Mean IgG Levels Research Articles

Cross-sectional evaluation of anti-SARS-CoV-2 antibody response to AZD1222 recombinant vaccine deployment in the Bono region, Ghana

BackgroundPreliminary data across the globe shows that the AZD1222 recombinant vaccine was highly effective in preventing not only the symptoms but also the transmission of the SARS-CoV-2 virus. In Ghana, data on the immune response generated by different vaccination doses is lacking. The present study aimed to compare the anti-SARS-CoV-2 antibody response among single and double-vaccinated versus unvaccinated individuals. MethodsA case-control design was employed for this study. Seventy-nine participants (35 vaccinated, 44 unvaccinated) were recruited from the Sunyani West municipality and screened for the presence of SARS-CoV-2 specific IgG and IgM antibodies in plasma samples using a Standard COVID IgG and IgM Combo immunoassay test. Data analysis was carried out with STATA (version 21). ResultsThe current study showed that mean IgG levels among vaccine groups (Group 1: Not vaccinated, Group 2: 1 dose, Group 3: 2 doses) differed significantly (F2, 76=11.457, p<.001) between Group 1 and Group 3; and between Group 2 and Group 3. Participants in Group 2 and Group 3 were 4.1 and 12.5 times more likely to develop stronger antibody responses compared to their counterparts in Group 1 respectively. ConclusionThis baseline study demonstrated that in the short term, individuals who received either one or two doses of the AZD1222 recombinant vaccine generated a higher antibody response compared to individuals who did not receive any dose of the vaccine. Further studies are needed to understand how long the generated immune response will last in this population and whether a booster shot could be a useful strategy.

Association of CD19+-targeted chimeric antigen receptor (CAR) T-cell therapy with hypogammaglobulinemia, infection, and mortality

BackgroundCD19-targeted chimeric antigen receptor T-cell therapy (CAR-T therapy) has revolutionized the treatment of hematologic malignancies. As these cells target CD19+ receptors on B-cells, there is the potential for B-cell aplasia and hypogammaglobulinemia. Data on the degree and clinical significance of hypogammaglobulinemia are sparse. ObjectiveTo evaluate hypogammaglobulinemia after CD19-targeted CAR-T therapy and risk factors for hypogammaglobulinemia, infections, and mortality. MethodsWe performed a retrospective evaluation of 579 patients receiving CD19-directed CAR-T therapy and evaluated demographics, hypogammaglobulinemia (immunoglobulin G [IgG]≤600mg/dL), infections pre- and post-CAR-T therapy, and risk factors for hypogammaglobulinemia, infection, hospitalizations, and mortality. ResultsPatients had a mean age of 64 years and 64% were male. Prior to CAR-T therapy, 60% of patients had hypogammaglobulinemia, which increased to 91% post-CAR-T therapy. Mean IgG levels decreased from pre- to post-CAR-T therapy (587 to 362 mg/dL; p<0.0001). 37% of patients developed a serious infection post-CAR-T therapy. Hypogammaglobulinemia pre-CAR-T therapy was associated with worsening hypogammaglobulinemia post-CAR-T therapy. Hypogammaglobulinemia post-CAR-T therapy was associated with an increased risk of serious infection post-CAR-T therapy (IRR=2.7; 95% CI=1.5-5.2; p=0.002). Risk factors for mortality included mild hypogammaglobulinemia (400mg/dL<IgG≤600mg/dL), infections ≤100 days post-CAR-T therapy, and hospitalizations for infections. Immunoglobulin replacement was associated with a decreased risk of mortality. ConclusionsWe identified ∼90% of patients with hypogammaglobulinemia after CAR-T therapy. Hypogammaglobulinemia pre-CAR-T therapy was strongly predictive of worsening hypogammaglobulinemia post-CAR-T therapy, which was associated with an increased risk of serious infection and mortality post-CAR-T therapy. Increased immunological monitoring is needed to identify high-risk patients who may benefit from interventions to decrease morbidity and mortality.

