title: Inefficacy of intestinal secretory immune response to Cryptosporidium in acquired immunodeficiency syndrome.
abstract: OBJECTIVE
  An alteration of the secretory immune response has been forwarded to explain frequent and chronic mucosal infections in patients with acquired immunodeficiency syndrome (AIDS). The aim of this study was to explore the intestinal immunoglobulin (Ig) secretions in patients with AIDS and their relationships to cryptosporidiosis.
  
  
  METHODS
  Patients with AIDS and enteric cryptosporidiosis (n = 12), other enteric infections (n = 10), and no identifiable enteric pathogen (n = 10) and human immunodeficiency virus-seronegative controls (n = 18) were studied. The number of intestinal IgA and IgM plasma cells of the duodenal lamina propria mucosa and total and anti-Cryptosporidium IgA, IgM, and IgG were measured in serum and feces.
  
  
  RESULTS
  Although not significantly increased, the number of IgA and IgM plasma cells was greater in patients with AIDS (n = 20) than in controls (n = 5). In feces, total IgA outputs and specific anti-Cryptosporidium IgA levels were significantly higher in patients with AIDS and cryptosporidiosis than in the two other groups of patients with AIDS (P < 0.05 and P < 0.01, respectively) and controls (P < 0.001 and P < 0.01, respectively). Total fecal IgM output and specific anti-Cryptosporidium IgM coproantibodies were increased only in the Cryptosporidium-infected patients relative to the controls (P < 0.05).
  
  
  CONCLUSIONS
  Despite the development of pathogen-specific mucosal antibody responses, patients with AIDS and cryptosporidiosis fail to clear the parasite.
authors.affiliation: Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Benhamou
authors.forename: N
authors.initials: N
authors.lastname: Kapel
authors.forename: C
authors.initials: C
authors.lastname: Hoang
authors.forename: H
authors.initials: H
authors.lastname: Matta
authors.forename: D
authors.initials: D
authors.lastname: Meillet
authors.forename: D
authors.initials: D
authors.lastname: Magne
authors.forename: M
authors.initials: M
authors.lastname: Raphael
authors.forename: M
authors.initials: M
authors.lastname: Gentilini
authors.forename: P
authors.initials: P
authors.lastname: Opolon
authors.forename: J G
authors.initials: JG
authors.lastname: Gobert
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000276:immunology*; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000032:analysis*; D000917:Antibody Formation; D002452:Cell Count; D003457:Cryptosporidiosis / Q000150:complications; D003458:Cryptosporidium / Q000276:immunology*; D004591:Electrophoresis, Polyacrylamide Gel; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D015151:Immunoblotting; D007136:Immunoglobulins / Q000032:analysis; D007413:Intestinal Mucosa / Q000276:immunology* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology; D000515:alpha 1-Antitrypsin / Q000378:metabolism
chemical_list: D000913:Antibodies, Protozoan; D007136:Immunoglobulins; D000515:alpha 1-Antitrypsin