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1.
J Allergy Clin Immunol Pract ; 12(1): 185-194, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37863316

RESUMO

BACKGROUND: Studies show that IgE-deficient patients (IgE <2.5 kU/L) have a high prevalence of malignancy, but relevant clinical and laboratory characteristics associated with this susceptibility have never been well characterized. OBJECTIVE: To evaluate if there is an association between a malignancy diagnosis and other immunological parameters (atopy or other immune abnormalities) in IgE-deficient patients. METHODS: We retrospectively analyzed medical records of 408 IgE-deficient adults seen at our institution between 2005 and 2020. RESULTS: A malignancy diagnosis was found in 23.5% (96 of 408) of IgE-deficient patients. Among those who had allergy skin testing performed for allergic rhinitis-like symptoms, the nonatopic IgE-deficient patients (negative environmental skin tests) were more likely to have a malignancy diagnosis than the atopic group (odds ratio [OR] = 4.36, 95% confidence interval [CI]: 1.11-17.13, P = .03). The IgE-deficient individuals with an additional non-common variable immunodeficiency (non-CVID) humoral abnormality (n = 75; with low IgG, IgA, or IgM without meeting criteria for CVID) were more likely to have a malignancy diagnosis than those with only a selective IgE deficiency (n = 134; with normal IgA, IgM, and IgG) (OR = 2.79, 95% CI: 1.37-5.68, P = .005). Among the IgE-deficient patients, certain less well-defined immune abnormalities such as IgM deficiency (OR = 2.46, 95% CI: 1.13-5.36, P = .02), IgG2 deficiency (OR = 10.14, 95% CI: 1.9-54.1, P = .007), and CD4 lymphopenia (OR = 7.81, 95% CI: 2.21-27.63, P = .001) were associated with higher malignancy odds than those without these abnormalities. CONCLUSION: The odds of a malignancy diagnosis are not shared equally by all IgE-deficient patients. Prospective studies are needed to determine the utility of performing skin testing and measuring additional immunological parameters in assessing the long-term malignancy risk in IgE-deficient patients.


Assuntos
Imunodeficiência de Variável Comum , Hipersensibilidade Imediata , Síndromes de Imunodeficiência , Neoplasias , Adulto , Humanos , Imunoglobulina A , Imunoglobulina E/deficiência , Imunoglobulina G , Imunoglobulina M , Síndromes de Imunodeficiência/diagnóstico , Síndromes de Imunodeficiência/epidemiologia , Neoplasias/epidemiologia , Estudos Retrospectivos
5.
J Pediatr Hematol Oncol ; 43(4): e472-e477, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32769562

RESUMO

BACKGROUND: Immunoglobulin (Ig) E-deficient adults (IgE<2.5 kU/L) have increased susceptibility for developing malignancy. We evaluated the association between IgE deficiency and cancer diagnosis in children (age younger than 18 y), compared with those non-IgE-deficient (IgE≥2.5 kU/L). MATERIALS AND METHODS: Information about malignancy diagnosis were compared between 4 cohorts of children who had IgE levels measured at our institution: IgE-deficient (IgE<2.5 kU/L), normal IgE (2.5

Assuntos
Imunoglobulina E/sangue , Imunoglobulina E/deficiência , Neoplasias/sangue , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Neoplasias/diagnóstico , Neoplasias/etiologia , Razão de Chances , Estudos Prospectivos , Fatores de Risco
7.
Clin Immunol ; 213: 108366, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32092471

RESUMO

The nuclease Artemis is a enzyme for V(D)J recombination allowing for the creation of T and B lymphocytes as well as for the repair of radiation-induced DNA double strand breaks encoded by the DCLRE1C gene. Artemis-null mutations are a known cause of severe combined immunodeficiencies (SCIDs) with radiosensitivity. Hypomorphic mutations in Artemis have been reported to cause a "leaky SCID"" phenotype, typically with hypogammaglobulinemia. We present four patients, all harboring the same unique hypomorphic mutation in the DCLRE1C gene, an 8-base pair insertion (c.1299_1306dup, p.Cys436*) presenting with a relatively mild phenotype including pulmonary infectious EBV-related lymphoproliferative diseases, an autoimmune phenomenon. Non-typical findings of IgG hypergammaglobulinemia accompanied by IgA and IgE deficiency were recorded in all patients. The typical viral, fungal, and opportunistic infections were absent, and patients reached a relatively old age.


