French M A, Harrison G
Clin Exp Immunol. 1984 Apr;56(1):18-22.
Serum IgG tetanus toxoid antibody (IgGTTab) concentrations were measured in patients with chronic chest infections or recurrent acute chest infections following immunization and compared with results obtained in a group of 43 controls. Apart from selective IgA deficiency in some patients, all had normal or high serum immunoglobulins. Using an enzyme linked immunosorbent assay (ELISA) for IgG TTab, antibody was present following one immunization in all controls who had previously been immunized and following two immunizations in those not previously immunized. Ninety-seven and a half per cent of controls had a serum antibody concentration of greater than 4 micrograms/ml. Following the same immunization schedule, eight of 45 (18%) patients with chronic chest infections and three of 11 (27%) patients with recurrent acute infections had a serum IgG TTab of less than 4 micrograms/ml. The three patients with a low IgG TTab concentration and recurrent acute infections all had selective IgA deficiency. Two of these patients have benefited from injections of normal human immunoglobulin. It is suggested that systemic antibody deficiency as a cause of chronic or recurrent respiratory tract infections cannot be excluded by measuring serum immunoglobulin concentrations alone and that it is of value to measure antibody responses following immunization.
在免疫后对患有慢性胸部感染或复发性急性胸部感染的患者测定血清破伤风类毒素IgG抗体（IgGTTab）浓度，并与43名对照组的结果进行比较。除部分患者存在选择性IgA缺乏外，所有患者的血清免疫球蛋白均正常或升高。使用酶联免疫吸附测定（ELISA）检测IgG TTab，所有既往已免疫的对照组在一次免疫后出现抗体，而既往未免疫的对照组在两次免疫后出现抗体。97.5%的对照组血清抗体浓度大于4微克/毫升。按照相同的免疫程序，45名慢性胸部感染患者中有8名（18%）、11名复发性急性感染患者中有3名（27%）的血清IgG TTab低于4微克/毫升。IgG TTab浓度低且患有复发性急性感染的3名患者均有选择性IgA缺乏。其中2名患者已从注射正常人免疫球蛋白中获益。提示不能仅通过测定血清免疫球蛋白浓度来排除全身性抗体缺乏作为慢性或复发性呼吸道感染病因的可能性，且测定免疫后的抗体反应具有重要价值。
