title: Secretory immunoglobulin A (sIgA) deficiency in serum of patients with GALTectomy (appendectomy and tonsillectomy).
abstract: BACKGROUND
  In adult human beings, 80-85% of the immune cells are located in the digestive tract mucosa; hence the importance of the Gut Associated Lymphoid Tissue (GALT) in host defence. We studied the influence of the surgical removal of two important parts of the gut associated with lymphoid tissue (tonsillectomy and appendectomy) on immune parameters.
  
  
  METHODS
  One hundred and sixty patients were enrolled in this study. They were divided into four groups of forty patients each and matched for gender and age: group 1, appendectomized and tonsillectomized; group 2, only appendectomized; group 3, only tonsillectomized; and group 4, control group, neither tonsillectomized nor appendectomized. We analysed in blood: hemogram, protein electrophoresis, lymphocytic populations (T4 cells, T8 cells, NK cells), IgG, IgM, IgA immunoglobulin, and their fractions IgA1, IgA2, and secretory IgA.
  
  
  RESULTS
  Levels of secretory IgA in serum of patients in group 1 were significantly lower than in the other three groups (1.89 mg/dl, group 1; 2.32 mg/dl, group 2; 2.19 mg/dl, group 3 and 4.97 mg/dl, group 4; p<0.0001). Also, the values found in the two groups that had undergone only one of the operations were clearly lower than in control patients (p<0.0001). In this study, the reduction was sustained for a period of between 3 months and 3 years in appendectomized patients, and more than 20 years in tonsillectomized patients.
  
  
  CONCLUSIONS
  GALTectomy (appendectomy and tonsillectomy) significantly decreases secretory IgA levels in serum. The decrease is more intense when both operations have been done.
authors: Emergency Department, and Clinical Analysis Laboratory, Arnau de Vilanova Hospital, c/ San Clemente 12, 46015, and Unit of Epidemiology and Statistics, Valencian School of Studies for Health, Valencia, Spain. jcandreu@ono.com
authors: Juan Carlos
authors: JC
authors: Andreu-Ballester
authors: Jaime
authors: J
authors: Pérez-Griera
authors: Ferran
authors: F
authors: Ballester
authors: Enrique
authors: E
authors: Colomer-Rubio
authors: Inmaculada
authors: I
authors: Ortiz-Tarín
authors: Carlos
authors: C
authors: Peñarroja Otero
mesh_terms: D000328:Adult; D000368:Aged; D001062:Appendectomy; D001491:Basophils / Q000166:cytology; D001772:Blood Cell Count; D001798:Blood Proteins / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D002452:Cell Count; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007071:Immunoglobulin A, Secretory / Q000097:blood*; D007136:Immunoglobulins / Q000097:blood; D008221:Lymphoid Tissue / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D014068:Tonsillectomy
chemical_list: D001798:Blood Proteins; D007070:Immunoglobulin A; D007071:Immunoglobulin A, Secretory; D007136:Immunoglobulins