Assuntos
Proteínas de Ligação a DNA/genética , Endonucleases/genética , Hipergamaglobulinemia/genética , Imunoglobulina G , Imunodeficiência Combinada Severa/genética , Imunodeficiência Combinada Severa/imunologia , Adolescente , Doenças Autoimunes/genética , Feminino , Humanos , Deficiência de IgA/genética , Imunoglobulina E/deficiência , Transtornos Linfoproliferativos/genética , Masculino , Mutação , Fenótipo , Imunodeficiência Combinada Severa/complicações
8.
FASEB J ; 34(2): 3091-3104, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31909541

RESUMO

Allergic asthma with high plasma IgE levels is a significant risk factor of human abdominal aortic aneurysm (AAA). This study tests a direct role of IgE in angiotensin-II (Ang-II) perfusion- and peri-aortic CaCl2 injury-induced AAA in mice. In both models, IgE-deficiency in Apoe-/- Ige-/- mice blunts AAA growth and reduces lesion accumulation of macrophages, CD4+ and CD8+ T cells, and lesion MHC class-II expression, CD31+ microvessel growth, and media smooth muscle cell loss, compared with those from Apoe-/- control mice. Real time-PCR reveals significant reductions in expression of neutrophil chemoattractants MIP-2α and CXCL5 in AAA lesions or macrophages from Apoe-/- Ige-/- mice, along with reduced lesion Ly6G+ neutrophil accumulation. Consistent with reduced lesion inflammatory cell accumulation, we find significant reductions of plasma and AAA lesion IL6 expression in Apoe-/- Ige-/- mice. Immunofluorescent staining and FACS analysis show that AAA lesion neutrophils express FcεR1. Mechanistic study demonstrates that IgE induces neutrophil FcεR1 expression, activates MAPK signaling, and promotes IL6 production. This study supports a direct role of IgE in AAA by promoting lesion chemokine expression, inflammatory cell accumulation, MAPK signaling, and cytokine expression. IgE inhibition may represent a novel therapeutic approach in AAA management.


Assuntos
Aneurisma da Aorta Abdominal/imunologia , Imunoglobulina E/deficiência , Neutrófilos/metabolismo , Animais , Aneurisma da Aorta Abdominal/induzido quimicamente , Aneurisma da Aorta Abdominal/genética , Aneurisma da Aorta Abdominal/prevenção & controle , Cloreto de Cálcio/toxicidade , Quimiocina CXCL2/genética , Quimiocina CXCL2/metabolismo , Imunoglobulina E/imunologia , Interleucina-6/genética , Interleucina-6/metabolismo , Camundongos , Camundongos Knockout para ApoE , Neutrófilos/patologia , Receptores de IgE/genética , Receptores de IgE/metabolismo
9.
Arterioscler Thromb Vasc Biol ; 40(3): 597-610, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31996021

RESUMO

OBJECTIVE: By binding to its high-affinity receptor FcεR1, IgE activates mast cells, macrophages, and other inflammatory and vascular cells. Recent studies support an essential role of IgE in cardiometabolic diseases. Plasma IgE level is an independent predictor of human coronary heart disease. Yet, a direct role of IgE and its mechanisms in cardiometabolic diseases remain incompletely understood. Approach and Results: Using atherosclerosis prone Apoe-/- mice and IgE-deficient Ige-/- mice, we demonstrated that IgE deficiency reduced atherosclerosis lesion burden, lesion lipid deposition, smooth muscle cell and endothelial cell contents, chemokine MCP (monocyte chemoattractant protein)-1 expression and macrophage accumulation. IgE deficiency also reduced bodyweight gain and increased glucose and insulin sensitivities with significantly reduced plasma cholesterol, triglyceride, insulin, and inflammatory cytokines and chemokines, including IL (interleukin)-6, IFN (interferon)-γ, and MCP-1. From atherosclerotic lesions and peritoneal macrophages from Apoe-/-Ige-/- mice that consumed an atherogenic diet, we detected reduced expression of M1 macrophage markers (CD68, MCP-1, TNF [tumor necrosis factor]-α, IL-6, and iNOS [inducible nitric oxide synthase]) but increased expression of M2 macrophage markers (Arg [arginase]-1 and IL-10) and macrophage-sterol-responsive-network molecules (complement C3, lipoprotein lipase, LDLR [low-density lipoprotein receptor]-related protein 1, and TFR [transferrin]) that suppress macrophage foam cell formation. These IgE activities can be reproduced in bone marrow-derived macrophages from wild-type mice, but muted in cells from FcεR1-deficient mice, or blocked by anti-IgE antibody or complement C3 deficiency. CONCLUSIONS: IgE deficiency protects mice from diet-induced atherosclerosis, obesity, glucose tolerance, and insulin resistance by regulating macrophage polarization, macrophage-sterol-responsive-network gene expression, and foam cell formation.