Measles immunity status in Iranian infants and children and outbreak concerns: Time for reconsidering the vaccination schedule?

Introduction: Measles vaccination has greatly reduced the disease burden worldwide, but challenges remain due to variations in vaccine effectiveness across age groups. This study aimed to assess the serological profile of measles antibodies across different age groups, evaluate the impact of maternal immunity on antibody levels in infants under 12 months, and assess measles immunity in vaccinated individuals. Material and methods: This cross-sectional study was conducted from June 2022 to January 2023 at the Children’s Medical Center, a referral hospital in Iran. Serum samples were tested for measles-specific IgG and IgM antibodies using a commercial enzyme-linked immunosorbent assay (ELSA). An avidity assay was performed to assess measles virus-specific IgG antibodies on the samples that were positive and borderline for the measles IgG ELISA. Results: The study included 969 participants across various age groups. Among them, 23% (221 out of 953) tested positive for measles IgM ELISA, and 52% (504 out of 969) for measles IgG ELISA. Regarding the avidity assay for measles virus-specific IgG, the majority (418 out of 573, 73%) showed high-avidity antibodies. Measles-specific IgG levels varied significantly across different age groups, with infants below 6 months old showing a mean IgG level of 477 mIU/mL, declining to 230 mIU/mL between 6 and 12 months, and increasing significantly to 683 mIU/mL in the 12 to 18 month age group, reaching a peak at 938 mIU/mL among children aged 18–72 months. Conclusion: The increasing IgM positivity among young Iranians suggests a rising risk of measles outbreaks, possibly due to vaccination gaps. Inadequate antibody levels in infants raise concerns about vaccination effectiveness. Considering declining maternal antibodies, vaccinating infants at 6–9 months could be beneficial. Boosters for adolescents and women may further mitigate outbreak risks.

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...

Acquired Immunity and Effects of SARS-CoV-2 Vaccination in Healthcare Work-ers and Nursing Students. Post-Booster Follow-Up

Introduction: Discussions on COVID-19 vaccine efficacy and the duration of immunity are relevant to health policy intervention. Aims: To assess adherence to SARS-CoV-2 vaccination in healthcare workers (HCWs) and nursing students (NS). To determine IgG levels after booster doses and to identify effects of vaccination. Methods: Observational followup study on the impact of COVID-19 and vaccine efficacy in 2021 and 2022. The study population comprised HCWs and NS from Albacete (Spain). The sample size was 179 HCWs and 120 NS. Data was gathered using a self-administered questionnaire and venous blood samples 6 months after full vaccination and 6 months after the booster dose, in which IgG levels against SARS-CoV2 were measured. Univariate statistical analyses and bivariate analyses were performed using SPSS (28.0). The project was ap-proved by the Ethics and Clinical Research Committee of Albacete. Results: A total of 229 individuals completed the questionnaires and participated in the initial analyses (148 HCWs and 81 NSs). Adherence to the SARS-CoV-2 vaccination regimen was high (100% in NS and 97% in HCWs). Booster doses were received by 94% of the sample. Homologous vaccines were received by 29% and het-erologous vaccines by 71%. IgG levels: 6 months after full vaccination, seropositivity was 100% and mean IgG levels were 3,017.2 AU/ml in HCWs and 2,484.62 AU/ml in NS (p&lt;0.001). At 6 months after the booster dose the mean IgG levels were 25,789.34 AU/ml in PS and 17,155.07 AU/ml in NS (p&lt;0.001). Adverse effects of the vaccines were mild and local, with some present in a high proportion of those vaccinated. Conclusions: After vaccination, antibody levels were positive at 6 months and increase considerably after the booster dose, remaining high 6 months later. No serious side effects were reported, but a high incidence of mild effects, both general and local, was observed.

