[The gastrointestinal tract as an immunologic organ: the gut-associated immune system]

The gastrointestinal mucosa separates the intraluminal gastrointestinal fluid, which contains a high number of antigens from different sources, and prevents free access of antigens to the body. Simultaneously, it allows some vital host-environment interactions. A number of unspecific factors are important in preventing antigen invasion. The specific mucosal immunity is related to secretory IgA. IgA is derived from mucosal plasma cells after antigen-induced proliferation of its precursors in Peyer's patches. These IgA-positive B-lymphoblasts migrate through the systemic circulation and then "home" to the mucosa. IgA is translocated as a dimer to the gut lumen after attachment to the secretory component (SC). Part of it is excreted into the bile via small bile ducts after portal and possibly systemic circulation and binding to SC. T cells and mast cells are also considered to show migration and homing phenomena. In addition to the gut, some other mucosa-associated lymphoid tissues, (e.g. bronchus, mammary, salivary and lacrimal glands as well as the female genital tract), can participate in homing. Little is known about the local regulatory mechanisms, which allow an immunoglobulin class specifity of immune responses. Induction of local immunity and specific systemic tolerance seems to be a characteristic immune response of the gut-associated lymphoid tissue (GALT). The knowledge of the local immune system allows a better understanding of many aspects of gastrointestinal pathology, especially in immuno-inflammatory and immunoproliferative diseases as well as in gastrointestinal immunodeficiency syndromes.