The Biochemistry of Adenosylmethionine

Immunology of the Gut, Ciba Symposium 46, is a welcome update of our current understanding of the role of gut-associated lymphoid tissue in health and disease. It succeeds admirably in documenting the fruitful interaction between clinical medicine and immunology in this field. The symposium is a series of papers presented by leaders in the field of gut immunology and despite multiple authorship, the volume as a whole is consistently clear, logical, and highly readable. Figures and tables are adequate in number and well-executed. The chapter bibliographies are appropriately detailed. As is often true, the discussion section following each paper contains some lively exchanges of views and involves the reader in the close scrutiny of the methods and conclusions offered in the preceding manuscript. Each discussion section has a bibliography as well which greatly facilitates locating specific references. One such which caught this reader's eye was a study of secretory IgA production in man induced by prolonged nasal selfimmunization with serum albumin of Alligator mississippiensis. The topics covered are representative of critical areas in gut immunology. Several papers are concerned with the secretory immunoglobulin system. The site of origin and the natural history of the IgA secreting plasma cell are presented, as recent experimental evidence has described them. The protective functions of secretory IgA and IgM against bacterial and dietary antigens are detailed, as are related clinical applications. The status of controversial elements of the gut immune response, such as IgE and eosinophils, are reviewed, indicating at least some functions these entities do not have in immune-mediated phenomena. The mechanism of gastrointestinal disease in immunodeficiency syndromes is the subject of a series of papers which offers some new concepts of pathogenesis and treatment. Finally, the immunopathologic characteristics of inflammatory bowel disease, alpha chain disease, and coeliac disease are discussed. A final discussion section highlights several other areas of interest, each of which ought perhaps to have been a major topic. The Symposium is an excellent review of recent work in gut immunology and is particularly well suited for interested clinicians and investigators in related areas.