Mean IgA Levels Research Articles

Planned dose reduction of ocrelizumab in relapsing-remitting multiple sclerosis: a single-centre observational study

BackgroundOcrelizumab, a humanised anti-CD20 monoclonal, is a highly effective treatment for relapsing-remitting multiple sclerosis (RRMS). The long-term safety of B-cell depletion in RRMS, however, is uncertain and there are no...

Selective IgA Deficiency and Blood Component Transfusion: In Search of the Lost Evidence

Background: Selective IgA deficiency (IgA-D) has been historically considered a high-risk entity for developing allergic/anaphylactic reactions after blood transfusion (AATRs). However, it has been suggested that the IgA-D-related anaphylactic transfusion reaction is not evidence-based. Methods: We conducted three different approaches to collect evidence about epidemiology, AATRs, and transfusion management of patients with IgA-D at La Fe University Hospital. Firstly, we analysed the prevalence of IgA-D in a population of patients diagnosed with acute leukaemia, The second approach consisted of collecting transfusion data from IgA-D patients. Finally, we reviewed the IgA levels of patients recorded in the hemovigilance system suffering an AATR. Results: IgA-D prevalence was 1 in 334 patients. At least one blood component was transfused to 23 patients diagnosed with IgA-D. Plasma was transfused to eight IgA-D patients, while six patients received red blood cells, platelets, and plasma. No adverse reactions were reported in any patient. AATRs occurred in 325 men and 264 women with a median age of 52 years. Severe reactions occurred in 56 patients (1/14,520 components). Mean IgA levels were 215 mg/dL (4–5570) for mild reactions and 214 mg/dL (14–824) for severe reactions (p = ns). Washed platelets were administered to two patients who developed severe and repeated AATRs. Both had normal IgA levels. Conclusions: Since the AATRs related to IgA-D are extremely low, as reported in current hemovigilance systems, IgA-D should not be considered a high-risk entity to develop AATRs. On the contrary, our findings support standard transfusion management of IgA-D patients.

Serum IgG and IgA level in children with acute lymphoblastic leukaemia and its relation with outcome in induction chemotherapy

Background: Immunosuppression in children with Acute Lymphoblastic Leukaemia (ALL) escalates vulnerability to severe infectious complications which leads to higher morbidity and mortality rates among patients. Immunoglobulins are important part of defence mechanism of the body contributing to the humoral immunity. Of all the immunoglobulins, IgG and IgA represents most common type of antibody in blood circulation and provides most long-lived antibody-based immunity against invading pathogens. In earlier years, studies have shown that, serum immunoglobulins are found to be decreased during chemotherapy and this reduction is related with severe sepsis and death in patients. Early identification of immune status can be much useful for assessment of severity and better risk stratification of the patients. Objective: Evaluation of serum IgG and IgA levels in children with ALL and its relationship with sepsis in induction phase of chemotherapy. Method: This prospective observational study was conducted in the Departments of Paediatric Haematology & Oncology and Department of General Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka. During January 2022 to December 2022, a total 60 paediatric patients of newly diagnosed ALL were included as study population. As control, 30 patients were included in this study from General paediatrics and Paediatric Haematology & Oncology, BSMMU to compare baseline immunoglobulin levels with the study group. Complete history and physical examination of all patients were undertaken, and all prior reports were collected. Serum IgG and IgA level assay was done before starting chemotherapy and at the end of induction chemotherapy in the study group. Patients diagnosed with ALL received chemotherapy modified UK-ALL 2003 protocol. History and data of any event of sepsis, along with the symptoms of complications were taken from all patients during the course of induction chemotherapy. Results: The mean age of the cases were 5.49±3.15 (mean ± SD) years, which ranged from 1.9 to 15 years. Among the cases, 41 patients (68.3%) were male and 19 (31.7%) females. Seven (11.7%) subjects expired during induction chemotherapy. In comparison to the control group the mean IgG level in the study group was lower at baseline and even lower at the end of induction and it was statistically significant (p<0.05). The mean IgG level was low in patients with septic events in comparison with the patients with no septic events. Difference of mean of IgG between septic and aseptic patients was significant only at the end of induction chemotherapy (p<0.05). The mean IgA level was low in study group in comparison with the control group and it was statistically significant (p<0.05) only at the end of induction chemotherapy. The mean IgA level was low in patients with septic events in comparison with the patients with no septic events. Difference of mean of IgA between septic and aseptic patients was significant (p<0.05). Based on the receiver-operator characteristic (ROC) curves of change of S. IgG, with a cut off value 50% decreased from baseline having 68.8% sensitivity and 29.7% specificity for prediction of sepsis. Considering change of S. IgA with a cut off value 50% decreased from baseline having 67.6% sensitivity and 27.5% specificity for prediction of sepsis. Conclusion: In our study, the mean IgG and IgA level of the cases were low in comparison to the control group. The mean IgG and IgA level of the patients were lower who had infectious complications, and it was more marked after induction chemotherapy. Therefore, evaluation of immunoglobulin profiles is recommended to be considered in patients with ALL in further studies.

