Griese M, Walda M, Meuser M, Reinhardt D
Kinderklinik, Heinrich-Heine-Universität Düsseldorf.
Monatsschr Kinderheilkd. 1990 Oct;138(10):674-9.
A group of 130 children presenting with frequent respiratory tract infections was examined for serum levels of IgG-subclasses IgG1, IgG2, IgG3 and IgG4 using radial immunodiffusion according to Mancini. Additionally a control group of 175 children not prone to infections was investigated. Both, low and high levels compared to controls were observed for IgG3 and IgG4. 11.5% of the children with frequent airway infections had IgG3 values below 2 SD below the mean for age compared to 2.8% in the control group (p less than 0.01). Likewise a low IgG4 level was observed more frequently in children prone to airway infections (9.8% versus 2.8% in control; p less than 0.05). IgG4 was undetectable (level less than 3.4 mg/dl) in 5 of the 175 control children. Despite an accumulation of low or undetectable IgG3 or IgG4 levels in children with frequent respiratory tract infections, no correlation between low IgG subclass-levels and the degree of the individual disease could be detected. Based on this lack of a simple causal relationship between frequent respiratory tract infections and the finding of low or undetectable IgG-subclass levels, an immunoglobulin replacement therapy has to be considered with reserve.
采用曼奇尼（Mancini）放射免疫扩散法，对130名经常出现呼吸道感染的儿童进行了血清IgG亚类IgG1、IgG2、IgG3和IgG4水平检测。另外，对175名不易感染的儿童组成的对照组也进行了调查。与对照组相比，IgG3和IgG4均观察到了低水平和高水平情况。在经常出现气道感染的儿童中，11.5%的儿童IgG3值低于同年龄组均值2个标准差，而对照组这一比例为2.8%（p<0.01）。同样，在易患气道感染的儿童中，IgG4低水平更为常见（9.8%对对照组的2.8%；p<0.05）。在175名对照儿童中，有5名IgG4检测不到（水平低于3.4mg/dl）。尽管在经常出现呼吸道感染的儿童中，IgG3或IgG4水平低或检测不到的情况有所累积，但未发现低IgG亚类水平与个体疾病程度之间存在相关性。基于经常出现呼吸道感染与低或检测不到的IgG亚类水平之间缺乏简单的因果关系，免疫球蛋白替代疗法必须谨慎考虑。
