From the Division of Allergy & Immunology, Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI; and.
Allergy Asthma Proc. 2024 Sep 1;45(5):310-316. doi: 10.2500/aap.2024.45.240052.
Primary antibody deficiencies are characterized by the inability to effectively produce antibodies and may involve defects in B-cell development or maturation. Primary antibody deficiencies can occur at any age, depending on the disease pathology. Certain primary antibody deficiencies affect males and females equally, whereas others affect males more often. Patients typically present with recurrent sinopulmonary and gastrointestinal infections, and some patients can experience an increased risk of opportunistic infections. Multidisciplinary collaboration is important in the management of patients with primary antibody deficiencies because these patients require heightened monitoring for atopic, autoimmune, and malignant comorbidities and complications. The underlying genetic defects associated with many primary antibody deficiencies have been discovered, but, in some diseases, the underlying genetic defect and inheritance are still unknown. The diagnosis of primary antibody deficiencies is often made through the evaluation of immunoglobulin levels, lymphocyte levels, and antibody responses. A definitive diagnosis is obtained through genetic testing, which offers specific management options and may inform future family planning. Treatment varies but generally includes antibiotic prophylaxis, vaccination, and immunoglobulin replacement. Hematopoietic stem cell transplantation is also an option for certain primary antibody deficiencies.
原发性抗体缺陷症的特征是无法有效产生抗体,可能涉及 B 细胞发育或成熟缺陷。原发性抗体缺陷症可发生在任何年龄,具体取决于疾病的病理。某些原发性抗体缺陷症在男女中的发病率相等,而另一些则更常影响男性。患者通常表现为反复发生的鼻窦和胃肠道感染,一些患者可能会增加机会性感染的风险。多学科合作对于原发性抗体缺陷症患者的管理非常重要,因为这些患者需要高度监测特应性、自身免疫性和恶性合并症和并发症。许多原发性抗体缺陷症相关的潜在遗传缺陷已被发现,但在某些疾病中,潜在的遗传缺陷和遗传方式仍不清楚。原发性抗体缺陷症的诊断通常通过评估免疫球蛋白水平、淋巴细胞水平和抗体反应来进行。通过基因检测可以明确诊断,这可以提供具体的管理方案,并可能为未来的计划生育提供信息。治疗方法因疾病而异,但通常包括抗生素预防、疫苗接种和免疫球蛋白替代治疗。对于某些原发性抗体缺陷症,造血干细胞移植也是一种选择。