Assuntos
Aorta/metabolismo , Aterosclerose/metabolismo , Células Espumosas/metabolismo , Imunoglobulina E/metabolismo , Inflamação/metabolismo , Ativação de Macrófagos , Macrófagos Peritoneais/metabolismo , Obesidade/metabolismo , Animais , Aorta/imunologia , Aorta/patologia , Aterosclerose/imunologia , Aterosclerose/patologia , Aterosclerose/prevenção & controle , Glicemia/metabolismo , Células Cultivadas , Citocinas/metabolismo , Modelos Animais de Doenças , Células Espumosas/imunologia , Células Espumosas/patologia , Redes Reguladoras de Genes , Imunoglobulina E/deficiência , Imunoglobulina E/genética , Inflamação/imunologia , Inflamação/patologia , Inflamação/prevenção & controle , Mediadores da Inflamação/metabolismo , Resistência à Insulina , Macrófagos Peritoneais/imunologia , Macrófagos Peritoneais/patologia , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout para ApoE , Obesidade/imunologia , Obesidade/patologia , Obesidade/prevenção & controle , Fenótipo , Placa Aterosclerótica , Receptores de IgE/genética , Receptores de IgE/metabolismo , Transdução de Sinais , Esteróis/metabolismo
10.
Ann Allergy Asthma Immunol ; 121(5): 613-618, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30086407

RESUMO

BACKGROUND: Data on patients from tertiary-level health care facilities suggest that IgE-deficient (IgE <2.5 kU/L) patients have high rates of prior malignant tumors. OBJECTIVE: To investigate the association between IgE levels and diagnosis of malignancy in non-institution-associated patients using the 2005-2006 US National Health and Nutrition Examination Survey (NHANES) cohort. METHODS: All individuals with available IgE levels and known prior diagnosis of malignancy were divided into 4 groups: IgE deficient (IgE, <2.5 kU/L), normal IgE levels (2.5-100 kU/L), high IgE levels (100-1,000 kU/L), and very high IgE levels (≥1,000 kU/L). Rates of malignancy were compared among groups. RESULTS: Of 4,488 individuals with data on IgE levels and malignancy status, 7.4% had a prior diagnosis of cancer. The rate of prior malignancy was significantly higher in the IgE-deficient group (12.6%) compared with individuals with high (6.7%, P = .04) and very high IgE levels (5.3%, P = 0.04). In the IgE-deficient group, only 3 patients had a diagnosis of malignancy within 3 years of IgE measurement. A mean (SD) of 10.3 (9.6) years elapsed between the time of malignancy diagnosis and IgE collection time; therefore, active neoplasm or recent chemotherapy was less likely to explain the very low IgE levels. Types of malignancies in the IgE-deficiency group included breast cancer (n = 6), nonmelanoma or unknown skin cancer (n = 3), uterine cancer (n = 2), cervical cancer (n = 1), lung cancer (n = 1), prostate cancer (n = 1), and hematologic cancer (n = 1). CONCLUSION: In this non-institution-based cohort, IgE deficiency was associated with a higher rate of prior diagnosis of malignancies compared with individuals with high or very high IgE levels. Prospective studies are essential to better evaluate the association between IgE levels and risk of cancer.