A study of anti-SARS-CoV-2 antibodies among healthcare personnel and the general population

Bulgaria, like many other countries, has experienced the far-reaching consequences of the Coronavirus disease 2019 (COVID-19) pandemic. Seroprevalence studies serve as a crucial method for assessing the exposure and immunity levels within a population. In this serosurvey, which is the first of this kind conducted in Bulgaria, we enrolled 104 healthcare workers (HCWs) from one front-line Bulgarian hospital and 237 individuals from the general population. Serum samples were collected in December 2021 from the general population and in February 2023 from HCWs and the general population. The presence of four anti-SARS-CoV-2 antibodies was evaluated: anti-Spike 1-IgG, anti-Nucleoprotein-IgG, anti-Spike1-IgA and anti-Recombinant binding domain neutralizing antibodies. Our results showed high percentages of seropositivity in both the HCWs and the general population (99% and 78%, respectively) in February 2023. HCWs had significantly higher mean IgA and mean anti-S1-IgG antibody levels compared to the general population. The seropositivity in the general population in December 2021 was 79%. The mean levels of IgA and anti-NCP-IgG were significantly higher, whereas the mean anti-S1-IgG levels were significantly lower in February 2023 compared to December 2021. We found a strong correlation between neutralizing antibodies and anti-S1-IgA and anti-S1-IgG antibodies for all tested groups. It is necessary to perform large-scale serosurveys to provide analysis of the seroprevalence in a larger population and its dynamics over time and to facilitate evidence-based strategies that will safeguard the health and well-being of the Bulgarian population and contribute to the global efforts in combating the COVID-19 pandemic.

The effect of cladribine on immunoglobulin levels compared to B cell targeting therapies in multiple sclerosis.

Cladribine is a useful therapeutic option in RRMS with moderate to high disease activity. Its oral formulation and tolerability make it a useful alternative to infusion therapies. Cladribine is known to deplete CD19+ B lymphocytes, but its effect on immunoglobulin subsets is unclear. To identify whether cladribine therapy in pwMS reduces immunoglobulin subset levels as a surrogate marker of infection risk. A 'real-world' retrospective analysis of 341 pwMS presenting to a single tertiary centre between March 2017 and July 2021. Differences in immunoglobulin levels between cladribine, other disease-modifying therapies and no active treatment were assessed using a univariate ANOVA. Three hundred and forty-one patients had immunoglobulin levels assessed, with 29 patients treated with cladribine. The mean IgG, IgM and IgA levels on cladribine therapy were 10.44 ± 0.40, 0.99 ± 0.09 and 2.04 ± 0.18 g/L respectively. These were not significantly different from patients not on active treatment. There was a statistically significant reduction in IgG and IgM levels for patients treated with ocrelizumab (9.37 ± 0.19 and 0.68 ± 0.04 g/L) and natalizumab (8.72 ± 0.53 and 0.69 ± 0.12 g/L) compared to patients not on treatment. Cladribine therapy for RRMS was not associated with immunoglobulin subset deficiencies. This is contrasted to ocrelizumab and natalizumab which demonstrate significant reductions in both IgG and IgM levels.

Selective immunoglobulin A deficiency in children with diabetes mellitus: Data from a medical center in Ukraine.

