Secretory immunoglobulin A in the vesical urothelium of patients with neuropathic bladder - an immunohistochemical study

Study design: A pilot study was carried out on archival material of bladder biopsies taken during 1994 and 1995 from patients with neuropathic bladder . Objectives: To compare the pattern of immunostaining for sIgA in the urothe lium of biopsies taken from neuropathic bladder with the biopsies obtained from patients with nonneuropathic bladders. Setting: Regional Spinal Injuries Centre, Southport and Department of Patho logy, Royal Liverpool University Hospital, Liverpool. Methods: Formalin-fixed, paraffin-embedded biopsies of bladder mucosa taken from patients with neuropathic urinary bladder (n = 43) during 1994 and 19 95 were processed for immunostaining with rabbit polyclonal antibody for se cretory component of IgA. Archival specimens of bladder biopsies from non-n europathic bladder were stained as controls. All sections were stained cont emporaneously. Results: In all the control biopsies, strong immunostaining for sigh was ob served in the superficial cells of transitional epithelium. In the biopsies taken from patients with neuropathic bladder, immunostaining in the transi tional epithelium was variable: strong in 14 cases; moderate in four; faint in 16; and absent in three. Immunostaining for sIgA was absent in all the five biopsies in which the urothelium had undergone squamous metaplasia. On e biopsy showed intestinal metaplasia; immunostaining for sIgA was seen in the basal cells. Conclusion: Strong immunostaining for sIgA was observed in the urothelium o f all biopsies taken from non-neuropathic bladder. In contrast to this, onl y 18 of 37 biopsies obtained from neuropathic bladder showed strong or mode rate immunostaining for sIgA in the transitional epithelium.