Digestive Diseases and Sciences

, Volume 44, Issue 5, pp 939–944 | Cite as

Serum Immunoglobulin and Soluble IL-2 Receptor Levels in Small Intestinal Overgrowth with Indigenous Gut Flora

  • Stephen M. Riordan
  • Christopher J. Mciver
  • Denis Wakefield
  • Mervyn C. Thomas
  • Vic M. Duncombe
  • Terry D. Bolin


Murine studies have demonstrated that thepresence of indigenous gut flora is crucial for theinduction of systemic immune hyporesponsiveness toantigens initially encountered within thegastrointestinal lumen. This study investigated whetherincreased titers of such flora, as occur in human smallintestinal bacterial overgrowth, may be associated withincreased suppression of systemic immune responsiveness and the possible relation between systemic andmucosal immunity in this setting. Serum totalimmunoglobulin (Ig), immunoglobulin subclass, andsoluble interleukin-2 receptor levels and lamina propriaIgA plasma cell counts were determined in 50consecutive subjects with (N = 30) and without (N = 20)small intestinal bacterial overgrowth. Luminal IgAlevels were measured in 35 of these subjects. Serumconcentrations of IgG3, but not of otherimmunoglobulin isotypes or soluble interleukin-2receptors, were significantly reduced in subjects withbacterial overgrowth (P < 0.0005). Small intestinallamina propria IgA plasma cell counts (P < 0.0005) andluminal IgA concentrations (P = 0.001) weresignificantly increased in this group. SerumIgG3 levels were significantly inverselycorrelated with luminal IgA levels (P < 0.01) and fell below the lower limit ofnormal (0.41 g/liter) in 17/30 (56.7%) subjects withbacterial overgrowth compared to 1/20 (5.0%) subjectswithout (P < 0.0005). These findings document an association between small intestinalbacterial overgrowth with indigenous gut flora andreduced serum IgG3 reactivity in humans,possibly via an interaction with mucosa-relatedimmunoregulatory mechanisms. The possibility of underlying small intestinalbacterial overgrowth should be considered in patientswith serum IgG3 deficiency, especially thosewith compatible symptoms and/or knownpredisposition.



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Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Stephen M. Riordan
  • Christopher J. Mciver
  • Denis Wakefield
  • Mervyn C. Thomas
  • Vic M. Duncombe
  • Terry D. Bolin

There are no affiliations available

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