Intra-abdominal sepsis: an immunocytochemical study of the small intestine mucosa.
OBJECTIVE
To investigate immunocytochemical changes in intestinal tissues from patients with intra-abdominal sepsis, and to relate the changes to the possibility of enhanced bacterial adhesion and translocation.


METHODS
Tissues from 17 patients suffering from intra-abdominal sepsis and from controls were sectioned and stained immunocytochemically for IgA, IgM, secretory component, J chain, and HLA-DR. Differences in the distribution and characteristics of positively staining cells between the patient groups were assessed.


RESULTS
Patients with intra-abdominal sepsis had noticeable reductions in numbers of IgA and IgM plasma cells, reduced J chain staining, and had little immunoglobulin on the surfaces of enterocytes. In contrast, HLA-DR positive cells were increased in the sepsis compared with the control group. The plasma cells present showed cytological changes suggestive of apoptosis.


CONCLUSIONS
Stress associated with sepsis and its immediate causes might result in increased plasma glucocorticoid levels that bring about apoptosis of mucosal plasma cells (or their precursors). The consequent reduction in expression of IgA and IgM may favour bacterial adhesion to the enterocytes and facilitate bacterial translocation into the tissues.
Coutinho
H B
HB
Centro de Pesquisas Aggeu Magalhaes/FIOCRUZ, Recife, Brazil.
Robalinho
T I
TI
Coutinho
V B
VB
Amorim
A M
AM
Furtado
A F
AF
Ferraz
A
A
Ferraz
E
E
Walker
F
F
King
G
G
Sewell
H F
HF
Wakelin
D
D
D000328:Adult; D000368:Aged; D017209:Apoptosis; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007144:Immunoglobulin J-Chains / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007150:Immunohistochemistry; D007410:Intestinal Diseases / Q000276:immunology* / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000276:immunology / Q000473:pathology; D012635:Secretory Component / Q000032:analysis; D018805:Sepsis / Q000276:immunology* / Q000473:pathology
D006684:HLA-DR Antigens; D007070:Immunoglobulin A; D007144:Immunoglobulin J-Chains; D007075:Immunoglobulin M; D012635:Secretory Component