Camacho M T, Outschoorn I, Tellez A
Centro Nacional de Microbiología, Virología e Inmunología Sanitarias, Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 1995 Dec;14(12):1070-5. doi: 10.1007/BF01590941.
The progression of Q fever to either acute or chronic disease has been attributed both to biological characteristics of the bacteria and to the host immune response. In order to determine whether a specific immunoglobulin G (IgG) subclass distribution could play a diagnostic or prognostic role in Q fever, IgG subclass levels were measured in patients with acute or chronic disease. It was observed that (i) IgG1 and IgG3 levels were elevated in patients with chronic Q fever compared to patients with acute disease or normal controls; (ii) variations over time reflected inverse complementary relationships of subclass levels, such as between IgG1 and IgG3 compared with IgG2 and IgG4, or an inverse relationship between IgG1 and IgG2; (iii) variations in IgG2 and IgG3 total subclass levels during follow-up of patients with chronic Q fever showed a decrease in IgG2 with a concomitant increase in IgG3 two years from disease onset. These findings indicate that measurements of IgG subclasses may be a simple, additional tool useful in the diagnosis of Q fever. This data raises the question of an unusual immunoregulatory mechanism in Q fever that is implicated in the presentation of the clinical disease.
Q热进展为急性或慢性疾病既归因于细菌的生物学特性，也归因于宿主的免疫反应。为了确定特定的免疫球蛋白G（IgG）亚类分布是否在Q热中发挥诊断或预后作用，对急性或慢性疾病患者的IgG亚类水平进行了测量。观察到：（i）与急性疾病患者或正常对照相比，慢性Q热患者的IgG1和IgG3水平升高；（ii）随时间的变化反映了亚类水平的反向互补关系，如IgG1和IgG3与IgG2和IgG4之间，或IgG1和IgG2之间的反向关系；（iii）慢性Q热患者随访期间IgG2和IgG3总亚类水平的变化显示，从疾病发作两年起，IgG2减少，同时IgG3增加。这些发现表明，IgG亚类的测量可能是一种简单的辅助工具，有助于Q热的诊断。该数据提出了Q热中一种异常免疫调节机制的问题，这种机制与临床疾病的表现有关。