Investigating the diagnostic and prognostic value of anti-SARS-CoV-2 Spike IgG/IgM ELISA tests in patients infected with coronavirus Delta variant.

This study aimed to investigate the diagnostic and prognostic value of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike IgG/IgM antibodies in patients infected with coronavirus Delta variant. This analytical observational study included 270 unvaccinated patients (aged ≥18 years) diagnosed with coronavirus disease 2019 (COVID-19) Delta variant who referred to Emergency Department of our hospital. The serum levels of anti-SARS-CoV-2 Spike IgG and IgM were measured by indirect ELISA. Main measured outcomes included anti-SARS-CoV-2 Spike IgG and IgM, chest computed tomography (CT) severity score, clinical and laboratory findings which were prospectively evaluated throughout the study period. The IgM levels in critical patients were significantly higher than non-critical patients (p<0.05). But the mean level of IgG in critical patients was not significantly different from its level in non-critical patients (p>0.05). However, a significant positive correlation was observed between the levels of both antibodies and chest CT severity score (p<0.0001); this implies that their levels may reflect the degree of lung involvement. The IgM level on 15th-16th days after symptoms onset was significantly associated with the hazard of death even after adjusting for all other factors (adjusted HR (95%CI):1.28(1.014_1.63), p=0.03), whereas IgG was not (p>0.05). The survival probability among patients with IgM level ≥8.67 RU/ml (34.2%) was significantly lower than those with IgM level <8.67 RU/ml (99.5%, p=0.0001). Anti-SARS-CoV-2 Spike IgM antibody was significantly associated with the disease severity and risk of death in unvaccinated patients infected with coronavirus Delta variant. However, further large-scale investigations on diverse infected populations are required to precisely determine the diagnostic/prognostic value of these antibodies.

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 &amp; 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 &amp; 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&lt;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&lt;0.05). The mean IgA level was low in study group in comparison with the control group and it was statistically significant (p&lt;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&lt;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.

Evaluation of SARS-Cov-2 neutralizing antibody among Sinopharm Vero Cell (BBIBP-CorV) vaccinated medical students.

Information regarding seropositivity and vaccine efficacy among medical students is scarce. This study aims to detect the status of SARS-CoV-2 neutralizing antibodies among the Sinopharm's Vero Cell (BBIBP-CorV) vaccinated medical students. A prospective, cross-sectional study was carried out among medical students of Gandaki Medical College Teaching Hospital, Pokhara, Nepal from March through August 2022. The level of SARS-CoV-2 serum- neutralizing IgG antibody was measured and its relation with participants' age and sex, duration of vaccination, and any comorbid condition was determined. A total of 110 medical students were included in the final analysis, the majority being females (65.5%) and the mean age is 23.1 ± 3.2years. Most of the students (96.4%) had neutralizing antibodies against SARS-CoV-2. Among the 29 (26.36%) students who received a booster dose, the positivity rate was 100%. The mean IgG levels were 9.57 ± 9.58μg/ml and 2.91 ± 2.47μg/ml among students receiving an additional booster dose and among those not receiving it, respectively. In the cohort receiving a booster dose of the vaccine, the average value of neutralizing IgG antibodies was high. In contrast, the ones not receiving it, the titers were low and showed a declining trend. Though the dose strategy of the Sinopharm vaccine is effective, booster vaccination may be an important strategy to ensure protection among medical students, who are at high risk of COVID-19 due to constant patient exposure during their training. Further studies should assess vaccine efficacy among individuals who received other vaccines as well.

