Immunohistological study on ulcerative colitis.
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概要
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In order to observe the immunological background of ulcerative colitis (UC), immunoglobulins (Igs) in tissues and sera of patients with UC were studied by the immuno-fluorescent technique (IF), single radial immunodiffusion (SRID), and enzyme-linked immunosorbent assay (ELISA). We examined 58 biopsied mucosal specimens of the colon and 37 serum samples obtained simultaneously from 27 patients with UC. The biopsied specimens were histologically classified into four phases as was described in our previous paper, and at the same time studied by either the direct or indirect IF method in order to observe the numbers of each Ig-containing cell, degrees of positiveness of the secretory component (SC) and the presence of anti-colonic antibodies (ACA).<BR>The distribution of each Ig-containing cell was almost similar in both normal controls and UC patients: IgG-containing cells were present in the deep layer of the lamina propria mucosae, IgA-containing cells in the upper layer and IgM-containing cells were scattered in both layers. Both IgG-and IgM-containing cells were increased locally in the granulation phase while in contrast, IgA-containing cells were increased mostly in the exudation phase. The rate of increase of IgA-containing cells was diminished in the granulation phase. It was suggested, therefore, that IgA played a major role as the first form of defense in the local immune response. An increase of IgM-containing cells accompanied by a diminished rate of increase of IgA-containing cells in the granulation phase also suggested the presence of a cooperative system of secretory immunoglobulins in local immunity. SC in the crypt epithelial cells was almost absent in the granulation phase.<BR>ACA in sera was detected in 60% of cases, and was determined as an IgG fragment. However, the correlation between ACA and the IgG level in sera was not significant. The IgA value in sera of UC patients was increased in the exudation and granulation phase, peshaps due to outflow of dimeric IgA (d-IgA) into the blood, rather than into the cryptal lumina.<BR>Derangement of the secretory IgA system, which is a component of the mucosal defense mechanism, may thus occur in the earliest stage of UC subsequently having a serious influence on the progress of the disease thereafter.
- 日本大腸肛門病学会の論文
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