Kidney International (1983) 23, 759–763; doi:10.1038/ki.1983.90
Does low urinary sIgA predispose to urinary tract infection?
Gerd Riedasch1, Peter Heck1, Ernst Rauterberg1 and Eberhard Ritz1
1Departments of Urology, Immunology, and Internal Medicine, University of Heidelberg, Federal Republic of Germany
Correspondence: Prof Dr E Ritz, Sektion Nephrologie, Klinikum der Universität Heidelberg, Bergheimer Stra
e 58 a, D-6900 Heidelberg 1, Federal Republic of Germany
Received 18 November 1981; Revised 8 October 1982.
Top of pageAbstract
Does low urinary sIgA predispose to urinary tract infection? Median urinary secretory IgA (sIgA) (ELISA technique in unprocessed urine) was 1.36 mg/liter (range, 0.29 to 2.31) in healthy female controls at various times of the menstrual cycle. It was significantly lower in women with urinary tract infection (UTI) without antibody-coated bacteria. Such decrease was found both in women with acute UTI episodes (median, 0.16; range, 0.06 to 1.71) and in asymptomatic nonbacteriuric women with a history of UTI (median, 0.52; range, 0.05 to 2.13). In the latter women, sIgA in nasal secretions tended to be low, but salivary sIgA was unchanged. Urinary sIgA was elevated significantly in individuals with nephrostomy and antibody-coated bacteria (14.4 mg/liter, range, 3.6 to 20). The study showed that locally synthesized sIgA immunoglobulins were low in the urine of individuals with recurrent UTI independent of the presence or absence of bacteriuria at the time of the study. UTI per se did not interfere with sIgA secretion as shown by high sIgA in patients with upper UTI. Low urinary sIgA may represent one factor predisposing to recurrent UTI.
Des sIgA urinaires basses prédisposent-elles à l'infection urinaire? La médiane des sIgA urinaires (technique ELISA sur des urines non traitées) était de 1,36 mg/litre (extrêmes 0,29 à 2,31) chez des femmes contrôles normales à différentes périodes du cycle menstruel. Elle était significativement plus basse chez les femmes ayant une infection urinaire (UTI) sans bactérie recouverte d'anticorps. Cette diminution a été trouvée chez les femmes avec des épisodes d'UTI aiguë (médiane, 0,16; extrêmes 0,06 à 1,71) et chez des femmes nonbactérieuriques asymptomatiques avec une histoire d'UTI (médiane, 0,52; extrêmes 0,05 à 2,13). Chez ces dernières, les sIgA dessécrétions nasales tendaient à être basses, mais les sIgA salivaires étaient inchangées. Les sIgA urinaires étaient significativement élevées chez des sujets ayant une néphrostomie et des bactéries recouvertes d'anticorps (14,4 mg/litre; extrêmes, 3,6 à 20). Cette étude montre que les immunoglobulines sIgA synthétisées localement sont basses dans les urines de sujets ayant des UTI récidivantes, indépendamment de la présence ou de l'absence de bactériurie au moment de l'étude. L'UTI en soi n'interfère pas la sécrétion de sIgA comme le montre les sIgA élevées chez des malades avec des UTI du tractus supérieur. Les sIgA urinaires basses pourraient constituer un facteur prédisposant à des UTI récidivantes.
Top of pageReferences
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