Comparative analysis of IgG levels in blood sera from patients with COVID-19, persons vaccinated by «Gam-COVID-Vac» and healthy donors before the pandemic

Introduction. Serum IgG measurement is used in the diagnosis and monitoring of many diseases. Therefore, it seems important to study the impact of coronavirus pandemic on IgG levels in population and the role of this parameter in COVID-19.&#x0D; The aim of this study was to compare mean IgG levels in sera obtained from 31 hospitalized COVID-19 patients, 30 healthy donors before pandemic and 34 donors vaccinated with «Sputnik V» (have not had COVID-19).&#x0D; Materials and methods. Total IgG was quantitated by two enzyme immunoassays (EIAs): «IgG Total-ELISA-BEST» kit certificated in Russia and homemade competitive EIA utilizing bispecific monoclonal antibodies (bsAbs) against human IgG (HIgG) and horseradish peroxidase (HRP).&#x0D; Results and discussion. The groups did not show differences in IgG levels (regardless of sex) with both methods giving comparable results. However, «IgG Total-ELISA-BEST» kit revealed statistically significant differences in mean serum IgG levels in subgroups of male patients depending on the levels of antibodies to viral RBD-antigen: below and above 400 BAU/ml. In the first subgroup (10 men) the mean serum IgG content was 14.3 ± 4.1 mg/mL, while in the second (6 men) — 6.9 ± 2.7 mg/mL.&#x0D; Conclusion. Sera obtained before pandemic contained the same mean IgG concentrations as sera from donors vaccinated with «Sputnik V» and COVID-19 patients. The relatively decreased mean IgG concentration was found only in COVID-19 male patients with anti-RBD antibodies levels above 400 BAU/ml. In light of literature data on association of decreased serum IgG with COVID-19 severity, it would be reasonable to further compare larger groups, taking into account clinical differences. The possibility of using bsAbs for human Ig measurements by competitive EIA was demonstrated.

Transient hypogammaglobulinemia of infancy and unclassified syndromic immunodeficiencies are highly common in oesophageal atresia patients.

Due to the high rate of post-operative sepsis and other infectious complications, a routine immunological screening protocol has been initiated since 2015 in our paediatric surgery clinic for all patients admitted with oesophageal atresia (EA) and warrant a delayed definitive treatment. In our study, we aimed to evaluate the immunodeficiencies in EA patients, by comparing them to healthy age-matched controls. As a prospective cohort study, EA patients admitted between 2015 and 2022, who had their definitive operation after the newborn period (>28 days of age) were included. On admission, serum concentrations of IgG, IgA, IgM, lymphocyte subset levels, C3 and C4 levels, specific IgG antibody responses against hepatitis B, hepatitis A, measles, varicella zoster were evaluated. The patients were age-matched with healthy controls to compare the results and followed up until three years of age. If a humoral immunodeficiency was detected, intravenous immunoglobulin treatment was administered before major oesophageal surgery and during follow-up. 31 EA patients (18 M/13F) with a mean age of 13.3 ± 9.0 months were compared with 40 age-matched healthy controls. Mean serum IgG levels were found to be statistically lower than controls in all age groups (P < .05). Transient hypogammaglobulinemia of infancy (THI) and unclassified syndromic immunodeficiencies (USI) were found to be strikingly high, accounting for 29.0% and 22.5%, respectively, adding up to 51.5% of EA patients. This is the first study evaluating immunodeficiencies in EA patients found in the reviewed literature. More than half of EA patients that required delayed surgery had humoral immunodeficiency, so preoperative screening and immunology referral may improve patient outcomes.

Immuno-PRISM: A Randomized Phase II Platform Study of Bispecific Antibodies in High-Risk Smoldering Myeloma