The aim of this study was to estimate the prevalence of selective immunoglobulin A deficiency (SIgAD) among children with type 1 diabetes mellitus (DM) in Ternopil region (western Ukraine). Serum IgA levels were measured in 240 patients aged 4-17 years with DM and in 324 children of a control group of the same age. Normal IgA level was observed in 210 (87.5%) patients, increased-in 18 (7.5%), decreased (lower than the age reference value)-in 12 (5.0%) patients with DM. The mean IgA level in patients with DM was 152.11±73.78 mg/dL. SIgAD criteria were met by 7 (2.9%) children with DM, but none of the children of the control group met the SIgAD criteria. Female / male ratio among the patients with SIgAD was 1/6. There was no history of recurrent infections in these patients. No correlation between IgA and HbA1c levels was detected. Autoimmune thyroiditis was observed in 42.9% of patients with DM and SIgAD, and in 3.5% of patients with DM and normal or increased IgA levels. Thus, the prevalence of selective IgA deficiency in children with DM in Ternopil region (Ukraine) is 2.9% (1:34). This study shows that patients with low IgA levels need further re-examination of IgA levels to exclude SIgAD. Children with SIgAD and DM should be monitored for autoimmune manifestations that may affect the course and consequences of the disease.

EVALUATION OF IMMUNOLOGICAL MARKERS IN PATIENTS WITH PULMONARY TUBERCULOSIS IN SOME HOSPITALS IN UYO, AKWA IBOM STATE, NIGERIA

Pulmonary tuberculosis (PTB) remains a major public health problem especially in the developing countries. Literature evidence opines that serological markers associated with PTB infections enhance early diagnosis. This study employed CD4+ T-lymphocyte counts and total serum immunoglobulin to establish early diagnosis in PTB patients in Uyo. Sputum samples of 105 patients were screened for Acid Fast Bacilli, while blood (7ml) was collected for CD4+ T-lymphocyte counts and quantification of total serum using cytoflow counter and Enzyme linked Immunoassay, respectively. A prevalence of 12.4% was established for PTB infection among the patients. The mean differences between immunoglobulins levels in relation to CD4+ T-lymphocyte counts was not significant at p ˃ 0.05. The mean IgG value of PTB patients was 737.29 ± 435.8 mg/dL, while the apparently healthy subjects (AHS) had the mean IgG value of 23.15 ± 32.2 mg/dL. The mean IgA level in PTB patients (190.91 ± 94.8 mg/dL) was higher than that of AHS (126.81 ± 35.5 mg/dL). The mean IgM value of PTB patients and that of the AHS was 317.75 ± 146.11 and 50.00 ± 32.3 mg/dL, respectively. There was significant difference between the immunoglobulin levels of PTB patients and AHS at p > 0.05 with respect to IgA and at p > 0.001 with respect to IgG and IgM. This study has indicated that biomarkers of humoral immunity were significantly affected when compared with AHS, thus, this study would enhance knowledge of the health practitioners and enable them to grasp the role of biomarkers in

Long-term immunological consequences of anti-CD20 therapies on humoral responses to COVID-19 vaccines in multiple sclerosis: an observational study.

Background:Anti-CD20 therapies induce pronounced B-cell depletion and blunt humoral responses to vaccines. Recovery kinetics of anti-CD20 therapy-mediated cellular and humoral effects in people with multiple sclerosis (pwMS) are poorly defined.Objective:To investigate the duration of the anti-CD20 treatment-induced effects on humoral responses to COVID-19 vaccines.Methods:This retrospective observational study included pwMS who had discontinued anti-CD20 therapy for ⩾12 months and remained without immunomodulation. We retrieved demographics and laboratory parameters including B-cell counts and immunoglobulin (IgG, IgM, IgA) levels prior to anti-CD20 commencement (baseline) and longitudinally after anti-CD20 treatment discontinuation from electronic medical records. Humoral responses to SARS-CoV-2 vaccines were compared with a population of 11 pwMS with ongoing anti-CD20 medication (control cohort).Results:A total of 24 pwMS had discontinued anti-CD20 therapy for a median of 34 months (range: 16–38 months). Antibody responses to COVID-19 vaccines were available in 17 (71%). Most individuals (n = 15, 88%) elicited a measurable antibody response [mean: 774 BAU/ml (±SD 1283 BAU/ml)] to SARS-CoV-2 immunization on average 22 months (range: 10–30 months) from the last anti-CD20 infusion, which was higher compared with the population with ongoing anti-CD20 therapy (n = 11, mean: 12.36 ± SD 11.94 BAU/ml; p < 0.00001). Significantly increased antibody levels compared with the control cohort were found among pwMS who were vaccinated >18 months after treatment discontinuation (19–24 months: n = 2, p = 0.013; 25–36 months: n = 9; p < 0.001). The interindividual kinetics for B-cell reconstitution were heterogeneous and mean B-cell counts approached normal ranges 18 months after treatment discontinuation. There was no correlation of B-cell repopulation and vaccine responses. Mean total IgG, IgM, and IgA levels remained within the reference range.Conclusion:Anti-CD20-induced inhibition of humoral responses to COVID-19 vaccines is transient and antibody production was more pronounced >18 months after anti-CD20 treatment discontinuation. The immunological effect on B-cell counts appears to wane by the same time.

