耳鼻咽喉科疾患における分泌型IgA

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Salivary IgA levels in healthy adults and children and in otolaryngological patients were measured by electroimmunodiffusion based on the hypothesis that secretory IgA might have an important role in chronic infection of the middle ear, maxillary sinus and palatine tonsil. Salivary IgA levels were as follow: normal adults, 3.2mg/d1±1.92 (N=57); normal children, 2.8mg/d1±2.37 (N=93); adults with chronic otitis media, 2.Omg/dl±1.21 (N=39); adults with chronic sinusitis, 1.6mg/d1±1.08mg/dl± (N=27) and children with chronic tonsilitis, 1.0mg/dl ±0.86 (N=32). The differences in mean salivary IgA concentration between the control and the patients with chronic otitis media, chronic sinusitis and chronic tonsillitis were highly significant at the level of P<0.005. This suggests that local IgA production decreases in these patients. Measu rements of a concentration of salivary IgA may be useful as an indicator of local IgA production in otolaryngic patients. In the next study, the volunteers were exposed to cold outdoor climate for two hours and then were asked to eat very hot noodles. The first gush of excess nasal secretion was collected for secretory IgA determination. The mean IgA level was 14.9mg/dl±8.44 in normal nasal secretion and 145.3mg/dl±157.4 in maxillary secretion from chronic sinusitis. The bulk of maxillary IgA might be derived from serum. A concentration of IgA and secretory piece was compared between saliva and nasal secretion from the same individual in normal subjects, and saliva and maxillary secretion from the patients with chronic sinusitis respectively. A ratio of salivary IgA to nasal averaged 11.0, while a ratio in secetory piece averaged 2.5. There was no relationship to a concentration of IgA betweensaliva and nasal secretion. A ratio of salivary IgA to maxillary averaged 237, while a ratio in secretory piece averaged 1.4. It should be mentioned that secretory piece was not detected in 5 of 14 maxillary secretions. Such deficiency might be due to a failure of production of secretory piece of the.infected epithelial cells.

耳鼻咽喉科疾患における分泌型IgA

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