Background: B-cell Maturation antigen-directed immunotherapies have demonstrated significant efficacy in relapsed and refractory multiple myeloma (RRMM), with recent approval of the bispecific antibody teclistamab (TEC) . However, the use of immunotherapy in high-risk smoldering myeloma (HR-SMM) has not been examined to date. We hypothesized that bispecific antibody therapy would have greater benefit in HR-SMM due to this population having a more intact immune system, lower disease burden and may therefore have a higher efficacy and less toxicity compared to RRMM. Based on previous studies of lenalidomide and dexamethasone demonstrating benefit in HR-SMM, the Immuno-PRISM trial is studying various bispecific antibodies against a control arm of lenalidomide and dexamethasone. Herein, we report our first results of TEC in HR-SMM. Methods: This is a multiple arm, randomized, phase II, platform study evaluating TEC vs lenalidomide and dexamethasone in HR-SMM. Eligibility criteria included HR-SMM per Mayo 2018 “20-2-20” model, total IMWG risk score of 9 or greater, and other previously established high-risk criteria including PETHEMA criteria, evolving-type SMM, and high-risk FISH abnormalities. This study has an initial, safety run-in cohort of 6 patients treated with TEC. All patients receive 2 step-up doses of subcutaneous TEC. In the safety run-in, patients receive a dose lower than the recommended phase 2 dose (RP2D) of TEC. If no dose limiting toxicities (DLTs) are observed, the next cohort receives the RP2D of TEC. Once safety run-in is complete, the randomized trial begins with 2:1 randomization to TEC (30 patients) vs control arm of lenalidomide and dexamethasone (15 patients). Treatment duration is for 24 cycles. All eligible patients undergo stem cell collection after 4 cycles of therapy. The primary objective is complete response rate. Secondary objectives include PFS, ORR, MRD negativity rates, safety, pharmacokinetics of TEC, and safety. Exploratory objectives include mass spectrometry quantification of M protein, molecular evolution of tumor cells, and immune biomarkers of response. Results: At the time of data cut off, 19 patients have been enrolled to study with median follow up of 6 months. The median age is 59 years old (range 35-73) with 9 females (47%) and 10 males ( 53%). Sixty-four percent of patients that had evaluable FISH results had high-risk abnormalities as follows: 1q gain (7 pts), t(4;14) 1 patient. No DLTs were observed in the safety run-in cohort and patients are now enrolling into the randomized portion of trial. In the TEC-cohort (12 patients), grade 3 or greater hematologic toxicities were neutropenia (4 patients, resolved) and thrombocytopenia (1 patient, resolved). Grade 3 or greater non-hematologic toxicities were ALT increased in 3 patients (grade 3, resolved) and pancreatitis in 1 patient (grade 3, resolved). Infections occurred in 9 patients but only 1 patient had grade 3 infection (sinusitis). Remainder of the infections were low grade and were mostly upper respiratory infections (6 patients). One patient had grade 2 uveitis. CRS occurred in 75% of patients (all grade 1 except 2 patients with grade 2 CRS requiring tocilizumab, all resolved). No patients experienced ICANS with no delayed neurotoxicity observed. All patients treated with TEC are receiving IVIG with mean IgG level at start of IVIG treatment of 418 mg/dL, with 64% of patients achieving normalization of IgG values within two IVIG doses. In the TEC- treated cohorts (12 patients), the ORR is 100% with 42% achieving a CR, 25% VGPR, 33% PR. Four patients with high risk FISH receiving TEC have achieved a CR within 5 cycles.In control arm of lenalidomide and dexamethasone (3 patients), the ORR is 66% without any complete responses to date. Of the 8 evaluable patients treated with TEC, the MRD negative rate at 10 -6 is 100%, including 2 patients with VGPR-MRD negative disease. Average time to MRD negativity observed among evaluable patients was 4.25 cycles. No patients have progressed on treatment. Stem cell collection was successful in all eligible patients with an average stem cell yield of 9.06 x 10 6CD34+ cells/kg. Conclusions: TEC in HR-SMM demonstrates significant activity with 100% ORR with MRD-negative disease in 100% of evaluable patients to date, and overall significantly improved safety profile compared to RRMM.

Impact of serum level concentrations of IgG and IgM on abortion in women who had both risk factors diabetes and hypertension.

