Torabi Sagvand B, Mirminachi B, Abolhassani H, Shokouhfar T, Keihanian T, Amirzargar A, Mahdaviani A, Aghamohammadi A
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Science, Tehran, Iran.
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Science, Tehran, Iran; Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden.
Allergol Immunopathol (Madr). 2015 Jul-Aug;43(4):403-8. doi: 10.1016/j.aller.2014.05.005. Epub 2014 Sep 6.
Immunoglobulin replacement therapy is an effective route of management for both infections and non-infectious complications in predominantly antibody deficiency (PAD). Trace levels of IgA (ranged from 0.4 to 2500 mg/ml), which exist in all immunoglobulin products, could lead to an increased susceptibility for adverse reactions in PAD patients. Furthermore, the exact mechanism which stimulates the anti-IgA antibody production in PAD is still unknown. The aim of this study was to evaluate IgG anti-IgA antibodies in PAD patients receiving intravenous immunoglobulin (IVIg) and its predisposing factors.
Available patients with confirmed diagnosis of PAD, who underwent regular IVIg replacement therapy in our centre, were enrolled in the study. Control group included 24 healthy individuals as the negative control and eight symptomatic patients with IgA deficiency as the positive control groups. IgG anti-IgA antibodies level was measured by the ELISA method.
A significant difference was observed between Anti-IgA level of common variable immunodeficiency (CVID) and other PAD groups (p=0.02). Moreover, six CVID patients were seropositive for the IgG anti-IgA antibody, with higher susceptibility to the adverse reactions (p<0.001). IgG anti-IgA level has a negative relationship with serum IgA level (r=-0.06) and IVIg treatment duration (r=-0.006).
Our data suggested that there was a significant association between anti-IgA antibody presence and the adverse reactions, especially in CVID patients with higher susceptibility to produce this constitutional antibody.
免疫球蛋白替代疗法是治疗主要抗体缺陷（PAD）患者感染性和非感染性并发症的有效途径。所有免疫球蛋白产品中存在的微量IgA（范围为0.4至2500mg/ml）可能导致PAD患者不良反应易感性增加。此外，刺激PAD患者产生抗IgA抗体的确切机制仍不清楚。本研究的目的是评估接受静脉注射免疫球蛋白（IVIg）的PAD患者中的IgG抗IgA抗体及其诱发因素。
纳入在本中心接受定期IVIg替代治疗、确诊为PAD的患者。对照组包括24名健康个体作为阴性对照，8名有症状的IgA缺乏患者作为阳性对照组。采用ELISA法检测IgG抗IgA抗体水平。
常见可变免疫缺陷（CVID）组与其他PAD组的抗IgA水平存在显著差异（p=0.02）。此外，6名CVID患者的IgG抗IgA抗体血清学呈阳性，不良反应易感性更高（p<0.001）。IgG抗IgA水平与血清IgA水平（r=-0.06）和IVIg治疗持续时间（r=-0.006）呈负相关。
我们的数据表明，抗IgA抗体的存在与不良反应之间存在显著关联，尤其是在对产生这种自身抗体易感性较高的CVID患者中。
