InfectionSerum Immunoglobulins and Risk of Infection: How Low Can You Go?
Section snippets
Methods
Information for this article was gathered from a search of the PubMed database between January 1990 and November 2007. The search strategies included [IgA OR IgG OR IgM] AND [deficiency]; [IgA OR IgG OR IgM] AND [infection]; [agammaglobulinemia] OR [hypogammaglobulinemia] AND [infection]; [immunoglobulin] AND [transplantation] AND [infection]; [immunomodulation] AND [immunoglobulin] and were limited to articles in the English language. Relevant publications were hand-searched to identify
Results
Immunoglobulins play 3 critical roles: (1) neutralization of foreign antigens through direct binding; (2) alteration of antigens to a form more readily engulfed by phagocytes; and (3) triggering the release of chemicals to facilitate antigen destruction (3, 4). The immunoglobulin family comprises 5 major classes: immunoglobulin G (IgG); immunoglobulin A (IgA); immunoglobulin M (IgM); immunoglobulin D (IgD); and immunoglobulin E (IgE). Table 1 shows the normal ranges of immunoglobulin levels in
Discussion
Low levels or absence of immunoglobulins in primary and secondary immunodeficiency syndromes are associated with an increased risk of infections, in particular, when immunoglobulin levels remain very low for protracted periods of time. Bacterial infections of the respiratory tract are the most common types of infection seen in these conditions. Deficiency of IgG is most frequently implicated in increased susceptibility to infection. IgA deficiency appears to be less serious in terms of
Acknowledgment
Support for third-party writing assistance for this article, furnished by Neil Anderson, was provided by Genentech, Inc.
References (79)
- et al.
Clinical manifestations of IgE hypogammaglobulinemia
Ann Allergy Asthma Immunol
(1997) Pulmonary complications of primary immunodeficiencies
Paediatr Respir Rev
(2004)Primary immunodeficiency disorders: antibody deficiency
J Allergy Clin Immunol
(2002)- et al.
Early and prolonged intravenous immunoglobulin replacement therapy in childhood agammaglobulinemia: a retrospective survey of 31 patients
J Pediatr
(1999) - et al.
Efficacy of intravenous immunoglobulin on the prevention of pneumonia in patients with agammaglobulinemia
FEMS Immunol Med Microbiol
(2004) - et al.
Common variable immunodeficiency in systemic lupus erythematosus
Semin Arthritis Rheum
(2007) - et al.
Hypogammaglobulinemia and rheumatic disease
Semin Arthritis Rheum
(1993) - et al.
Preterm infants with low immunoglobulin G levels have increased risk of neonatal sepsis but do not benefit from prophylactic immunoglobulin G
J Pediatr
(2000) - et al.
Antibody deficiency syndromes
Pediatr Clin North Am
(2000) - et al.
Hypogammaglobulinemia following cardiac transplantation: a link between rejection and infection
J Heart Lung Transplant
(2001)
Decreased levels of serum immunoglobulins as a risk factor for infection after heart transplantation
Transplant Proc
Protein A-immunoadsorption (Prosorba column) in the treatment of rheumatoid arthritis
Joint Bone Spine
Infection and immunity in chronic lymphocytic leukemia
Mayo Clin Proc
Risk factors for infection and immunoglobulin replacement therapy in adult nephrotic syndrome
Am J Kidney Dis
Effects of antiepileptic drugs on concentration of serum proteins and immunoglobulins of epileptic patients
Gen Pharmacol
Humoral immunity in steroid-dependent children with asthma and hypogammaglobulinemia
J Pediatr
Rituximab administration following autologous stem cell transplantation for multiple myeloma is associated with severe IgM deficiency
Blood
Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis
N Engl J Med
Serologic changes following B lymphocyte depletion therapy for rheumatoid arthritis
Arthritis Rheum
Evaluating and managing hypogammaglobulinemia
Cleve Clin J Med
Understanding cancer series: the immune system
Specific immunity
IgG deficiency in adults with recurrent respiratory infections
Ann Allergy
Serum IgG subclasses in chronic and recurrent respiratory infections
Clin Exp Immunol
Immunoglobulins in otitis-prone children
Pediatr Res
IgA and/or IgG subclass deficiency in children with recurrent respiratory infections and its relationship with chronic pulmonary damage
J Investig Allergol Clin Immunol
The function of immunoglobulin A in immunity
J Pathol
Antibodies
Primary immunodeficiencies
Am Fam Physician
Population prevalence of diagnosed primary immunodeficiency diseases in the United States
J Clin Immunol
Agammaglobulinemia
Pure B-cell disorders
X-linked agammaglobulinemia: report on a United States registry of 201 patients
Medicine (Baltimore)
Epidemiology of serious infections in PIDD
Clinical and immunological features of 65 Iranian patients with common variable immunodeficiency
Clin Diag Lab Immunol
IgG deficiency in adults with recurrent respiratory infections
Ann Allergy
Clinical relevance of IgG subclass deficiencies
Ann Biol Clin (Paris)
The efficacy of immunoglobulin replacement therapy in the long-term follow-up of the B-cell deficiencies (XLA, HIM, CVID)
Turk J Pediatr
Intravenous immunoglobulin replacement prevents severe and lower respiratory tract infections, but not upper respiratory tract and non-respiratory infections in common variable immune deficiency
Allergy
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The author has received research grants from Genentech and has been a consultant to Genentech.