Abortion is a significant global public health concern affecting millions of women each year. Factors such as maternal diabetes and hypertension have been recognized as major contributors to increased abortion risk. Immunoglobulins, specifically IgG and IgM, play crucial roles in pregnancy outcomes and have been studied extensively. This study aimed to assess the levels of Toxoplasma IgG and IgM in aborted women with and without diabetes or hypertension. This cross-sectional study examined 64 women who experienced Toxoplasma gondii-induced abortions at Erbil Maternity Teaching Hospital between January 2021 and May 2021. Their medical history, including diabetes and hypertension status, was collected through interviews. Blood samples were analyzed using VIDAS technology to measure serum IgG and IgM levels. The mean IgG and IgM antibody levels were compared between groups of women based on the number of abortions, diabetes status, and hypertension status. In women with a history of abortion, IgM antibody levels differed significantly among the five groups (P ≤ 0.01). While the average serum toxoplasma IgG concentration varied between diabetic and non-diabetic women, these differences were not significant (P>0.05). Conversely, there were highly significant differences in the concentration of serum toxoplasma IgM (P<0.01). Comparing women with and without hypertension, no significant differences were found in the mean concentrations of serum toxoplasma IgG and IgM (P > 0.05). The IgM antibody had a significant impact on the number of performed abortions, and these effects were also observed in abortion in women with diabetes.

Study of the Levels of Immunoglobulin G and Complement 3 in Gestational Diabetes and Their Newborn

Background: The most typical metabolic issue related to pregnancy is gestational diabetes. Because it eliminates undesired germs and causes inflammation, the complement system (C3) is an essential part of the cellular immune system. It has been linked to metabolic diseases, including diabetes, obesity, dyslipidemia, insulin resistance, and liver dysfunction. C3 is also becoming more well recognized as a risk factor for cardiovascular and metabolic diseases. Immunoglobulin levels in maternal blood and colostrum are decreased by hyperglycemia, which also affects IgG transfer across the placenta. Aim of study: to compare the levels of C3 and immunoglobulin G in the sera of pregnant women with gestational diabetes and their babies to pregnant women without the disease. Methods: a case control study that was carried out over the course of four months, from August 18 to December 20, 2020, at the department of obstetrics and gynecology at Salahaddin General Hospital/Salahaddin. It involved 92 pregnant women who separated into two groups and went to the delivery room to deliver a viable fetus: 47 pregnant women in the case group had been diagnosed with gestational diabetes mellitus, whereas the 45 pregnant women in the control group had no complaints and were matched with the other groups' ages and gestational ages. Results for C3 and IgG levels in maternal and cord blood were noted. Results: In this study, the case group's mean birthweight and maternal serum C3 levels were both considerably greater than those of the controls. The mean cord serum IgG level in the case group was substantially lower than that in the controls. Conclusion: Understanding the underlying chronic inflammation that affects the developing fetus' innate immune system and predisposes the person to future diabetes and its consequences may be possible with complement C3 estimate in GDM.

Antibody response in elderly vaccinated four times with an mRNA anti-COVID-19 vaccine

The humoral response after the fourth dose of a mRNA vaccine against COVID-19 has not been adequately described in elderly recipients, particularly those not exposed previously to SARS-CoV-2. Serum anti-RBD IgG levels (Abbott SARS-CoV-2 IgG II Quant assay) and neutralizing capacities (spike SARS-CoV-2 pseudovirus Wuhan and Omicron BA.1 variant) were measured after the third and fourth doses of a COVID-19 mRNA vaccine among 46 elderly residents (median age 85 years [IQR 81; 89]) of an assisted living facility. Among participants never infected by SARS-CoV-2, the mean serum IgG levels against RBD (2025 BAU/ml), 99 days after the fourth vaccine, was as high as 76 days after the third vaccine (1987 BAU/ml), and significantly higher (p = 0.030) when the latter were corrected for elapsed time. Neutralizing antibody levels against the historical Wuhan strain were significantly higher (Mean 1046 vs 1573; p = 0.002) and broader (against Omicron) (Mean 170 vs 375; p = 0.018), following the fourth vaccine. The six individuals with an Omicron breakthrough infection mounted strong immune responses for anti-RBD and neutralizing antibodies against the Omicron variant indicating that the fourth vaccine dose did not prevent a specific adaptation of the immune response. These findings point out the value of continued vaccine boosting in the elderly population

