Summary
Most infections reach man via the mucosal membranes, and more than half of the lymphoid system is found in connection with mucosae. The major antibodies found on mucous membranes are secretory IgA, which function primarily by binding microorganisms and thereby preventing their contact with the host tissues. The optimal mode of immunization to obtain a secretory IgA response is not well defined. Repeated mucosal exposure with antigen may result in oral tolerance, with decreasing circulating antibodies but a remaining secretory IgA response. The secretory IgA response is usually short-lived and can be difficult to boost. IgM as well as IgG antibodies may add to host defence at the mucosal level, but when engaged, they usually induce inflammation in host tissues. Analogues to bacterial receptors on mucosal epithelium may be present in exocrine secretions such as human milk. During an attack on the host, it is possible that such receptor analogues may aid in the prevention of attachment of bacteria to mucous membranes used as an initial site. A number of non-specific host factors support mucosal defence. One of them is lactoferrin. Lactoferrin deficiency seems to result in recurrent bacterial infections, suggesting its importance in normal host defence.
Zusammenfassung
Beim Menschen gelangen Infektionen zum größten Teil über die Schleimhäute in den Organismus; mehr als die Hälfte des lymphatischen Systems findet sich in Verbindung mit den Schleimhäuten. Sekretorisches IgA stellt die wichtigste Antikörperklasse der Schleimhäute dar; seine Funktion besteht primär darin, daß es Mikroorganismen bindet und damit ihren Kontakt mit den Geweben des Wirtes verhindert. Wie durch Immunisierung am besten eine Antwort von sekretorischem IgA erzielt werden kann, ist bislang nicht hinreichend geklärt. Wiederholte Antigenexposition von Schleimhäuten kann eine orale Toleranz hervorrufen, bei der es zu einer Verminderung der zirkulierenden Antikörper kommt, während die Antwort von sekretorischem IgA erhalten bleibt. Für gewöhnlich hält die Antwort von sekretorischem IgA nur kurze Zeit an, eine Boosterung ist schwierig. IgM — und IgG-Antikörper unterstützen wahrscheinlich die Abwehr im Bereich der Schleimhäute, doch kommt es in der Regel zu einer Entzündung der Gewebe, wenn diese Antikörper beteiligt sind. Exokrine Sekrete wie die Muttermilch enthalten wahrscheinlich Analoga zu Rezeptoren für Bakterien auf dem Schleimhautepithel. Es ist möglich, daß solche Rezeptorenanaloga das Anheften von Bakterien an den Schleimhäuten verhindern helfen, die als primärer Angriffsort beim Eindringen der Erreger dienen. Eine Reihe unspezifischer Wirtsfaktoren unterstützen die Abwehr im Schleimhautbereich. Dazu gehört Lactoferrin. Lactoferrin-Mangel führt offensichtlich zu rezidivierenden bakteriellen Infektionen, was auf seine Bedeutung für die normale Abwehr schließen läßt.
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Hanson, L., Andersson, B., Carlsson, B. et al. Defence of mucous membranes by antibodies, receptor analogues and non-specific host factors. Infection 13 (Suppl 2), S166–S170 (1985). https://doi.org/10.1007/BF01644424
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DOI: https://doi.org/10.1007/BF01644424