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Properties of immunoglobulin A in serum of individuals with liver diseases and in hepatic bile.

In comparison with normal individuals, sera of patients with alcoholic cirrhosis and other liver diseases had two to four times higher levels of immunoglobulin A and three to ten time higher levels of polymeric immunoglobulin A. The possible participation of the liver in the selective removal of polymeric immunoglobulin A from serum into bile was investigated by analyzing immunoglobulin A in serum and bile specimens obtained from a group of patients with T-tube drainage of the common bile duct. Gel filtration revealed three principal fractions of biliary immunoglobulin A: secretory immunoglobulin A with J chain and secretory component; polymeric immunoglobulin A associated with J chain; and monomeric immunoglobulin A devoid of J chain and secretory component. Secretory component-complexed immunoglobulin A composed only 50% or less of the total biliary immunoglobulin A. In comparison with immunoglobulin G, polymeric forms of immunoglobulin A appeared to be selectively transported into bile whereas monomeric immunoglobulin A was not. These data suggested that the liver selectively transports polymeric immunoglobulin A from serum into bile by both secretory component-dependent and -independent mechanisms.