Assuntos
Imunoglobulina E/deficiência , Síndromes de Imunodeficiência/epidemiologia , Neoplasias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imunoglobulina E/sangue , Síndromes de Imunodeficiência/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Inquéritos Nutricionais , Estudos Prospectivos , Estados Unidos/epidemiologia , Adulto Jovem
11.
Ann Allergy Asthma Immunol ; 119(3): 267-273, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28778662

RESUMO

BACKGROUND: Immunoglobulin E (IgE) deficiency (<2.5 kU/L) has unclear clinical significance. Very little is known about the clinical characteristics of IgE deficiency in patients with Common Variable Immunodeficiency (CVID). OBJECTIVE: To evaluate the clinical and laboratory differences between patients with IgE deficiency and those with non-IgE deficiency with and without CVID diagnosis. METHODS: This is a retrospective study of adult patients who had total serum IgE levels measured at our facility from 2010 through 2015. Patients with IgE levels lower than 2.5 kU/L composed the IgE deficiency group. We used Clinical Looking Glass software to identify laboratory results and comorbid conditions including CVID and malignancy. RESULTS: The IgE levels were measured in 2,339 patients and 63 (2.7%) had IgE deficiency. Of those with IgE deficiency, 14 of 63 (22%) had CVID diagnosis compared with only 62 of 2,276 patients (2.7%) with non-IgE deficiency and CVID. A significantly higher rate of prior malignancy was found in patients with IgE deficiency (21 of 63, 33%) compared with those with non-IgE deficiency (197 of 2,276, 8.7%; P = .001; odds ratio 5.51, 95% confidence interval 3.07-9.88). Six of 14 patients with CVID and IgE deficiency (43%) had a prior malignancy diagnosis compared with 8 of 62 patients (13%) with CVID and non-IgE deficiency (P = .009; odds ratio 10.65, 95% confidence interval 1.79-63.19). In addition to the higher rate of malignancy, patients with CVID and IgE deficiency did not have more severe disease than those with CVID and non-IgE deficiency. CONCLUSION: The rate of prior malignancy is significantly higher in patients with IgE deficiency than in those without IgE deficiency. Similarly, patients with CVID and IgE deficiency have a higher frequency of prior malignancy than those with CVID and non-IgE deficiency. However, patients with IgE deficiency have higher frequency of malignancy than patients with normal IgE levels even in the absence of CVID.


Assuntos
Imunoglobulina E/deficiência , Síndromes de Imunodeficiência/epidemiologia , Neoplasias/epidemiologia , Adulto , Idoso , Feminino , Humanos , Imunoglobulina E/sangue , Síndromes de Imunodeficiência/sangue , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Razão de Chances , Estudos Retrospectivos
13.
Allergy Asthma Proc ; 36(3): 225-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25976439

RESUMO

Selective immunoglobulin E (IgE) deficiency (IgED) is defined as serum levels of IgE more than or equal to 2 kIU/L and is associated with immune dysregulation and autoimmunity. This study aimed to investigate a prevalence of atherosclerotic cardiovascular disease (ASCVD) in population with IgED. Within the electronic patient record (EPR) database of Leumit Health Care Services (LHS) in Israel, data capture was performed using IBM Cognos 10.1.1 BI Report Studio software. The case samples were drawn from the full study population (n = 18,487), having any allergy-related symptoms and/or those requesting antiallergy medications and performed serum total IgE measurement during 2012 at LHS. All subjects aged more than or equal to 40 years old, with serum total IgE less than 2 kIU/L were included in case group. Control group was randomly sampled from the remained subjects, with a case-control ratio of 10 controls for each case (1:10). The comorbid cardiovascular diseases during less than or equal to 10 years before serum total IgE testing were identified and retrieved using specific International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes. There were 103 in case and 1030 subjects in control group. Compared with control group patients, the case group had significantly more arterial hypertension [34 (37.7%) versus 187 (18.2%), p < 0.001], ischemic heart disease (IHD) [26 (25.2%) versus 87 (8.4%), p < 0.001], carotid stenosis [5 (4.9%) versus 7 (0.7%), p = 0.003], cerebrovascular disease (CVD) [3 (2.9%) versus 5 (0.5%), p = 0.029], and peripheral vascular disease (PVD) [4 (3.9%) versus 9 (0.9%), p = 0.024]. IgED is associated with higher prevalence of arterial hypertension and ASCVD.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Disgamaglobulinemia/complicações , Imunoglobulina E/deficiência , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Bases de Dados Factuais , Disgamaglobulinemia/sangue , Feminino , Humanos , Imunoglobulina E/sangue , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
14.
Clin Exp Dermatol ; 40(6): 629-32, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25704069