Role of serum immunoglobulins in patients of oral lichen planus and oral lichenoid reaction

The aim of the study is to find out the role of immunoglobulin IgA and IgM as indicators of humoral immune response in the etiopathogenesis and for the differentiation between oral lichen planus (OLP) and oral lichenoid reaction (OLR). The study comprises of 50 patients. From them 20 patients were of OLP, 20 patients of OLR and 10 patients as controls. After histopathological confirmation, approximately 5 ml of venous blood was collected by venepuncture from OLP patients, OLR patients and from control patients. The serum IgA and IgM were measured by immunoturbidimetry method using automated chemistry analyzer and data were analysed using t-test. The mean serum level of IgA and IgM was 2.14±1.19g/L and 0.88±0.47g/L respectively in reticular OLP, 2.21±0.98g/L and 0.78±0.49g/L respectively in erosive OLP, 1.64±0.60g/L and 0.99±0.34g/L respectively in OLR, 2.62±0.40g/L and 1.51±0.47g/L respectively in control patients. The results showed statistically significant IgM level for reticular and erosive OLP (p value=0.007 and 0.042 respectively). Patients with OLP shows systemic immunologic alterations suggest that humoral immune system may play a part in pathogenesis of OLP and also OLP and OLR lesions can be differentiate on the basis of serum level of IgM.

Effect of non-surgical periodontal therapy on concentrations of salivary biomarkers in patients with chronic periodontitis: A clinical trial.

Background Certain salivary biomarkers that are considered unique in relation to the physiological aspects of periodontitis can be helpful in the diagnosis of periodontitis by considering quantitative changes in such biomarkers. This study was undertaken to answer the question to what extent non-surgical periodontal treatment can affect concentrations of salivary biomarkers in patients suffering from chronic periodontitis. Methods Eighteen patients with generalized moderate-to-severe chronic periodontitis were recruited for this study by considering periodontal parameters of gingival index (GI), probing pocket depths (PPD), clinical attachment levels (CAL) and a number of radiographic parameters. Salivary samples were analyzed at baseline and at one-month interval after non-surgical periodontal treatment consisting of scaling and root planing. Concentrations of salivary biomarkers, including cortisol, immunoglobulin A (Ig A), IL-6, interferon-γ, soluble intercellular adhesion molecule-1 (sICAM) and ALP, were determined with the use of an ELISA kit. Data were subjected to statistical analyses using paired t-test, with SPSS 15. Statistical significance was set at P<0.05. Results Mean levels of IgA and interferon-γ decreased significantly after treatment (P<0.05); however, cortisol concentrations increased significantly after treatment. In addition, the decrease in IL-6, sICAM-1 and ALP levels were not significant (P>0.05). Conclusion The results showed that the salivary levels of IgA and interferon-γ decreased and those of cortisol increased significantly subsequent to scaling and root planing.

Serum IgG, and IgM Levels in Children with Febrile Convulsions

At the Dr. Sami Ulus Children's Hospital Ankara, Turkiye, 20 patients, twelve being between 6 months-2 year old and eight being between 2-4 years, with their first febrile convulsions (FC) were examined for serum IgG, IgA, IgM levels during the period of March 1989-]uly 1989. Twenty healthy children were used as controls, seven being between 6 months-2 years old and thirteen being between 2-6 years. The serum IgG, IgA and IgM levels of the patients between 6 months-2 years were 805.000 + 307.8984 mg/ dl, 49.7167 + 27.9807 mg/dl and i55.1833 + 62.9696 mg/dl respecttvelly.&#x0D; The serum IgG, IgA and IgM levels of the patients between 2-4 years were : 989.1250 ± 314.5359 mg/dl, 92.6125 ± 34.5663 mg/dl and 159.8750 ± 45.6647 mg.ldl respectivelly. The mean IgA levels of the 12 FC patients between 6 months-2years were 49.7167 ± 27.9807 mg/dl and the mean level of IgA in the age matched control group was 81.0427± 31.3551 mg/dl and the difference between them was statistically significant (p &lt;0. 005).&#x0D; We conclude that FC under 2 years of age is associated with low serum IgA levels.

