The role of IgA in the prevention of bacterial colonization of the jejunum in the vagotomized subject

McLoughlin, Gráinne; Hede, J. E.; Temple, James; Bradley, John R.; Chapman, D.M; McFarland, J. B.

doi:10.1002/bjs.1800650619

Cited by 39 publications

(13 citation statements)

References 13 publications

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“…In patients with complex immunodeficiency increased bacterial colonization is seen in the upper gut, predominantly by URT flora, which may be related to concurrent gastric hypo-or achlorhydria [54,191]. Similar findings have been made in a limited study of jejunal flora in children [192].…”

Section: Systemic Immunitysupporting

confidence: 69%

“…Humoral Immunity Blood donors with selective IgA deficiency have a normal gastrointestinal microflora without evidence of bacterial overgrowth [191]. In patients with complex immunodeficiency increased bacterial colonization is seen in the upper gut, predominantly by URT flora, which may be related to concurrent gastric hypo-or achlorhydria [54,191].…”

Section: Systemic Immunitymentioning

confidence: 99%

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The Pathogenesis of Gastrointestinal Bacterial Overgrowth

Husebye

2005

Chemotherapy

137

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The normal indigenous intestinal microflora consists of about 10¹⁵ bacteria that under physiological conditions reside mainly in the lower gastrointestinal tract. Bacterial overgrowth implies abnormal bacterial colonization of the upper gut, resulting from failure of specific defense mechanisms restricting colonization under physiological conditions. At present two types of bacterial overgrowth with defined pathogenesis can be distinguished: (1) gastric overgrowth with upper respiratory tract microflora resulting from selective failure of the gastric acid barrier, and (2) gastrointestinal overgrowth with Gram-negative bacilli (enteric bacteria) resulting from failure of intestinal clearance. Helicobacter pylori-induced gastritis of the oxyntic mucosa is the main cause of acquired failure of the gastric acid barrier, which is common among the healthy elderly. Intestinal clearance may fail as the result of impaired intestinal peristalsis or anatomical abnormalities that alter luminal flow. Impaired peristalsis is associated with conditions interfering with intestinal neuromuscular function including myopathic, neuropathic, autoimmune, infectious, inflammatory, metabolic, endocrine, and neoplastic diseases. Anatomical abnormalities are mainly the result of gastrointestinal surgery, intestinal diverticula or fistula. Combined failure of intestinal clearance and the gastric acid barrier results in more severe colonization with Gram-negative bacilli. Gram-negative bacilli are uncommon in the upper gut of otherwise healthy individuals with gastric hypochlorhydria, being acquired (H. pylori) or drug-induced. Significant bacterial overgrowth with Gram-negative bacilli is a rational in the search for an explanation to optimize clinical management. The clinical significance of colonization with upper respiratory tract microflora remains unclear. Translocation of live bacteria, their metabolic products, or antigens from a small bowel colonized by Gram-negative bacilli play a role in the pathogenesis of spontaneous bacterial peritonitis in hepatic disease and in certain types of sepsis, indicating that further studies can point to new patient populations with potential benefit from medical treatment.

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Section: Systemic Immunitysupporting

confidence: 69%

Section: Systemic Immunitymentioning

confidence: 99%

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

Husebye

2005

Chemotherapy

137

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“…Indeed, the jejunal IgG + PCs expand more than the IgM + PCs in response to oral cholera vaccination in IgA-deficient subjects (Nilssen et al, 1993a;Friman et al, 1994). Therefore, intestinal SIgM together with IgG antibodies usually afford satisfactory mucosal protection of the gut with preserved local homeostasis in IgA-deficient subjects as long as the innate defense mechanisms are functioning adequately (McLoughlin et al, 1978), probably aided by cell-mediated immunity such as an increased number of TCRγδ + and TCRαβ + intraepithelial lymphocytes ( Figure 26). Nevertheless, the proinflammatory properties of IgG antibodies are potentially deleterious to epithelial barrier function (Brandtzaeg and Tolo, 1977).…”

Section: Selective Iga Deficiency and Related Clinical Problemsmentioning

confidence: 94%

The Mucosal B Cell System

Brandtzæg

2015

Mucosal Immunology

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“…35,87 Importantly, bacterial overgrowth occurs in the jejunum of vagotomized patients only when IgA deficiency is combined with suboptimal function of innate defenses such as gastric acid and peristalsis. 45,88 In this context, it is notable that the frequency of selective IgA deficiency among patients with Crohn's disease in Sweden is significantly increased, that is, one in 100 compared to one in 600 for the healthy population (Lennart Hammarström, personal communication).…”

Section: The Gut Epithelial Barriermentioning

confidence: 95%

Mucosal immunity in a healthy gut

Brandtzæg¹

2013

Diet, Immunity and Inflammation

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The role of IgA in the prevention of bacterial colonization of the jejunum in the vagotomized subject

Cited by 39 publications

References 13 publications

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

The Pathogenesis of Gastrointestinal Bacterial Overgrowth

The Mucosal B Cell System

Mucosal immunity in a healthy gut

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