Abdukhakimova Diyora, Dossybayeva Kuanysh, Almukhamedova Zhaina, Mukusheva Zaure, Assylbekova Maykesh, Zhangabylova Dilnaz, Nurgaliyeva Kadisha, Boluspayeva Nurgul, Kulmangabetova Kenzhekhan, Hasanova Liliya, Tanko Matthew, Poddighe Dimitri
Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan.
Program of Pediatric Rheumatology, Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan.
Heliyon. 2023 Jun 28;9(7):e17479. doi: 10.1016/j.heliyon.2023.e17479. eCollection 2023 Jul.
Immunoglobulin A (IgA) is the most abundant antibody isotype in the human body, considering its presence on the mucosal surfaces, in addition to the amount circulating in the bloodstream. Serum IgA levels can be variably altered in several pathological settings. However, very few studies specifically investigated serum IgA in Juvenile Idiopathic Arthritis (JIA). In the present study, we specifically assessed serum IgA levels in our cohort of patients affected with JIA.
In this cross-sectional study, serum IgA levels were measured in patients with JIA (and age-matched controls) and analyzed according to age class. The correlation of serum IgA levels with hematological, inflammatory, and disease activity parameters was assessed.
No significant difference in the frequency of low IgA levels (according to the definition of complete and partial IgA deficiency) was observed between JIA patients and controls, overall. This pediatric study population showed a progressive increase of total serum IgA concentrations with age, as expected; however, in JIA patients aged 10-17 years, total IgA serum levels resulted to be significantly higher than in age-matched control subjects. No clear correlation between IgA levels and the examined inflammatory, hematological, and disease activity parameters was observed in JIA patients, except for the erythrocyte sedimentation rate (ESR) in oligoarticular JIA patients: here, serum IgA levels showed a positive and moderate covariation with ESR, which was also observed for disease activity (JADAS-10) in selected oJIA patients without biological therapy.
In our cohort of JIA patients, total serum IgA levels were not reduced and were actually increased in adolescents compared to controls. Larger studies are needed to confirm this finding, which cannot be certainly explained based on the available data in this study, even though JIA disease control and/or chronic inflammation may be implicated to some extent.
免疫球蛋白A（IgA）是人体中含量最丰富的抗体亚型，不仅存在于血液循环中，还存在于黏膜表面。在多种病理情况下，血清IgA水平可能会发生不同程度的改变。然而，专门研究青少年特发性关节炎（JIA）患者血清IgA的研究非常少。在本研究中，我们专门评估了JIA患者队列中的血清IgA水平。
在这项横断面研究中，测量了JIA患者（以及年龄匹配的对照组）的血清IgA水平，并根据年龄组进行分析。评估了血清IgA水平与血液学、炎症和疾病活动参数的相关性。
总体而言，JIA患者和对照组之间在低IgA水平（根据完全和部分IgA缺乏的定义）的频率上未观察到显著差异。正如预期的那样，该儿科研究人群显示血清总IgA浓度随年龄逐渐增加；然而，在10 - 17岁的JIA患者中，总IgA血清水平显著高于年龄匹配的对照受试者。在JIA患者中，除了少关节型JIA患者的红细胞沉降率（ESR）外，未观察到IgA水平与所检查的炎症、血液学和疾病活动参数之间有明显相关性：在这里，血清IgA水平与ESR呈正相关且具有中等共变性，在未接受生物治疗的选定少关节型JIA患者的疾病活动度（JADAS - 10）中也观察到了这种情况。
在我们的JIA患者队列中，血清总IgA水平没有降低，与对照组相比，青少年患者的血清总IgA水平实际上有所升高。需要更大规模的研究来证实这一发现，尽管JIA疾病控制和/或慢性炎症可能在一定程度上与之相关，但根据本研究中的现有数据尚不能肯定地解释这一现象。