A study on the failure of breast feeding during the first month of life with effect on immunological level

Background: In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Breastfeeding provides unsurpassed natural nutrition to the newborn and infant. Study was done to know the effects of breast milk feeding versus formula feeding in early infancy on the development of serum IgA, IgM and IgG.Methods: The present study investigated 100 cases of failure of breast feeding. The cases included both complete and partial failure. Values of immunoglobulin levels (IgA, IgM and IgG) in the serum of eleven breast fed and eleven artificially fed infants (all aged one month) were determined using Tripartigen plates.Results: Mean level of IgA in artificially fed infants was 20.72±3.82µg/100 ml. The diameter of precipitin ring using sample number 7 was 3.9 mm. The mean level of IgA in breast fed infants was 25.94±3.89 µg/100 ml. The mean level of IgM in artificially fed infants was 31.690±3.504 µg/100 ml. The mean level of IgM in breast fed infants was 36.81±5.13 µg/100 ml. The mean level of IgG in artificially fed infants was 480.25±52.23 µg /100 ml. The mean level of IgG in breast fed infants was 517.59±56.72 µg /100 ml.Conclusions: It is evident from the results of immunoglobulin estimation (Ig A, Ig M and IgG) in infants with artificial milk and in infants with breast milk (vide table 5, 6, 7, 8, 9 and 10) that though the mean serum levels (Ig A, Ig M and IgG) in breast fed infants were slightly higher than that of artificially fed infants. There was no statistically significant difference in the serum immunoglobulin levels between these two groups.

Immunological Status of Children Born to Female Liver Recipients

BackgroundImmunosuppressive treatment in pregnant organ recipients can affect functions of the fetal and newborn immune system. The aim of this study was to evaluate the effect of this treatment on selected parameters of the immune system of children born to mothers after liver transplantation.Material/MethodsThe study included 52 children born to liver recipients and 52 children in the control group. The study was conducted in the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw. Children from the 1st day of life to 10 years of age were examined. Serum antibody concentrations of IgG, IgM, and IgA were measured by the immune agglutination method on a Cobas 6000 analyzer.ResultsComparison of mean IgG, IgM, and IgA levels and with reference values did not show a significant difference between the study and control group (p>0.05). Immunoglobulin concentrations were also analyzed in the groups of children according to their age at the time of the test and the type of calcineurin inhibitor used in the mother’s treatment. The analysis showed a significant difference in the distribution of IgA concentrations in comparison to the normal values (p<0.05), as well as mean IgA (p<0.05) and IgM concentrations (p<0.05) according to the type of immunosuppressive treatment of the mother (tacrolimus or cyclosporin treatment regimen).ConclusionsAnalysis of the type of immunosuppressive therapy used during pregnancy revealed a possible influence of the type of calcineurin inhibitor on selected parameters of the immune system of the children; however, further research is needed to confirm these findings.

Comparison of long-term follow-up outcomes between multiple-drugs combination therapy and tonsillectomy pulse therapy for pediatric IgA nephropathy.

To clarify the long-term efficacy of multiple-drugs combination therapy (PWDM) and tonsillectomy pulse therapy (TPT) for pediatric IgA nephropathy (IgAN), we retrospectively evaluated the clinical and laboratory findings as well as the prognosis for IgAN patients treated with each treatment at long-term follow-up. We collected data on 61 children who had been diagnosed with severe IgAN. The children were retrospectively divided into two groups. Group 1 consisted of 44 severe IgAN children treated with PWDM, and Group 2 consisted of 17 severe IgAN children treated with TPT. The clinical features, pathological findings, and prognosis were analyzed for both groups. The mean urinary protein excretion, serum creatinine, IgA levels, MESTCG scores, and percentage of glomeruli showing crescents in both groups at the second renal biopsy were lower than those at the first renal biopsy. At the time of the second biopsy, the IgA level in Group 2 was lower than that in Group 1; however, there were no significant differences in the mean urinary protein excretion, frequency of hematuria, serum albumin, creatinine, or e-GFR between the two groups. At the most recent follow-up, there were no significant differences in prognosis between the groups. Our study suggested that PWDM and TPT are effective in ameliorating urinary abnormalities and improving the long-term outcome of pediatric IgAN.

