Efficacy of intravenous gammaglobulin for immunoglobulin G subclass and/or antibody deficiency in adults

The clinical significance and efficacy of treating patients who have immunoglobulin (Ig) G subclass deficiency and/or antibody deficiency with Ig-replacement therapy has been debated. There are no clear guidelines to recommend intravenous gammaglobulin (IgIV) in these patients as there are few publi...

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Bibliographic Details
Published in:	International archives of allergy and immunology Vol. 149; no. 3; p. 267
Main Authors:	Abdou, Nabih I, Greenwell, Cindy A, Mehta, Reena, Narra, Madhu, Hester, Jeffery D, Halsey, John F
Format:	Journal Article
Language:	English
Published:	Switzerland 01-01-2009
Subjects:	Adult Aged Female Genotype Humans IgG Deficiency - drug therapy IgG Deficiency - genetics IgG Deficiency - immunology Immunoglobulin G - blood Immunoglobulins, Intravenous - administration & dosage Injections, Intravenous Male Mannose-Binding Lectin - blood Mannose-Binding Lectin - genetics Middle Aged Polymorphism, Genetic Quality of Life Surveys and Questionnaires Toll-Like Receptors - genetics Toll-Like Receptors - immunology Treatment Outcome
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Summary:	The clinical significance and efficacy of treating patients who have immunoglobulin (Ig) G subclass deficiency and/or antibody deficiency with Ig-replacement therapy has been debated. There are no clear guidelines to recommend intravenous gammaglobulin (IgIV) in these patients as there are few published studies documenting its efficacy. We studied in an open-label protocol 10 adult patients with recurrent respiratory infections and IgG subclass and/or antibody deficiency. All patients received monthly IgIV for 12 months and then were observed for 3 months without IgIV infusions. We studied quality of life, incidence of infections, need for antibiotics, frequency of hospitalizations due to infections, IgG subclass and antibody (tetanus and pneumococcal) levels. Innate immunity was evaluated by studying the status of Toll-like receptors and polymorphisms, mannan-binding lectin levels and genotypes. Correction of the immune defects during IgIV therapy was evaluated. Monthly IgIV significantly improved quality of life, decreased the number of infections and the need for antibiotics, and improved IgG subclass and antibody serum levels. No consistent finding of innate immunity could be detected. IgIV could be beneficial in patients with IgG subclass or antibody deficiency.
ISSN:	1423-0097
DOI:	10.1159/000199723