IgA and IgM and of a serum component referred to as immunoreactive free secretory component, identified by its reactivity with monoclonal and polyclonal antibodies specific to secretory component, were significantly elevated in all posttransplant patients compared with 45 healthy subjects and 10 kidney transplant patients (p less than 0.0001). The highest serum levels of bound secretory component and of immunoreactive free secretory component were observed in patients with acute rejection. The elevation of immunoreactive free secretory component was significantly higher in patients with rejection as compared with patients with a graft ischemia (p = 0.002) or an uncomplicated postoperative evolution (p = 0.01). The highest levels of immunoreactive free secretory component and secretory IgM were observed in a transplant patient with selective IgA deficiency. No significant difference was seen between the levels of serum immunoreactive free secretory component observed in patients with rejection and those of patients with cytomegalovirus hepatitis or sepsis. Immunoreactive free secretory component, secretory IgA and secretory IgM levels measured in the serum of three patients with primary nonfunction were lower than those observed in the other groups. Immunoreactive free secretory component bile/serum ratios calculated from 16 patients were significantly higher in patients with acute rejection than in infected patients. This study provides new insight into the mechanisms of increase of serum immunoreactive free secretory component, secretory IgA and secretory IgM in various types of liver dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum and bile secretory immunoglobulins and secretory component during the early postoperative course after liver transplantation

Secretory component was assayed in serum and bile from 34 patients within 40 days after a first or a second (three cases) liver transplantation. Levels of serum secretory IgA and IgM and of a serum component referred to as immunoreactive free secretory component, identified by its reactivity with monoclonal and polyclonal antibodies specific to secretory component, were significantly elevated in all posttransplant patients compared with 45 healthy subjects and 10 kidney transplant patients (p < 0.0001). The highest serum levels of bound secretory component and of immunoreactive free secretory component were observed in patients with acute rejection. The elevation of immunoreactive free secretory component was significantly higher in patients with rejection as compared with patients with a graft ischemia (p = 0.002) or an uncomplicated postoperative evolution (p = 0.01). The highest levels of immunoreactive free secretory component and secretory IgM were observed in a transplant patient with selective IgA deficiency. No significant difference was seen between the levels of serum immunoreactive free secretory component observed in patients with rejection and those of patients with cytomegalovirus hepatitis or sepsis. Immunoreactive free secretory component, secretory IgA and secretory IgM levels measured in the serum of three patients with primary nonfunction were lower than those observed in the other groups. Immunoreactive free secretory component bile/serum ratios calculated from 16 patients were significantly higher in patients with acute rejection than in infected patients. This study provides new insight into the mechanisms of increase of serum immunoreactive free secretory component, secretory IgA and secretory IgM in various types of liver dysfunction. The increase observed in all the transplant patients (except in ischemia and primary nonfunction) could be the result of liver regeneration. However, the major increase observed in rejection could also be explained both by the cholangiocyte cytolysis and by an enhancement of secretory component synthesis by cytokines involved in the mechanisms of this immune reaction. (HEPATOLOGY 1991;14:1046–1053.)

Elevated serum secretory IgA in patients with IgA nephropathy.

Serum secretory IgA was measured to elucidate the significance of secretory IgA in patients with IgA nephropathy. The levels of serum secretory IgA and IgA were, respectively, 6.8 +/- 3.5 micrograms/ml and 231.0 +/- 69.2 mg/dl in the controls and 11.8 +/- 3.2 micrograms/ml and 385.3 +/- 78.7 mg/dl in the patients. The levels of serum secretory IgA and IgA in the patients were significantly higher than those in controls (p less than 0.01). Elevated serum secretory IgA may reflect the excessive state of the IgA-secreting system in IgA nephropathy patients.

Secretory IgA(S-IgA) levels in sera from patients with diffuse panbronchiolitis.

The serum S-IgA levels of 33 patients with diffuse panbronchiolitis (DPB) were compared with those of 13 patients with chronic bronchitis (CB) and 24 patients with bronchiectasis (BE), to obtain information on differences in the pathologic states in DPB and other chronic bronchial diseases. The S-IgA levelw as elevated in all three bronchial diseases, being significantly higher in DPB than in CB, and intermediate in BE. Persistent bacterial infections developed in most of the patients with DPB and two-thirds of those with BE, but in few of those with CB. Serum S-IgA levels were especially high in patients expectorating Pseudomonas aeruginosa-positive sputum, who constituted two-thirds of the patients with DPB and about one-third of those with BE. The highest levels over (100 micrograms/ml) were observed in far-advanced patients with DPB who expectorated P. aeruginosa-positive sputum. The increase in the serum level of IgA was less than that of S-IgA in all three diseases. These results indicate that the marked elevation of the serum S-IgA level in patients with DPB is due to extensive, chronic infection of the airways of the lungs, especially the peripheral airways, and that serum S-IgA is a useful marker for determining the clinical stage and the pathologic state of patients with diffuse peripheral airway diseases.

Serum secretory IgA levels in patients with neoplastic disease

A double antibody inhibition type radioimmunoassay has been used to quantitate the amount of secretory IgA in the serum of patients with a variety of diseases. Secretory IgA (S-IgA) was found in almost all serum specimens tested. The S-IgA levels were elevated in some patients with neoplastic disease. The assay, however, does not appear to be of value for cancer detection. High levels of S-IgA were also found in patients with regional enteritis and ulcerative colitis.