Immunotherapy as an Adjuvant Therapy for Malignant Melanoma of the Female Urethra : Report of a Case

Mucosal immunity as well as enzymatic and mucociliary defense mechanism acts in the mucous membrane of nasal and paranasal sinus cavities, preventing viral, bacterial and other antigenic invasions. Chronic nasal and paranasal sinus infection is very common disease, but the etiology and pathogenesis of this entity is still a subject of controversy. To obtain an additional information about the pathogenesis of chronic paranasal sinusitis, we investigated secretory component (SC), lactoferrin and immunoglobulins in nasal secretions and nasal and paranasal sinus mucosae. Forty-seven specimens of nasal secretion were obtained by adsorption onto filter papers from patients with chronic rhinosinusitis, 74 specimens were from patients with allergic rhinitis and 40 from normal subjects. Tissue speciments of the inferior turbinate, nasal polyp, and maxillary and ethmoidal sinus mucosa were obtained from 32 patients who underwent paranasal sinus operation. These tissue specimens were subjected to the immunofluorescent observation and immunohistochemical SC affinity test of IgA immunocytes. Concentrations of IgA and IgG in both nasal secretions and sera were determined by single radial diffusion technique, while radioimmunoassay was employed to measure concentrations of SC and lactoferrin in nasal secretions. Mean concentrations of total protein, IgG and IgA in nasal secretions for patients with chronic rhinosinusitis exceeded significantly those of normal subjects. However, mean concentrations of SC and lactoferrin in nasal secretions from the group of chronic rhinosinusitis were less than those of normal subjects. Lactoferrin was chiefly synthesized in serous secretory cells of nasal and paranasal sinus mucosae. However, the production of this protein was reduced in chronic rhinosinusitis, even though glands were apparently abundant. Although IgA content in nasal secretions was elevated in chronic rhinosinusitis, the number of IgA immunocytes capable of binding SC was smaller than that of IgA immunocytes not binding SC. Findings of this investigation suggest that the function fo local mucosal immunity is limited in the nasal and paranasnasat sinus cavities of patients with chronic rhinosinusitis, and that antibodies originating from the plasma contribute significantly to the constitution of immunoglobulins in nasal secretions.