INCREASED IMMUNOGLOBULIN-G PRODUCTION BY SHORT-TERM CULTURED DUODENALBIOPSY SAMPLES FROM HIV-INFECTED PATIENTS

Background-Secretory immunity is a major defence mechanism against inf ections at mucosal surfaces which are common in HN infected patients. Aims-To analyse intestinal immunoglobulin production in HIV infection in comparison with that in saliva and serum. Patients and methods-Immu noglobulin G (IgG), A (IgA), and M (IgM) concentrations were determine d in supernatants of short term cultured duodenal biopsy samples, seru m, and saliva from HN infected patients (n = 28) and controls (n = 14) by radial immunodiffusion. Results-IgG was increased in the supernata nts of short term cultured biopsy samples and saliva from HIV infected patients compared with controls (p<0.01), but IgA and IgM levels were normal. In contrast, both IgG and IgA concentrations in serum were hi gher in HIV infected patients than in controls (p<0.002). No correlati on was found between IgA produced by duodenal biopsy specimens and ser um IgA. Conclusion-Abnormalities in mucosal immunoglobulin production in HIV infection were surprisingly small, indicating that specific sec retory immunity rather than quantitative immunoglobulin production may be impaired. However, increased production of IgG could contribute to mucosal inflammation by complement activation. Our findings of normal mucosal IgA production and the lack of correlation between serum and mucosal IgA argues against an intestinal origin for the increased seru m IgA levels in HIV infected patients.