原発性胆汁性肝硬変症における高IgM血症の成因について

概要

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The mechanisms of elevation of serum IgM levels in primary biliary cirrhosis (PBC) were investigated, and following results were obtained: a) HPLC provided no evidence of elevated serum levels of monomeric IgM. b) The highest secretory IgM (sIgM) levels were demonsrated in the patients by ELISA, but patients with other liver diseases, such as intrahepatic cholestasis and liver cirrhosis, had also elevated sIgM levels. c) Predominant distribution of IgM-containing cells was observed in the portal area of the liver by immunohistochemistry. d) Electron microscopic observation revealed that Kupffer cells seemed to be reduced their endocytotic function. e) ELISA and immunoblotting studies demonstrated that patients with PBC had the highest serum levels of IgM class anti-Lipid A antibody.<BR>These results suggest that increased number of IgM-containing cells in the liver and elevated serum levels of gut-derived bacterial antigens, associated with reticuloendothelial system dysfunction, may participate in the elevation of serum IgM levels in PBC.
社団法人日本肝臓学会の論文