Linde A, Hammarström L, Smith C I
Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.
Clin Immunol Immunopathol. 1988 Dec;49(3):341-8. doi: 10.1016/0090-1229(88)90124-9.
Immunoglobulin G subclass titers to three herpesviruses (herpes simplex; HSV; cytomegalovirus, CMV; varicella zoster virus, VZV) were examined in patients with common variable immunodeficiency (CVI) before and after immunoglobulin substitution. Like healthy controls, CVI patients expressed IgG1 and IgG3 to HSV and CMV, but only IgG1 to VZV. Individual titers varied as in healthy individuals, but as a mean, specific IgG titers were lowered in proportion to the decrease of total IgG. HSV and CMV IgG3 titers were relatively higher than the IgG1 titers in CVI patients, resulting in a lower IgG1/IgG3 ratio than in healthy individuals (P = 0.025 and 0.05, respectively). The high IgG3 titers in CVI patients could be due to subclinical reactivations of HSV and CMV in these patients. Low VZV IgG1 and absence of IgG3 could explain the increased frequency of zoster infections reported in CVI patients. After immunoglobulin substitution, herpesvirus-specific IgG1 titers increased while HSV and CMV IgG3 decreased or remained stationary. In two unsubstituted patients, HSV and CMV titers remained stationary during 1 and 5 years, respectively, while an increase of VZV IgG1 and IgG3 indicated VZV reactivation although the patients remained asymptomatic.
在进行免疫球蛋白替代治疗前后，对常见可变免疫缺陷（CVI）患者检测了针对三种疱疹病毒（单纯疱疹病毒，HSV；巨细胞病毒，CMV；水痘带状疱疹病毒，VZV）的免疫球蛋白G亚类滴度。与健康对照一样，CVI患者表达针对HSV和CMV的IgG1和IgG3，但仅表达针对VZV的IgG1。个体滴度与健康个体一样存在差异，但总体而言，特异性IgG滴度与总IgG的降低成比例下降。在CVI患者中，HSV和CMV的IgG3滴度相对高于IgG1滴度，导致IgG1/IgG3比值低于健康个体（分别为P = 0.025和0.05）。CVI患者中高IgG3滴度可能是由于这些患者中HSV和CMV的亚临床再激活。VZV IgG1低水平和IgG3缺失可以解释CVI患者中带状疱疹感染频率增加的原因。免疫球蛋白替代治疗后，疱疹病毒特异性IgG1滴度升高，而HSV和CMV的IgG3滴度降低或保持稳定。在两名未接受替代治疗的患者中，HSV和CMV滴度分别在1年和5年内保持稳定，而VZV IgG1和IgG3的升高表明VZV再激活，尽管患者仍无症状。