RESUMO

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown aetiology. We report a 27-year-old male patient with diabetes, who presented with a nonhealing ulcer on the left leg, pruritic hyperpigmented papules distributed over the trunk and limbs, and chronic diarrhoea. He had eosinophilia, low haemoglobin and serum IgE levels, and raised erythrocyte sedimentation rate. Histopathology of the leg ulcer was consistent with the diagnosis of PG, while the histology of the hyperpigmented papule revealed tissue eosinophilia. Subsequent evaluation was conclusive of the diagnosis of PG, idiopathic hypereosinophilic syndrome (IHES) and selective IgE deficiency. Dexamethasone pulse therapy achieved resolution of the ulcer and reduction in the eosinophilia. Further evaluation for the persistent diarrhoea led to a diagnosis of lymphocytic colitis (LC), which responded to budesonide. To our knowledge, the association of PG with IHES, selective IgE deficiency or LC has not been previously reported.


Assuntos
Colite Linfocítica/complicações , Diabetes Mellitus Tipo 1/complicações , Síndrome Hipereosinofílica/complicações , Imunoglobulina E/deficiência , Pioderma Gangrenoso/etiologia , Adulto , Humanos , Úlcera da Perna/etiologia , Masculino
15.
World J Gastroenterol ; 21(1): 240-5, 2015 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-25574097

RESUMO

AIM: To investigate the prevalence and clinical characteristics of Helicobacter pylori (H. pylori)-infected dyspeptic patients with selective immunoglobulin E deficiency (IgEd). METHODS: All individuals who underwent serum total immunoglobulin E (IgE) measurement at the Leumit Healthcare Services (Israel) in 2012 were identified in an electronic database search (n = 18487). From these, selected case group subjects were ≥ 12 years of age and had serum total IgE < 2 kIU/L (n = 158). The control group was selected from a random sampling of the remaining subjects ≥ 12 years of age to obtain a case-control ratio of 1:20 (n = 3160). Dyspeptic diseases, diagnosed no more than 5 years before serum total IgE testing, were identified and retrieved from the electronic database using specific International Classification of Diseases diagnostic codes. Results of C(13)-urea breath tests were used to identify subjects infected with H. pylori. Categorical variables between case and control subjects were analyzed using Fisher's exact tests, whereas continuous variables were analyzed using χ (2) tests. RESULTS: Dyspepsia was present in 27.2% (43/158) of case subjects and 22.7% (718/3160) of controls. Of these, significantly more case subjects (32/43, 74.4%) than controls (223/718, 31.1%) were positive for H. pylori (P < 0.01). Esophagogastroduodenoscopy was performed in 19 case and 94 control subjects, revealing that gastritis was more prevalent in IgEd case subjects than in controls (57.9% vs 29.8%, P < 0.05). Furthermore, a significantly greater proportion of case subjects presented with peptic duodenal ulcers (63.2% vs 15.9%, P < 0.01). Histopathologic examination showed marked chronic inflammation, lymphoid follicle formation and prominent germinal centers, with polymorphonuclear cell infiltration of gastric glands, that was similar in case and control biopsy tissues. Finally, IgEd case subjects that underwent esophagogastroduodenoscopy were more likely to exhibit treatment-refractory H. pylori infections that require second-line triple antibiotic therapy (47.4% vs 11.7%, P < 0.01). CONCLUSION: IgEd is associated with higher rates of H. pylori-associated gastritis and peptic duodenal ulcers.


