Selective subnormal IgG3 in 121 adult index patients with frequent or severe bacterial respiratory tract infections

被引:23
作者
Barton, James C. [1 ,2 ,3 ]
Bertoli, Luigi F. [1 ,2 ,4 ]
Barton, J. Clayborn [2 ]
Acton, Ronald T. [2 ,5 ]
机构
[1] Brookwood Med Ctr, Dept Med, Birmingham, AL USA
[2] Southern Iron Disorders Ctr, Birmingham, AL USA
[3] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA
[4] Brookwood Biomed, Birmingham, AL USA
[5] Univ Alabama Birmingham, Dept Microbiol, Birmingham, AL 35294 USA
关键词
Allergy; Atopy; Autoimmunity; Human leukocyte antigen (HLA); IgG3; IgG subclass deficiency (IgGSD); deficiency; Pneumovax; Respiratory tract infections; COMMON VARIABLE IMMUNODEFICIENCY; HYPER-IGM SYNDROME; CLASS-SWITCH RECOMBINATION; AUTOSOMAL RECESSIVE FORM; SUBCLASS DEFICIENCY; REFERENCE RANGES; IMMUNOGLOBULIN-G; SUSCEPTIBILITY LOCUS; AFRICAN-AMERICANS; ANTIBODY-RESPONSE;
D O I
10.1016/j.cellimm.2015.09.004
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
We characterized 121 adults with frequent or severe bacterial respiratory tract infections at diagnosis of selective subnormal IgG3. Mean age was 47 +/- 13 (SD) y; 87.6% were women. Associated disorders included: autoimmune conditions 33.1%; hypothyroidism 14.9%; atopy 29.8%; and other allergy manifestations 41.3%. In 34.1%, proportions of protective Streptococcus pneumoniae serotype-specific IgG levels did not increase after polyvalent pneumococcal polysaccharide vaccination. Blood CD19+, CD3+/CD4+, CD3+/CD8+, and CD56+/CD16+ lymphocyte levels were within reference limits in most patients. In regression analyses, independent variables age; sex; autoimmune conditions; hypothyroidism; atopy; allergy manifestations; corticosteroid therapy; and lymphocyte subsets were not significantly associated with IgG subclass, IgA, or IgM levels. Frequencies of HLA haplotypes A*01, B*08; A*02, B*14; A*02, B*15; A*02, B*44; A*02, B*57; and A*03, B*07 were greater in 80 patients than 751 controls. We conclude that subnormal IgG3 and non-protective S. pneumoniae IgG levels contribute to increased susceptibility to respiratory tract infections. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:50 / 57
页数:8
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