Antı-β2 Glycoprotein I Antibodies in Children with Rheumatologic Disorders.

Anti-beta-2-glycoprotein I antibodies (anti-β2GPI) which are the main antiphospholipid antibodies that characterize the autoimmune "antiphospholipid syndrome" are pathogenic and are contributing to thrombosis. We aimed to evaluate the presence and the diagnostic importance of these antibodies in children with different rheumatologic diseases with or without thrombosis risk. A total of 100 children with different rheumatologic diseases evaluated retrospectively. The mean anti-β2GPI IgG (p=0.108), IgA (p=0.547), and IgM (p=0.807) levels showed no statistically significant difference between different diagnosis groups. But anti-β2GPI IgA and IgM levels were higher in SLE patient group. The mean anti-β2GPI IgG (p=0.375), IgA (p=0.811), and IgM (p=0.276) levels were not also showed difference between disease groups with/without predisposition to thrombosis even though concentrations were higher in thrombosis group. In children with rheumatological complaints, anti-β2GPI antibody measurements should not be the first diagnostic criteria if vasculitis is not thought as the primary defect underlying the clinical symptoms.

Immunoglobulin levels and infection risk with rituximab induction for anti-neutrophil cytoplasmic antibody-associated vasculitis.

BackgroundRituximab (RTX), a B cell–depleting anti-CD20 monoclonal antibody, is approved for treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Low immunoglobulin (Ig) levels have been observed surrounding RTX treatment. The association between the degree of Ig deficiency and infection risk is unclear in AAV patients.MethodsAAV patients treated with RTX for remission induction at a single center (2005–15) with serum Ig measurements were included. Patient characteristics; serum IgG, IgM and IgA levels and occurrence of infections were collected retrospectively. Low IgG was defined as mild (376–749 mg/dL) or severe (>375 mg/dL). Logistic regression models were adjusted for age at RTX administration, estimated glomerular filtration rate (eGFR) and race to examine the association of degree and type of Ig deficiency and infection risk.ResultsOur cohort of 30 patients had a mean age of 63 (SD 7) years, 23 were women, 16 had granulomatosis with polyangiitis and 13 were PR3 ANCA positive. Nine patients received concomitant cyclophosphamide. The mean IgG level was 625 mg/dL (SD 289), mean IgM level was 55 mg/dL (SD 41) and mean IgA level was 133 mg/dL (SD 79). In this cohort, 20 patients had low serum IgG levels (<750 mg/dL) following RTX treatment. During the follow-up period, four individuals developed infections requiring hospitalization. In unadjusted logistic regression analysis, an IgG level ≤ 375 mg/dL was associated with 23 times higher odds of hospitalized infection [95% confidence interval (CI) 1.8–298.4; P = 0.02]. After adjustment for age, race and eGFR, results were similar [odds ratio (OR) 21.1 (95% CI 1.1–404.1) P = 0.04]. Low IgA was also associated with an increased risk of infections requiring hospitalization after adjusting for age, race and eGFR [OR 24.6 (95% CI 1.5–799.5) P = 0.03]. Low IgM was not associated with a higher risk of infections requiring hospitalization.ConclusionsSevere hypogammaglobulinemia was associated with increased odds of infection requiring hospitalization in this cohort. Further investigation is warranted given our study is limited by small sample size, concomitant cyclophosphamide use and variable timing of Ig measurement.

Assessment of Humoral Immunity of Patients with ?- Thalassemia

Background: Infectious complications form an important cause for morbidity and mortality in thalassemia patients. Many studies tried to investigate any possible defect or change in immune state that can be responsible for increase susceptibility to infections in these patients. Objective: To assess the humoral immunity in thalassemia patients and evaluate its possible role in high rate of infections in these patients. Methods: Cross-sectional study of 34 β-thalassemia patients and 10 control case in period from first of March to end of May of 2015 in Wasit Provenance in Iraq. Results: Mean serum level of IgM was significantly higher in patients than control only in age group ≥ 15 years. However, it did not reach the significant level in age group ˂ 15 years. Mean serum level of C3, C4, IgG, and IgA did not show significant difference between patients and control in both age groups. Iron overload appeared to have no role on humoral immunity of our patients. Conclusion: Although our study did not show significant change in humoral immunity, the study of complement and immunoglobulin level can be useful in evaluating the function of immune system and explaining the high rate of infection in thalassemia patients.