Assuntos
Infecções por Helicobacter/epidemiologia , Helicobacter pylori/patogenicidade , Imunoglobulina E/deficiência , Síndromes de Imunodeficiência/epidemiologia , Adulto , Biomarcadores/sangue , Testes Respiratórios , Distribuição de Qui-Quadrado , Bases de Dados Factuais , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/epidemiologia , Úlcera Duodenal/imunologia , Úlcera Duodenal/microbiologia , Dispepsia/diagnóstico , Dispepsia/epidemiologia , Dispepsia/imunologia , Dispepsia/microbiologia , Endoscopia Gastrointestinal , Feminino , Gastrite/diagnóstico , Gastrite/epidemiologia , Gastrite/imunologia , Gastrite/microbiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/imunologia , Humanos , Imunoglobulina E/sangue , Síndromes de Imunodeficiência/diagnóstico , Síndromes de Imunodeficiência/imunologia , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Testes Sorológicos , Adulto Jovem
16.
J Exp Med ; 211(11): 2159-68, 2014 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-25267791

RESUMO

The (patho)physiological role of IgE in nonallergic inflammatory diseases is not well understood. Here, we explored the effect of IgE deficiency on the inflammatory response in FcγRIIB-deficient mice as well as in mice carrying both a deletion of FcγRIIB and the chromosomal translocation of Y-linked autoimmune acceleration (Yaa) that hastens and results in a more aggressive lupuslike disease in these mice. The findings show that deficiency of IgE delays disease development and severity as demonstrated by reduced autoantibody production and amelioration of organ pathologies. This was associated with decreased numbers of plasma cells and reduced levels of IgG2b and IgG3. Unexpectedly, the loss of IgE also caused a striking decrease of immune cell infiltration in secondary lymphoid organs with a marked effect on the presence of dendritic cells, monocytes, neutrophils, and eosinophils in these organs and decreased activation of basophils. The presence of autoreactive IgE in human systemic lupus erythematosus subjects was also associated with increased basophil activation and enhanced disease activity. These findings argue that IgE facilitates the amplification of autoimmune inflammation.


Assuntos
Imunoglobulina E/imunologia , Imunomodulação , Lúpus Eritematoso Sistêmico/imunologia , Animais , Autoanticorpos/biossíntese , Autoanticorpos/imunologia , Autoimunidade , Subpopulações de Linfócitos B/imunologia , Subpopulações de Linfócitos B/metabolismo , Linfócitos B/imunologia , Linfócitos B/metabolismo , Basófilos/imunologia , Basófilos/metabolismo , Relação CD4-CD8 , Estudos de Casos e Controles , Modelos Animais de Doenças , Humanos , Imunoglobulina E/deficiência , Imunoglobulina E/genética , Inflamação/genética , Inflamação/imunologia , Inflamação/metabolismo , Glomérulos Renais/imunologia , Glomérulos Renais/patologia , Lúpus Eritematoso Sistêmico/genética , Lúpus Eritematoso Sistêmico/patologia , Contagem de Linfócitos , Camundongos , Camundongos Knockout , Fenótipo , Plasmócitos/imunologia , Plasmócitos/metabolismo , Receptores de IgG/genética
17.
J Clin Pathol ; 67(9): 832-3, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24989023

RESUMO

Low serum immunoglobulin E (IgE) (<2 kU/L) found during allergy investigations may be a marker for other immunodeficiency states, in particular common variable immunodeficiency. The latter is characterised by recurrent infections, mainly respiratory, resulting in structural lung damage making early diagnosis important. We looked through 4013 samples retrospectively over a 12-month period to identify samples with IgE<2 kU/L. We identified 74/4013 (1.84%) with serum IgE levels<2 kU/L. Only 20 samples had serum immunoglobulin quantification and serum electrophoresis requested. Three of these samples were from the same patient, 10/18 (56%) had one or more classes of immunoglobulin above/below reference range for age and two of these had new diagnosis of immunodeficiency. Serum IgE<2 kU/L can be a marker for hypogammaglobulinaemia or common variable immunodeficiency. As early diagnosis is important to reduce morbidity and mortality, very low serum IgE should trigger further investigation­that is, serum protein electrophoresis and immunoglobulin quantification.


