Every once in a while, an idea comes along that throws your mental models topsy turvey.
Recently while reading a book called The Wild Life of Our Bodies by Rob Dunn (good book, definitely worth a read), I came upon a section that did just that.
I closed the book, turned to look at my wife (she was driving at the time) and just said, “wow!”
The Barbed Wire of the Gut
Secretory IgA is an antibody that lines the surface of our digestive tract (and lungs, urinary tract, and vagina) and for the longest time I’ve always described it as “the barbed wire of the guts”.
IgA is the most common antibody in the body, accounting for about 75% of all the antibodies that we make. In the gut it’s made by B cells and then passed over to the cells that line the digestive tract which secrete it onto their surface (thus secretory IgA).
My old understanding was that it’s primary purpose was defensive. This line of secreted IgA on the surface of these cells served to protect them from bad bacteria, viruses and other “nasty stuff”. When I do stool testing, about 80% of people with gut problems have low or very low levels of secretory IgA. Thus their guts are not able to fight off the dysbiosis (or messed up bacteria).
But wait, there’s more!
But it seems my understanding was not quite right.
From the Wild life of Our Bodies “…Studies since the 1970s had noted that the bacteria the IgA attacked had a receptor…for IgA…When the IgA attacked those bacteria, they did so through that door. What, though, were the bacteria doing with a door for the very antibodies whose goal it was to attack and expel them from the body?…if…[the] body was, through the production of IgA, trying to get rid of or otherwise control these bacteria, it was doing a really bad job. If the bacteria were trying to avoid the IgA antibodies, they were similarly ineffective…”
Hrm, I didn’t know that. Of course the bacteria he’s talking about are our “good guys” like Lactobacillus and Bifidobacterium (among others). Maybe I’ve been missing something.
“…the IgA antibodies…help the bacteria by providing a kind of scaffolding with which they can link together to form biofilms…the human body…was producing compounds to help the bacteria adhere…instead of fighting the bacteria, [it was] helping some of them stay put…eventually…[scientists were] able to show in the lab that when IgA was added to biofilms, they formed faster and grew thicker. Bacteria were nearly twice as likely to stick to human cells when IgA was present. When an enzyme was used to break down the IgA, the biofilms fell apart…IgA, it now seemed evident, performs the primary function of helping bacteria…gut bacteria grow fifteen times as fast when IgA is present than when it is absent.”
Whoa! <KABOOM!> That popping sound was my mind exploding!
So it looks like sIgA’s primary job isn’t direct defense (killing off bad guys) but “mothering” – encouraging and stimulating the growth of good bacteria who of course provide a huge part of our defense system. And then, only secondarily, acting like “barbed wire”.
Thinking back through patients, this clicked. I have some patients who seem to stubbornly refuse to bring up their levels of good bacteria. We eradicate their bad bacteria, yeasts and parasites (if they have them), but despite probiotic, prebiotics and fermented food consumption their levels of good bacteria just don’t want to come up. And universally their sIgA levels remain significantly depressed.
So it looks like another, often overlooked, focus in gut restoration needs to be boosting sIgA levels back to healthy levels.
And might at least some of these people have a congenital (born with = genetic) IgA deficiency? A simple blood test can suggest whether this is true (measuring total serum IgA). If that test comes back quite low you may have hit the “bad genetics lottery” and may always have trouble maintaining a good gut flora.
Another puzzle piece in gut health, clicks into place. That’s why I always keep learning.
For more on which probiotics to take, click HERE.
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