Barton James C, Bertoli Luigi F, Barton J Clayborn, Acton Ronald T
Department of Medicine, Brookwood Medical Center, Birmingham, AL, United States; Southern Iron Disorders Center, Birmingham, Birmingham, AL, United States; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Medicine, Brookwood Medical Center, Birmingham, AL, United States; Southern Iron Disorders Center, Birmingham, Birmingham, AL, United States; Brookwood Biomedical, Birmingham, AL, United States.
Cell Immunol. 2016 Jan;299:50-7. doi: 10.1016/j.cellimm.2015.09.004. Epub 2015 Sep 14.
We characterized 121 adults with frequent or severe bacterial respiratory tract infections at diagnosis of selective subnormal IgG3. Mean age was 47 ± 13 (SD)y; 87.6% were women. Associated disorders included: autoimmune conditions 33.1%; hypothyroidism 14.9%; atopy 29.8%; and other allergy manifestations 41.3%. In 34.1%, proportions of protective Streptococcus pneumoniae serotype-specific IgG levels did not increase after polyvalent pneumococcal polysaccharide vaccination. Blood CD19+, CD3+/CD4+, CD3+/CD8+, and CD56+/CD16+ lymphocyte levels were within reference limits in most patients. In regression analyses, independent variables age; sex; autoimmune conditions; hypothyroidism; atopy; allergy manifestations; corticosteroid therapy; and lymphocyte subsets were not significantly associated with IgG subclass, IgA, or IgM levels. Frequencies of HLA haplotypes A01, B08; A02, B14; A02, B15; A02, B44; A02, B57; and A03, B07 were greater in 80 patients than 751 controls. We conclude that subnormal IgG3 and non-protective S. pneumoniae IgG levels contribute to increased susceptibility to respiratory tract infections.
我们对121例在诊断为选择性IgG3亚正常时患有频繁或严重细菌性呼吸道感染的成年人进行了特征分析。平均年龄为47±13（标准差）岁；87.6%为女性。相关疾病包括：自身免疫性疾病33.1%；甲状腺功能减退14.9%；特应性29.8%；以及其他过敏表现41.3%。在34.1%的患者中，多价肺炎球菌多糖疫苗接种后，保护性肺炎链球菌血清型特异性IgG水平未升高。大多数患者的血液CD19 +、CD3 + /CD4 +、CD3 + /CD8 +和CD56 + /CD16 +淋巴细胞水平在参考范围内。在回归分析中，自变量年龄、性别、自身免疫性疾病、甲状腺功能减退、特应性、过敏表现、皮质类固醇治疗和淋巴细胞亚群与IgG亚类、IgA或IgM水平无显著相关性。80例患者的HLA单倍型A01、B08；A02、B14；A02、B15；A02、B44；A02、B57；以及A03、B07的频率高于751例对照。我们得出结论，IgG3亚正常和非保护性肺炎链球菌IgG水平导致呼吸道感染易感性增加。
