Analysis of differences between total IgG and sum of the IgG subclasses in children with suspected immunodeficiency – indication of determinants

Pasternak, Gerard; Lewandowicz-Uszyńska, Aleksandra; Pentoś, Katarzyna

doi:10.1186/s12865-018-0259-7

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…In IgG 4 deficiency, the tendency to chronic lung diseases is increased. Although IgG 2 only functions in neutralisation, IgG 1 , IgG 3 and IgG 4 have neutralisation and antibody-dependent enhancement effects 25 26. Similar to total IgG against SARS-CoV-2, IgG subclass responses can be detected until late in the infection.…”

Section: Discussionmentioning

confidence: 99%

Memory B cells and serum immunoglobulins are associated with disease severity and mortality in patients with COVID-19

Çölkesen

Kurt

Vatansev

et al. 2022

Postgraduate Medical Journal

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Purpose of the studyThe aim of this study was to investigate the relationship of B cell-mediated immunity with disease severity and mortality in patients with COVID-19.Study designIn this retrospective cohort and single-centre study, 208 patients with laboratory-confirmed COVID-19 were recruited. A COVID-19 severity score, ranging from 0 to 10, was used to evaluate associations between various factors. Serum immunoglobulin levels and the number of cells in B lymphocyte subsets were measured and their association with disease severity and mortality in patients with COVID-19 examined.ResultsThe median age of the patients was 50 (35–63) years and 88 (42%) were female. The number of deceased patients was 17. The median COVID-19 severity score was 8 (6–8) in deceased patients and 1 (0–2) in survivors. Deceased patients had significantly lower levels of total B lymphocytes, naive B cells, switched memory B cells, and serum IgA, IgG, IgG1 and IgG2 than recovered patients (all p<0.05). In addition, a significant negative correlation was found between the number of these parameters and COVID-19 severity scores. Decrease in the number of total B cells and switched memory B cells as well as lower serum IgA, IgG and IgG1 levels were independent risk factors for mortality in patients with COVID-19.ConclusionIn the present study, the prognosis of patients with COVID-19 was shown to be associated with the B cell subset and serum immunoglobulin levels.

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Section: Discussionmentioning

confidence: 99%

Memory B cells and serum immunoglobulins are associated with disease severity and mortality in patients with COVID-19

Çölkesen

Kurt

Vatansev

et al. 2022

Postgraduate Medical Journal

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“…After correcting for multiple comparisons, only the IgG2 levels were found to be significantly lower in children compared with those in adults ( p < 0.0001). This was anticipated because the normal ranges for IgG2 are lower for children than for adults [ 32 ]; children and adults were pooled in further analyses. The mean IgG trough level of participants receiving IRT was 11.77 g/L (95% CI: 10.8–12.7).…”

Section: Resultsmentioning

confidence: 99%

Immunoglobulin Replacement Therapy Versus Antibiotic Prophylaxis as Treatment for Incomplete Primary Antibody Deficiency

et al. 2020

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Background Patients with an IgG subclass deficiency (IgSD) ± specific polysaccharide antibody deficiency (SPAD) often present with recurrent infections. Previous retrospective studies have shown that prophylactic antibiotics (PA) and immunoglobulin replacement therapy (IRT) can both be effective in preventing these infections; however, this has not been confirmed in a prospective study. Objective To compare the efficacy of PA and IRT in a randomized crossover trial. Methods A total of 64 patients (55 adults and 9 children) were randomized (2:2) between two treatment arms. Treatment arm A began with 12 months of PA, and treatment arm B began with 12 months of IRT. After a 3-month bridging period with cotrimoxazole, the treatment was switched to 12 months of IRT and PA, respectively. The efficacy (measured by the incidence of infections) and proportion of related adverse events in the two arms were compared. Results The overall efficacy of the two regimens did not differ (p = 0.58, two-sided Wilcoxon signed-rank test). A smaller proportion of patients suffered a related adverse event while using PA (26.8% vs. 60.3%, p < 0.0003, chi-squared test). Patients with persistent infections while using PA suffered fewer infections per year after switching to IRT (2.63 vs. 0.64, p < 0.01). Conclusion We found comparable efficacy of IRT and PA in patients with IgSD ± SPAD. Patients with persistent infections during treatment with PA had less infections after switching to IRT. Clinical Implication Given the costs and associated side-effects of IRT, it should be reserved for patients with persistent infections despite treatment with PA.