Effects of milking frequency in automatic milking systems on salivary cortisol, immunoglobulin A, somatic cell count and melatonin.

In barns with an automatic milking system (AMS), both the milking frequency and the number of nighttime milkings vary between cows. A low milking frequency might indicate problems in gaining access to the milking unit. Also, nighttime lighting in the waiting area of the AMS and in the milking unit increases exposure to light at night and could suppress nocturnal melatonin synthesis. These effects could result in increased stress, suppressed immune response, and poor udder health. A total of 125 cows (14-16/farm) on 8 farms with AMS were selected based on their average milking frequency. Eight to 10 saliva samples per cow were taken over the course of 4 days, and cortisol, IgA and melatonin concentrations were determined. Somatic cell counts (SCC) were determined in milk samples. Milking frequency had no significant relationship with mean cortisol and IgA levels, but a higher milking frequency tended to be associated with lower SCC levels. Nocturnal melatonin levels tended to be negatively associated with the number of nighttime milkings. In conclusion, no indication of increased stress or reduced immune defense was found in relation to milking frequency on farms with an AMS.

Effect of Anger Patterns and Depression on Serum IgA and NK Cell Frequency.

There are conflicting findings about relationship between depression and anger with immunological parameters. To investigate the relationship between anger patterns and immune system in depressed patients. Thirty-five patients with major depressive disorder were selected according to DSM-IV criteria. The Hamilton Depression Scale and Spielberger Anger questionnaires were used to determine severity of depression and "anger expression pattern", respectively. The control group without a previous history of mental illness was also selected. In the group of patients with moderate depression, serum IgA levels and NK cell percentage were measured. Mean differences of all types of "anger expression pattern", including; "state-trait anger", "anger expression out", "anger expression in", "anger control out" and "anger control in", between study and control groups, were statistically significant (p<0.05). Difference in mean serum levels of IgA in either group was not significant (p=0.9), but the mean difference was significant in terms of NK-cell percentage in both groups (p=0.04). There was no significant relationship between IgA levels and percentage of NK- cell with all types of "anger expression pattern" in both groups. Only in the control group, IgA had significant correlation with anger control out (p=0.04). Moderately depressed patients versus control group had higher Spielberger scores in all types of anger expression pattern except anger control-out and anger control-in. We found no evidence supporting the relationship between" anger expression pattern" and IgA levels and NK cell percentage; however, it seems that depression itself causes reduced number of NK cells and increased IgA levels.

Antibody profiling for the prognosis and diagnosis of multiple sclerosis in patients, compared with healthy subjects

Background: Multiple sclerosis is considered as an autoimmune disease of the central nervous system that is the main cause of disability in young adults around the world. The purpose of this study was to determine changes in antibodies in the prognosis of multiple sclerosis, and the use of antibody against aquaporin 4 for the diagnosis of multiple sclerosis. Materials and Methods: In this case - control study, 21 patients with a definite diagnosis of multiple sclerosis and 21 healthy subjects were selected as the study population. Blood and urine samples were collected, and nephelometry technique was used to assess the presence or absence of IgG, IgM and IgA in serum and urine samples. ELISA method for measuring of antibodies against aquaporin 4 was used. Results: There was no major difference in the mean of the total IgM in the case and control groups , but the mean IgA and IgG levels in the control group were evidently higher than in the case group. It was releaved that IgA, RBC and Hb mean differences between the two groups are statistically significant. Parallel with an increase in IgG, the probability of disease exacerbation was increased by 0.22, whereas with increasing ages, the probability of disease exacerbation was 15.0. There was also a positive and significant relationship between the average level of antibodies, IgG and IgM with the degree of illness However, the relationship between the mean serum IgA level and the degree of illness was inverse. It also became clear that antibodies against AQP-4 in serum and urine of patients with different degrees of illness showed no significant difference. The difference between the mean of antibodies against AQP in the serum of patients with mild and moderate MS was 54.1, but in mild and severe MS it was 53.3. Conclusion: The findings of this research suggest that serum antibody levels are directly related to the disease levels and can be used as a prognostic factor. Accordingly, it appears that the use of antibodies against aquaporin-4 in serum and urine for the diagnosis of this disease can be considered as a reliable approach.