Immunological Aspects of the Liver and Gastrointestinal Tract

We have been privileged to start our academic careers at the begin­ ning of the decade in which the immunological roles and hypersensitivity diseases of the gastrointestinal tract and liver have been defined. In the early 1960s IgA was reported to be the main secretory immunoglobulin, immunoblasts were shown to home to the intestinal mucosa and certain serum autoantibodies were described in patients with chronic liver disease. Shortly thereafter IgE and Australia antigen were discovered. Parallel advances in clinical investigation, in particular closed biopsy techniques, facilitated correlation of morphological changes with im­ munological mechanisms in disease of the gastrointestinal tract and liver. Only 10 years later, the concepts of immunity and hypersensitivity are regularly applied to the pathogenesis, diagnosis, treatment and prog­ nosis of many chronic diseases in these organs. In designing this book we have attempted to integrate theorectical and clinical immunology as they pertain in 1975; our ultimate aim is aptly described by Brachet as quoted by Professor Paronetto (page 319). We would like to think that this review provides a basis for the next major advances in the fields of gastrointestinal and hepatic immunology. As we see it, the outstanding problem in both sites is how to produce protective immunity without hypersensitivity. Front Matter....Pages i-xii The gut-associated lymphoid tissues and gastrointestinal immunity....Pages 1-32 The secretory antibody system....Pages 33-82 Gastrointestinal tract and immunodeficiency....Pages 83-120 Enteric infection and immunization....Pages 121-152 Celiac disease and gastrointestinal food allergy....Pages 153-202 Autoimmune and inflammatory diseases of the gastrointestinal tract....Pages 203-250 The mononuclear phagocytic functions of the liver....Pages 251-289 Aetiological factors in immune-mediated liver disease....Pages 291-317 Immune mechanisms in liver disease....Pages 319-343 Autoimmune diseases of the liver....Pages 345-386 The role of immunity and hypersensitivity in gut and liver disease: a comparison....Pages 387-396 Back Matter....Pages 397-404