Assuntos
Agamaglobulinemia/diagnóstico , Imunoglobulina E/deficiência , Adulto , Agamaglobulinemia/sangue , Agamaglobulinemia/imunologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Diagnóstico Precoce , Feminino , Humanos , Imunoglobulina E/sangue , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos
18.
Lik Sprava ; (12): 3-10, 2014 Dec.
Artigo em Ucraniano | MEDLINE | ID: mdl-26638461

RESUMO

The most significant:clinical manifestation of isolated IgE-deficiency is chronic and recurrent sinopulmonary diseases. A few papers about treatment of IgE-deficiency, which shows the effect of intravenous immunoglobulin (IVIG) at a dose of 300-400 mg/kg was found. The results of such studies has level of evidence D. In our study we included IgE-deficient patients with refractory rhinosinusitis, which confirmed the diagnosis on the basis of at least two-fold examination with an interval of 1 month in the absence of obvious causes of secondary immunosuppression. In the study group included 82 patients (49 female, 34 male) aged 18 to 61, with the refractory rhinosinusitis combined with deficient IgE, total--33 (group 1) and partial--4 patients (group 2). In 22 patients (26.8%) immunoglobulin E deficiency combined with decreased serum concentrations of IgG sub-classes and other classes. The control group are 33 patients with refractory rhinosinusitis who refused IVIG. Immunoglobulinl intramuscularly administered at a dose of 0.3-0.4 ml/kg body weight for 3 days in a row 2-3 courses at intervals of 2-3 weeks. In the absence of clinical effect of said treatment for 2-3 months, we used IVIG at a dose of 200-400 mg/kg 1 month 1-3 courses with the consent of the patient. The clinical ohserved in 49 patients (87%), which was to reduce the number, severity and duration of exacerhations course rhinosinusitis. After IVIG were marked with significantly higher serum concentrations of total IgE in patients with total and partial deficiency compared with the results of intramuscular immunoglobulin. During treatment significantly increased serum concentration not only IgE (from 3.05 IU/ml ± 1.21 IU/ml to 12.5/IU/ml ± 1.86 IU/ml in total deficit; P < 0.01; 7.23 IU/ml ± 1.37 IU/ml to 15.66 IU/ml ± 1.66 IU/ml at partial dcficiency), but significantly increased serum concentrations of total IgG and subclasses IgG1, IgG2. So we found clinical and immunological effect of the intramuscularly and ivig in patients with refractory rhinosinusitis deficient IgE. This clinical and immunological effects we regarded as the influence of small doses of immunoglobulin to Fc-receptors on B lymphocytes mediated by regulatory mechanism of antibody production (Bayry J. et al).


Assuntos
Imunidade Humoral/efeitos dos fármacos , Imunoglobulina E/deficiência , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Adolescente , Adulto , Linfócitos B/efeitos dos fármacos , Linfócitos B/imunologia , Linfócitos B/patologia , Esquema de Medicação , Feminino , Expressão Gênica , Humanos , Imunoglobulina E/genética , Imunoglobulina G/sangue , Imunoglobulina G/genética , Injeções Intramusculares , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Receptores Fc/genética , Receptores Fc/imunologia , Recidiva , Rinite/genética , Rinite/imunologia , Rinite/patologia , Sinusite/genética , Sinusite/imunologia , Sinusite/patologia , Resultado do Tratamento
19.
Lik Sprava ; (7-8): 3-9, 2014.
Artigo em Ucraniano | MEDLINE | ID: mdl-26118074

