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The humoral immune system of the intestinal mucosa of patients with common variable immuno deficiency (CVID) syndrome was studied immunohistologically using antibodies against immunoglobulin (Ig) A1-2, M and G1-4, against the J chain and the secretory component. In 9/13 CVID-patients IgA-positive cells were totally absent whereas a total IgM-defect was found only in 3/14 patients. Considerable numbers of J chain-positive cells were present in all CVID-patients irrespective of the extent of the Ig-defect indicating the presence of early B-cells unable to differentiate and to produce Ig. There was a strong expression of the secretory component in the cytoplasm and at the surface of enterocytes even in those CVID-patients who were totally defective in IgA- and IgM-positive cells.

Secretory IgA from human colostrum was fragmented by mercaptoethanol. The heavy chain fraction was prepared by means of gel chromatography on Sephadex G 100 in 1 N acetic acid. After immunization of rabbits with this heavy chain fraction the resulting antiserum contained antibodies specific for the alpha-chain and antibodies against the secretory component. These antibodies were separated by means of immunosorption. The antibodies against the secretory component precipitate free secretory component as well as bound secretory component. The antiserum is suitable for quantitative determination of secretory IgA, but free secretory component reacts too. Also secretory IgM may react, because secretory IgM contains up to 70% secretory component.

Saliva of 95 patients of different ages was investigated for S-IgA and free secretory component (SC). The two-directional rocket method was used as assay for separating S-IgA and free SC in the presence of heparin-Ca-EDTA. The method employs electrophoresis in an antibody containing agarose/agar gel.--The value of S-IgA in children about 4 years old was 40,0 mg/l and the relation of free SC to S-IgA was 1 to 5. The S-IgA level in patients over 50 years old was 55,2 mg/l, in no case free SC was detectable.

Secretory immunoglobulin A (S-IgA) or the secretory component (SC) in vaginal fluid of hysterectomised patients were established by means of simple and double immunodiffusion, according to Mancini or Ouchterlony, using an S-IgA standard. Since S-IgA was recorded from vaginal fluid, general questions were raised for origin and transport mechanisms of this localised immunoglobulin.

Immunologically mediated tissue lesions or functional disturbances can result from immune responses either to foreign antigens or autoantigenic constituents. Before a disease or a functional disorder can be called an (auto)immune disease, it must be established that immunological processes are involved in its etiology and/or pathogenesis. After reviewing the available data on immunology and on research on immunobiology of the inner ear, as well as clinical observations on disorders of the inner ear of possibly immunological origin, an attempt is made to determine whether (auto)immunopathology can be assumed in some patients with sensineural hearing loss. In patients with disorders presently recognized as autoimmune diseases, no hearing loss has been described so far. However, serum antibodies can be found via the indirect immunofluorescence method in some patients having functional disorders of the inner ear. These serum antibodies interact with normal human inner ear tissue. However, as long as immunopathological mechanisms have not been confirmed, these disorders should merely be called "diseases with autoimmune markers." It has been shown in animal experiments that the production of autoantibodies against inner ear components is associated with morphological and functional changes of the inner ear. The human endolymphatic sac releases secretory IgA into the lumen. Its epithelium contains (intraepithelial) lymphocytes, whereas lymphocytes, plasma cells (IgA, IgG) and macrophages occur in the perisaccular region. In this manner, the inner ear has its own immune system, which can possibly react independently of the systemic immune system.(ABSTRACT TRUNCATED AT 250 WORDS)

The free secretory piece is isolated from human colostrum by gel filtration and ion-exchange chromatography in high yield (200 mg/l colostrum). DEAE-Cellulose chromatography separates the free secretory piece in two fractions which are electrophoretically distinct, but otherwise have the same characteristics, like molecular weight, antigenic determinants, N-terminal sequence, peptide map and amino acid composition. It was therefore concluded that the protein part of the secretory piece is homogenous.

