Increased Levels of IgG4 Subclass in 5 Patients with Acquired Respiratory Disease

Abstract

5 sera from a series of more than 1,000 serum samples from hospitalized patients tested by immunoelectrophoresis were selected for further examination because of a disproportional increase in the anodic part of IgG. A marked polyclonal increase in IgG4 subclass level was detected in each of these sera. While the patients suffered from a variety of diseases (e.g. Loeffler’s syndrome, leiomyosarcoma, periarteritis nodosa, chronic bronchitis, and mycosis fungoides, respectively), they all had an acquired respiratory disease as the only common clinical denominator.

Measurement of serum IgG4 levels by a competitive immunoenzymatic assay with monoclonal antibodies

“…Normal figures for serum IgG4 levels were previously reported in studies based upon various methods: radioimmunoassay (Morell et al, 1972;Merret et al, 1983), single radial immunodiffusion (Yount et al, 1970(Yount et al, , 1975Shakib et al, 1975;Van der Giessen et al, 1975;Kaschka et al, 1982;Van Nieuwkoop et al, 1982;Sabbah et al, 1983), electroimmunodiffusion (Oxelius, 1978(Oxelius, , 1979a, nephelometry (Beck and Kaiser, 1981) and immunoenzymatic assay (ELISA) (Linde et al, 1983). The last study used a sandwich-ELISA method with a monoclonal antibody (Mab) but dealt with a very small number of samples.…”

“…The measurement of IgG4 levels seems to be of special clinical interest. Indeed, alterations in serum IgG4 levels have been observed in various primary immunodeficiency states, including ataxia-telangiectasia and selective IgA deficiency with frequent association with IgG2 defect and correlation with frequency of infections (Terry, 1968;Rivat et al, 1969;Schur et al, 1970;Yount et al, 1970;Natvig et al, 1971;Oxelius, 1974Oxelius, , 1979bYount, 1975;Morell et al, 1975;Rivat-Peran et al, 1981;Oxelius et al, 1981Oxelius et al, , 1982Lefranc et al, 1983;Ugazio et al, 1983), in atopic allergy (Parish, 1981;Merret et al, 1983), in malignant melanoma (Daveau et al, 1977) and in certain respiratory diseases (Van Nieuwkoop et al, 1982).…”

Spectrum of Disorders Associated with Elevated Serum IgG4 Levels Encountered in Clinical Practice

“…Van Nieuwkoop and colleagues [20] had previously described an association between a polyclonal increase in serum IgG4 subclass with acquired respiratory diseases. Bronchiectasis and chronic rhinosinusitis were most respiratory disorders in our study cohort likely reflecting the fact that suspected immunodeficiency was one of the main indications for IgG subclass testing in this population.…”

Subclass restriction and polyclonality of the systemic lupus erythematosus marker antibody anti-Sm.

“…In human studies, protein antigens which would be T-dependent in animals have tended to elicit IgGl and IgG3 responses, while T-independent antigens elicit IgG2 responses (15)(16)(17). IgG4 responses have mainly been seen in sera from patients hypersensitized to allergens (18)(19)(20)(21) and in hemophiliacs with anti-factor VIII (22) or anti-factor IX (23). Furthermore, in animals, IgG responses tend to be more T cell-dependent than IgM responses.…”