Popa V, Kim K, Heiner D C
Department of Medicine, University of California, Davis.
Ann Allergy. 1993 May;70(5):418-24.
Total IgA, IgM, IgG, and IgG subclasses were measured in 136 consecutive adults with recurrent respiratory infections. Sinus and chest radiographs were also obtained. IgG antibodies to H. influenzae and tetanus toxoid were determined in 27 immunodeficient subjects. Fifty-eight of the 136 were deficient in some immunoglobulin isotype, three in IgA, three in IgM, and 52 in total IgG or one or more IgG subclasses. The most common IgG deficiencies were single IgG subclass deficiencies, particularly IgG3 or IgG4, and a mild decrease in total IgG (between 450 and 650 mg/dL). In 21/27 subjects with IgG deficiency, the response to booster immunization was blunted, even when IgG1 and IgG2 were normal. Thirty-eight patients were smokers, 37 being > 40 years of age at the onset of respiratory infections. Twenty patients were nonsmokers, 19 being < 40 years of age at the onset. In conclusion, adults with recurrent respiratory infections frequently have some variant of IgG deficiency, often associated with a functional impairment of specific antibody response. Smoking may represent a risk factor for IgG deficiency in adults.
对136例连续性复发性呼吸道感染成人患者测定了总IgA、IgM、IgG及IgG亚类。同时还进行了鼻窦和胸部X线检查。对27例免疫缺陷患者测定了抗流感嗜血杆菌和破伤风类毒素的IgG抗体。136例患者中有58例存在某种免疫球蛋白同种型缺陷，3例IgA缺陷，3例IgM缺陷，52例总IgG或一种或多种IgG亚类缺陷。最常见的IgG缺陷是单一IgG亚类缺陷，尤其是IgG3或IgG4，以及总IgG轻度降低（450至650mg/dL之间）。在21/27例IgG缺陷患者中，即使IgG1和IgG2正常，加强免疫的反应也减弱。38例患者为吸烟者，37例在呼吸道感染发病时年龄>40岁。20例患者为非吸烟者，19例在发病时年龄<40岁。总之，复发性呼吸道感染成人患者常存在某种IgG缺陷变异，常伴有特异性抗体反应的功能损害。吸烟可能是成人IgG缺陷的一个危险因素。