RESUMO

Isolated IgE deficiency is one of the most common primary immunodeficiency, which is still underestimated cause of health disorders of modern man. Recent genetic studies report that the cause of the IgE deficiency is immune dysregulation caused by polymorphisms of the gene, which is responsible for the synthesis of activation-induced cytidinedeaminase (AICDA). The Institute of Immunology and Allergology at Bogomolets NMU during the years 2012-2014 were examined 5298 patients with a range of different diseases, which could be suspected violations of immunity. All patients were conducted comprehensive immunological study, and 4476 of them were examined for content of total serum IgE. The criterion for the selection of patients for follow-up began serum IgE < 10 kIU/l. Serum immunoglobulin E was determined by ELISA. Serum IgE < 10 IU/ml was detected in 342 patients (7%). Average reduction in the study group made up (5.30 ± 1.31) IU/ml. Partial deficiency (5-10 kIU/l) was detected in 212 patients (4%), while the total--130 (3%). For follow-up, we are clinically selected group of patients with deficiency of IgE (n = 60) and control group (n = 30). All patients were distributed as per clinical syndromes, and the frequency of their manifestations: sinopulmonary syndrome (63%), gastrointestinal syndrome (13%), autoimmune manifestations (10%), allergic reactions (7%) and chronic fatigue syndrome (7%). The levels of serum IgG, IgA, IgM in the study group were within the age norm (IgG = 1160.00 mg/dl ± 2.88 mg/dl, IgA = 138 g/l ± 37 mg/dl, IgM = 114 mg/dl ± 30 mg/dl). However, only a small proportion of patients was observed decrease in other classes of immunoglobulins in 8 patients with IgG < 700 mg/dL in 16 patients with IgA < 90 mg/dl and 6 patients with decreased serum IgM < 90 mg/dl. These patients were examined the levels of serum IgG subclasses and sIgA levels in saliva. Significant violations by cellular immunity in determining lymphocyte subpopulations by flow cytometry using monoclonal antibodies also were found. Phagocytic indices were also no significant abnormalities. An important aspect of clinical deficiency of immunoglobulin E is its association with diseases of bacterial origin (H. influenza, M. catarrhalis, Str. pneumoniae), indicating a protective role of these antibodies in the mucosa of the respiratory tract. Thus, isolated IgE deficiency is associated with sustained decrease in serum concentrations of immunoglobulin E (< 10 kIU/l) in patients with normal immune status of other indicators that require dispensary and treatment. The results of their study indicate a high incidence of the IgE-deficiency among the population and its high incidence among the humoral defects.


Assuntos
Doenças do Sistema Imunitário/sangue , Doenças do Sistema Imunitário/epidemiologia , Imunoglobulina E/sangue , Imunoglobulina E/deficiência , Adolescente , Adulto , Humanos , Doenças do Sistema Imunitário/etiologia , Doenças do Sistema Imunitário/imunologia , Imunidade Celular , Imunidade Humoral , Pessoa de Meia-Idade , Estações do Ano , Subpopulações de Linfócitos T/imunologia , Adulto Jovem
20.
Ocul Immunol Inflamm ; 21(1): 28-33, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23323578

RESUMO

PURPOSE: To determine the prevalence of systemic atopy and immunoglobulin (Ig) deficiencies in vernal keratoconjunctivitis (VKC). METHODS: Sixty-seven VKC subjects (79.1% boys) with a mean age of 11.3 ± 4.3 years were included. Serum Ig levels and specific IgE levels were measured using the nephelometric method and reversed enzyme immunoassay with sandwich ELISA technique, respectively. The patients underwent epidermal skin tests with commercial extracts. RESULTS: Family history of atopy and associated systemic allergies were detected in 32.8 and 40.3% of the subjects, respectively. Blood eosinophilia, elevated total, and specific IgE and positive skin tests were detected in 33.8, 42.2, 50, and 35% of the subjects, respectively. Out of 62 subjects, low levels of IgA, IgG, IgM, and IgG3 were detected in 12.9, 8, 6.5, and 1.6% of the patients, respectively. CONCLUSION: IgE-mediated mechanisms are involved in approximately 40% of VKC patients. A new finding was the higher incidence of Ig deficiency.


Assuntos
Conjuntivite Alérgica/complicações , Hipersensibilidade Imediata/complicações , Deficiência de IgG/complicações , Imunoglobulina E/deficiência , Imunoglobulina G/sangue , Adolescente , Adulto , Criança , Pré-Escolar , Conjuntivite Alérgica/epidemiologia , Conjuntivite Alérgica/imunologia , Ensaio de Imunoadsorção Enzimática , Eosinófilos/metabolismo , Feminino , Seguimentos , Humanos , Hipersensibilidade Imediata/sangue , Hipersensibilidade Imediata/imunologia , Deficiência de IgG/sangue , Deficiência de IgG/imunologia , Imunoglobulina E/sangue , Incidência , Masculino , Prevalência , Testes Cutâneos , Turquia/epidemiologia , Adulto Jovem
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