IgG subclass deficiency in asthma.

Abstract

SUMMARY Total immunoglobulin G (IgG) and subclasses were measured in serum samples from 82 children with chronic asthma, aged 1*5 to 6-3 years, and 76 controls. Concentrations of IgGj, IgG2, IgG3, and total IgG were significantly lower in asthmatic children aged 1 to 5, and IgG2 concentrations were also significantly lower in asthmatic children over 5 years of age. Twenty eight asthmatic children had at least one value in the deficient range, and 26 had IgG2 deficiency alone or in combination. Five children had IgG2 and IgA deficiency. These 28 children were significantly younger and fewer had raised IgE concentrations than the remainder.IgG subclass deficiency, which may reflect delayed maturation of the immune system, is common in young asthmatic children, and may have a role in the pathogenesis of the disease.The importance of respiratory infection in precipitating attacks of asthma is well known. Deficiencies of IgG limited to one or more subclasses have been recognised in children with recurrent infections' and one small study found evidence of IgG subclass deficiency in 'non-allergic children with chronic chest symptoms'.2 Because other forms of immunodeficiency have been associated with atopic diseases, we decided to study IgG subclass concentrations in a large group of chronic asthmatic children. Patients and methodsWe studied 82 children with chronic asthma, all of whom were attending the paediatric respiratory clinic at King's College Hospital. Children were included if they had asthma severe enough to warrant regular bronchodilators or prophylactic medication-that is, at least one severe attack a month, or symptoms on most days. Fifty six boys and 26 girls aged 1-5 to 6-3 years were recruited. The first symptoms of asthma occurred under the age of 1 year in 36, and under the age of 2 in 69. Half the children had symptoms of rhinitis, and half had present or past symptoms of eczema. Skin testing to six common allergens was carried out on 69, and yielded one or more positive reactions in 55. Sixty six had raised serum IgE concentrations (more than two standard deviations above the age matched mean). Forty eight children required steroids by inhalation, five sodium cromoglycate, 10 theophylline, and 19 regular I6 agonists. Serum samples from 76 unselected healthy controls, 38 boys and 38 girls aged 1 to 6-8 years were also analysed. These children were recruited in conjunction with the Michael McGough Foundation; they were in good health at the time of the study and had no history of serious disease.We compared values for male and female controls to determine whether there was any sex difference in IgG subclass concentrations. Because concentrations of IgG subclasses vary with age,3 asthmatic and control children were divided in three groups 1 to 2-99 years, 3 to 4-99 years, 5 to 6-99 years, for the purposes of analysis so that age matched comparison could be carried out. In the 1-2-99 years age group there were 17 controls (eight of whom were boys) and 22 asthmatic children (15 of whom were boys); in th...

Functional Expression of IgG-Fc Receptors in Human Airway Smooth Muscle Cells

“…The broad inhibitory actions of FcgRIIb in hASM are consistent with a role for this receptor in the beneficial effects of FcgR ligands implied by association of asthma severity and low IgG levels (7,8). It is unclear whether FcgR expression is disrupted in disorders such as asthma.…”

“…Several studies have shown an IgG deficiency in asthma, with low levels of IgG being associated with the severity of the asthmatic symptoms (7,8). This may reflect diminished capacity to neutralize allergens, thus enabling more effective IgE/FceR activation (1).…”

Use of intravenous immunoglobulin in human disease: A review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology

“…Patients who fit these descriptions are occasionally found to have antibody deficiency. [126][127][128][129][130][131][132][133] In some patients with immune abnormalities and infection-associated asthma, replacement doses of IGIV might eliminate the triggering infections, reduce the frequency and severity of their pulmonary symptoms, or both. This in turn might decrease the symptoms and morbidity of asthma.…”

Clinical and immunological evaluation of patients with mild IgG1 deficiency

“…Within an adult patient population with chronic bacterial respiratory infections, an isolated IgG1 subclass deficiency can be found [10][11][12][13][14], but normal IgG1 levels are also described in these patients [15,16].…”