In contrast to blood serology, which usually fails in specimens more than a few days old, immunohistochemistry (PAP technique) provided reliable information on the blood group (ABO) and, in most cases, also the secretor character of 23 kidney specimens stored for months at room temperature. Better results were obtained with monoclonal antibodies than with human sera. In the late stages of decomposition, blood group diagnosis is based on the more decomposition-resistant antigens of the collecting tubular epithelium (in secretors) and the endothelia of the arteriolae medullares rectae and not on the identification of erythrocytic antigens. In addition, a decomposition-resistant epithelial antigen in the distal convoluted tubules (Tc II) is unmasked by autolysis or heterolysis. "Blood group" antigens were frequently detected in bacteria and fungi. These antigens, however, were clearly distinguishable from blood group characters of the tissue. A transient, weak, false-positive reaction with monoclonal anti-B appeared in decomposed Tc II epithelia.

With the isolation of secretory IgA and secretory component from human colostrum following the route communicated by Kobayashi some differences revealed with respect to the preparative results. Mainly problems arising from lactoferrin and IgM encouraged us to offer some varied laboratory instructions.

The functional importance of the intestinal immune system will be shown in the following report. The secretory immune system, the pool of T-lymphocytes, the K-(killer-) and NK-(natural killer-) cells, the accessory cell-system (macrophages, mast cells, granulocytes), the so-called homing and the intestinal antigenabsorption will be described and discussed.

Secretory immunoglobulin A (S-IgA) was measured by means of radial immunodiffusion, according to Mancini, with a self-made antiserum to the secretory component being used together with a S-IgA standard. S-IgA serum concentrations went up with significance in the course of pregnancy, which was probably attributable to increased production of secretory protein in the breasts in preparation for lactation.

Secretory IgA is the prevailung immunoglobulin on the mucous membranes of different tissues. It is a polymer immunoglobulin and in comparison to the serum IgA the secretory IgA has a additional polypeptide chain, the secretory component. The secretory IgA is synthesized locally in the mucosa. Secretory IgA is a very important factor in the immune defence of the mucous membranes. Secretory antibodies are regulated independently from serum antibodies. They show a virus neutralizing effect and activities against bacteria and lifeless noxa. The mechanism is not yet clear. It is possible, that the reaction of the secretory IgA with the antigen prevents settlement of microorganisms on the mucous membranes. The clinical importance of secretory IgA is undoubted especially the deference of the mucosa in cases of a virus infection.

Secretory immunoglobulin A (S-IgA) and secretory component (SC) were estimated by means of double radial immunodiffusion and single radial immunodiffusion in 22 cystic effusions from 22 patients with cystic ovarian tumours and ovarian cysts. For the quantitative estimations of S-IgA a S-IgA standard preparation was used. S-IgA and/or SC were demonstrable in all cases of the mucinous cystadenomas and also in the cystic effusions of an endometrioid adenocarcinoma and of a serous cystadenoma. The S-IgA values were estimated between 230 and 1330 mg/1. The estimation of S-IgA in cystic effusions is useful to support and extend the histological diagnosis of ovarian tumours.

The gastrointestinal tract is replete with immunocompetent tissue represented by appendix, Peyer's patches and nonaggregated lymphocytes in the intestinal epithelium. This local immune system plays a vital role in the physiologic immune response and in the control of food, drug, microbial or viral antigens. Under certain situations this lymphoid tissue may contribute to the immunological reactions underlying the pathogenesis of various diseases. Generalised deficiencies of the immune apparatus frequently give rise to disturbances of gastrointestinal function. Furthermore plenty of immune reactions occurring in connection with human inflammatory bowel disease have been described. Some immunologic features are reported as typical for a disease, the majority seems to indicate only nonspecific autoimmune reactions. The relevance of immunological mechanisms for the pathogenesis of these diseases is still not full evaluated.

Serum concentrations of SP1, HPL and estriol were investigated for circadian variations: levels of SP1 were significantly decreased at the 24th and 4th hour. An investigation of serum concentrations of SP1, HPL and estriol during labours revealed a tendency of decreasing levels of estriol.