Abstract

Since the discovery of the subclasses of human IgG immunoglobulins there have been many attempts to detect these materials in the normal population as well as individuals with various immune disease states. In addition, various methods such as Mancini, 1-3 radio-precipitin, radioassay, 5 and nephelometry 6 have been used. High IgG4 levels have been associated with advanced stages of malignant melanoma.7 Eickoff et al. s found important changes in IgG4 levels in individuals with various infectious and neurological diseases. Oxelius 9 demonstrated IgGa immunodeficiency disease, and Shakib and Stanworth 1° showed decreased levels of IgG4 in sera and joint fluids of patients with rheumatoid arthritis. They also found elevated total and specific IgG4 in a hemophiliac patient, suggesting that IgG4 may be a possible mediator of anaphylaxis in this patient. Gwynn et al. u detected raised levels of IgE in 68% of the patients. No relationship was noted between raised levels of either IgE or IgG4 and infant feeding. Gwynn et al. u concluded that although these immunoglobulin patterns were not consistently associated with symptoms, they did tend to be associated in atopic families. Shakib et al. ~2 found elevated serum IgE and IgG4 in patients with atopic dermatitis, and suggested that these two immunoglobulins may play an important role in the genesis of the skin lesion of this disease. Several investigators 13-~6 have studied IgG subclass levels in infancy and childhood. Oxelius ~3 found that IgG subclasses followed the pattern of total IgG, with a fall during the first 3-6 months, and a subsequent gradual rise with age. With a limit of sensitivity of 10 ~g/ml of IgG4, Oxelius 13 was unable to detect IgG4 in cord serum, or in 12-21% of children above 7 years of age. Utilizing the radial immunodiffusion technique of Mancini, Zegers et al. ~4 were unable to detect IgG4 in 50% of healthy infants 13-62 weeks of age, and indicated that longitudinal investigations are needed in children suspected

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