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Where do IgA plasma cells in the gut come from?
  1. S J C Golby,
  2. J Spencer
  1. Histopathology Department, Guy's, King's and St Thomas' School of Medicine, St Thomas' Campus, London SE1 7EH, UK
  1. Correspondence to:
    J Spencer;
    jo.spencer{at}kcl.ac.uk

https://doi.org/10.1136/gut.51.2.150

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    The relationship between mucosal IgM and IgA has recently been addressed in murine systems to investigate how IgA secreting plasma cells localise in the intestine and to determine if switching from IgM to IgA occurs in the microenvironment of the gut mucosa

    The gut is the major site of antibody production in humans. The most abundant isotype produced is IgA, but the importance of IgA has been questioned. On the one hand, in IgA deficient patients, IgM can compensate functionally1,2; on the other hand, it might be argued that such flexibility is an absolute requirement because the system is indispensable.3 The relationship between IgM and IgA in humans has been studied by analysis of the immunoglobulin genes used by plasma cells. Such studies can give information on the history of the B cells that generated them because they contain a unique fingerprint acquired during B cell development that enables the identification of related cells. Investigations of human mucosal plasma cells have shown that in humans, clonally related IgM+ and IgA+ plasma cells that probably secrete antibody with the same specificity can occupy the same mucosal microenvironment.4–,7 In addition, immunoglobulin genes become mutated if the cell has been selected for the production of high affinity antibody. In the human gut, IgM is encoded by mutated genes4 and is therefore associated with secondary immune responses, alongside IgA and IgG, and it is perhaps not surprising that it can compensate functionally in IgA …

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