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Section: Discussionmentioning

confidence: 99%

“…Age and serum Ig data are expressed to the nearest integer. To determine factors that affect the percentage difference between IgGsum and IgG, we computed the D-parameter [ 27 ], defined as: where IgGsum is the sum of IgG subclasses (IgG1 + IgG2 + IgG3 + IgG4) and IgG is total serum IgG.…”

Section: Methodsmentioning

confidence: 99%

“…We performed a retrospective chart and data review to identify adults diagnosed with IgGSD in a hematology clinic who had subnormal IgG1 only, combined subnormal IgG1/IgG3, or subnormal IgG3 only at diagnosis without other subnormal IgG subclasses, subnormal IgA, or subnormal IgM. We compiled these data: age at diagnosis; sex; autoimmune condition(s) (AC); atopy; serum levels of IgG, IgG subclasses, IgA, IgM; IgGsum (IgG1 + IgG2 + IgG3 + IgG4); and the D-parameter (D), the percentage difference between IgGsum and IgG [ 27 ]. In subnormal IgG1 only or combined subnormal IgG1/IgG3 subclass groups, we compared clinical and laboratory attributes of patients with and without IgG < 7.00 g/L.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with IgG levels in adults with IgG subclass deficiency

Barton

Barton²,

Bertoli³

et al. 2021

BMC Immunol

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Background Factors associated with IgG levels in adults with IgG subclass deficiency (IgGSD) are incompletely understood. We studied adults with IgGSD with subnormal IgG1 only, subnormal IgG1/IgG3, or subnormal IgG3 only without other subnormal IgG subclasses, IgA, or IgM. We compiled: age; sex; autoimmune condition(s) (AC); atopy; IgG, IgG subclasses, IgA, IgM; IgGsum (IgG1 + IgG2 + IgG3 + IgG4); and D (percentage difference between IgGsum and IgG). We compared attributes of patients with/without subnormal IgG (< 7.00 g/L; subnormal IgG1 subclass groups only) and analyzed IgGsum and IgG relationships. We performed backward stepwise regressions on IgG using independent variables IgG subclasses, age, and sex and on D using independent variables age and sex. Results There were 39 patients with subnormal IgG1 only (89.7% women), 53 with subnormal IgG1/IgG3 (88.7% women), and 115 with subnormal IgG3 only (91.3% women). Fifteen patients (38.5%) and 32 patients (60.4%) in the respective subnormal IgG1 subclass groups had subnormal IgG. Attributes of patients with/without IgG < 7.00 g/L were similar, except that AC prevalence was lower in patients with subnormal IgG1 only and IgG < 7.00 g/L than ≥ 7.00 g/L (p = 0.0484). Mean/median IgG1 and IgG2 were significantly lower in patients with IgG < 7.00 g/L in both subnormal IgG1 subclass groups (p < 0.0001, all comparisons). Regressions on IgG in three subclass groups revealed positive associations with IgG1 and IgG2 (p < 0.0001 each association). Regressions on D revealed no significant association. IgG1 percentages of IgGsum were lower and IgG2 percentages were higher in patients with subnormal IgG1 subclass levels than subnormal IgG3 only (p < 0.0001 all comparisons). Conclusions We conclude that both IgG1 and IgG2 are major determinants of IgG in patients with subnormal IgG1, combined subnormal IgG1/IgG3, or subnormal IgG3 and that in patients with subnormal IgG1 or combined subnormal IgG1/IgG3, median IgG2 levels are significantly lower in those with IgG < 7.00 g/L than those with IgG ≥ 7.00 g/L.

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Analysis of differences between total IgG and sum of the IgG subclasses in children with suspected immunodeficiency – indication of determinants

Cited by 10 publications

References 8 publications

Memory B cells and serum immunoglobulins are associated with disease severity and mortality in patients with COVID-19

Memory B cells and serum immunoglobulins are associated with disease severity and mortality in patients with COVID-19

Immunoglobulin Replacement Therapy Versus Antibiotic Prophylaxis as Treatment for Incomplete Primary Antibody Deficiency

Factors associated with IgG levels in adults with IgG subclass deficiency

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