UPSC MainsMEDICAL-SCIENCE-PAPER-I20225 Marks
Q22.

Draw a diagram of IgA. What is its role in a disease?

How to Approach

This question requires a combined visual and descriptive answer. The candidate should first draw a well-labeled diagram of the IgA molecule, highlighting its key structural components. Following this, they should detail the role of IgA, particularly its function in mucosal immunity and its involvement in various diseases. The answer should demonstrate understanding of IgA's subclasses and mechanisms of action. A structured approach focusing on structure, function, and disease relevance is crucial.

Model Answer

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Introduction

Immunoglobulin A (IgA) is the most abundant antibody in mucosal secretions, such as saliva, tears, breast milk, and secretions of the respiratory, gastrointestinal, and genitourinary tracts. It plays a critical role in mucosal immunity, providing the first line of defense against pathogens at these entry points. Unlike other immunoglobulins, IgA exists in both monomeric and dimeric forms, with the dimeric form being predominant in secretions. Understanding its structure and function is vital for comprehending its role in preventing infections and maintaining immune homeostasis.

IgA Structure: A Diagrammatic Representation

IgA exists in two main isoforms: IgA1 and IgA2. The basic structural unit of IgA is a monomer consisting of two heavy chains (alpha chains) and two light chains (kappa or lambda). The diagram below illustrates the dimeric form of IgA, which is commonly found in mucosal secretions.

IgA Structure

Key components of the IgA molecule:

  • Heavy Chains (α chains): These form the main body of the antibody.
  • Light Chains (κ or λ chains): Associated with the heavy chains, contributing to antigen binding.
  • Hinge Region: Allows flexibility for antigen binding.
  • J Chain: A polypeptide chain that joins two IgA monomers to form the dimeric IgA. It's crucial for transport across epithelial cells.
  • Secretory Component (SC): A fragment of the polymeric immunoglobulin receptor (pIgR) that remains bound to IgA after transport across epithelial cells, protecting it from degradation in the mucosal environment.
  • Fab Region: Fragment antigen-binding region, responsible for recognizing and binding to antigens.
  • Fc Region: Fragment crystallizable region, mediates effector functions.

IgA's Role in Mucosal Immunity

IgA's primary function is to neutralize pathogens at mucosal surfaces, preventing their attachment and penetration into the body. This is achieved through several mechanisms:

  • Neutralization: IgA binds to pathogens, preventing them from adhering to epithelial cells.
  • Immune Exclusion: IgA aggregates with pathogens in the mucus, facilitating their removal through peristalsis or ciliary action.
  • Intracellular Neutralization: IgA can be transported into epithelial cells, neutralizing pathogens that have already entered.
  • Complement Activation (limited): While IgA doesn't typically activate the classical complement pathway efficiently, it can activate the alternative pathway under certain conditions.

IgA and Disease

Dysregulation of IgA production or function is implicated in several diseases:

  • Selective IgA Deficiency (SIAD): The most common primary immunodeficiency, characterized by low or absent IgA levels. SIAD is often asymptomatic but can be associated with recurrent respiratory infections, allergies, autoimmune diseases, and gastrointestinal disorders. Approximately 1 in 300-500 individuals are affected.
  • IgA Nephropathy (Berger's Disease): A common glomerulonephritis characterized by IgA deposits in the glomeruli of the kidneys. This leads to inflammation and kidney damage. It is more prevalent in certain populations, such as those of Asian and Caucasian descent.
  • Celiac Disease: IgA antibodies against tissue transglutaminase (tTG) are used in the diagnosis of celiac disease. These antibodies are produced in response to gluten and contribute to intestinal inflammation.
  • Henoch-Schönlein Purpura (HSP): A systemic vasculitis characterized by IgA deposits in small blood vessels, leading to inflammation in the skin, joints, kidneys, and gastrointestinal tract.
  • Cystic Fibrosis: Individuals with cystic fibrosis often exhibit elevated IgA levels in their lungs, contributing to chronic inflammation and airway obstruction.

Furthermore, IgA plays a role in maintaining gut microbiome homeostasis. It can coat commensal bacteria, preventing their excessive adhesion to the intestinal epithelium and modulating the immune response to them.

Conclusion

IgA is a crucial component of the mucosal immune system, providing a first line of defense against pathogens at mucosal surfaces. Its unique structure, particularly the dimeric form and the secretory component, allows it to function effectively in harsh mucosal environments. Dysregulation of IgA is linked to a variety of diseases, highlighting its importance in maintaining immune homeostasis. Further research into IgA's complex interactions with the microbiome and its role in disease pathogenesis is essential for developing novel therapeutic strategies.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Mucosal Immunity
The immune system's defense mechanisms at mucosal surfaces (e.g., gut, lungs, reproductive tract), involving both innate and adaptive immune responses.
Polymeric Immunoglobulin Receptor (pIgR)
A transmembrane receptor expressed by epithelial cells that binds to dimeric IgA and transports it across the cell into the mucosal lumen, releasing secretory IgA.

Key Statistics

Approximately 70-80% of the body’s immune cells are located in the gut-associated lymphoid tissue (GALT).

Source: Janeway's Immunobiology, 9th Edition (Knowledge Cutoff: 2021)

Selective IgA deficiency affects approximately 1 in 300 to 1 in 500 individuals in Europe and North America.

Source: PubMed Central (Knowledge Cutoff: 2021)

Examples

Breastfeeding and IgA

Breast milk is rich in IgA, providing passive immunity to the infant, protecting them from infections during the first few months of life. This is particularly important for protecting against gastrointestinal pathogens.

Frequently Asked Questions

What is the difference between IgA1 and IgA2?

IgA1 is the predominant subclass in serum and secretions, while IgA2 is more common in the gut and is more resistant to proteolytic enzymes. IgA2 also has a shorter hinge region.

Topics Covered

ImmunologyMicrobiologyAntibodiesImmune ResponseMucosal Immunity