Study of the Effects of Modified Colostrum Feeding Method on Passive Transfer Success in New-born Calves and Comparison with the Classical Method

In this study, it was aimed to evaluate a new colostrum feeding protocol in terms of passive transfer success. In the study, 70 calves each from two different farms with similar characteristics except colostrum feeding protocols were used. According to the modified method, new-born calves were given as much colostrum as the calf could drink, once every 3 hours, a total of 5 times in the first 12 hours. After 12 hours, as in the classical method, 2.5 liters of colostrum was given to the calves in the morning and evening, and then the calves were fed with milk. The amount of colostrum consumed by the calves fed with the modified method at each meal was recorded, and the blood IgG levels were measured using the ELISA method. In the first 5 feedings made in the modified method, the calves drank an average of 5.51 L colostrum in the first 12-hour period, 2.52 L in the first feeding, 0.86 L in the second feeding, 0.52 L in the third feeding, 0.98 L in the fourth feeding, and 0.63 L in the fifth feeding, respectively. While the mean blood IgG level of the calves in the modified colostral feeding group was 37.33 mg/ml, it was measured as 31.04 mg/ml in the classical colostral feeding group. As a result, with this difference made in the colostrum feeding method, the blood IgG levels of the calves reached a significantly higher level compared to the classical method (p˂0.05).

Quality of Life Evaluation in Saudi Arabian Pediatric Patients with Primary Immunodeficiency Diseases Receiving 20% Subcutaneous IgG Infusions at Home.

Subcutaneous immunoglobulin (SCIG) home infusion is widely used as an alternative to intravenous immunoglobulin (IVIG). This study aimed to determine the quality of life (QoL) of patients with primary immunodeficiency (PID) after switching to home-based SCIG. In this prospective open-label single-center study, QoL was determined using the validated Arabic version of the Child Health Questionnaire at baseline and 3 and 6 months after switching from IVIG to SCIG. Twenty-four patients were recruited from July 2018 to August 2021, including 14 females and 10 males. The median age of the patients was 5 years (range, 0-14 years). The patients' diagnoses included severe combined immunodeficiency, combined immunodeficiency, agammaglobulinemia, Omenn syndrome, immunodysregulation, hyper-IgE syndrome, common variable immunodeficiency, and bare lymphocyte syndrome. The median duration on IVIG before inclusion was 40 months (range, 5-125 months). The QoL score showed a significant improvement in the patients' global health at 3 and 6 months compared with those at baseline and a significant improvement in the patients' general health at 3 and 6 months compared with that at baseline. The mean baseline serum IgG trough level was 8.8 ± 2.1 g/L. The mean serum IgG level was significantly higher on SCIG at both 3 and 6 months (11.7 ± 2.3 and 11.7 ± 2.5 g/L, respectively). This is the first study involving an Arab population to show improvement in the QoL of patients with PID after switching from hospital-based IVIG to home-based 20% SCIG.

Five-Year Safety of Ofatumumab in People Living With Relapsing Multiple Sclerosis (P8-3.004)

Five-Year Safety of Ofatumumab in People Living With Relapsing Multiple Sclerosis (P8-3.004)

Long-Term Exposure to Air Pollution and COVID-19 Vaccine Antibody Response in a General Population Cohort (COVICAT Study, Catalonia).

Ambient air pollution has been associated with COVID-19 disease severity and antibody response induced by infection. We examined the association between long-term exposure to air pollution and vaccine-induced antibody response. This study was nested in an ongoing population-based cohort, COVICAT, the GCAT-Genomes for Life cohort, in Catalonia, Spain, with multiple follow-ups. We drew blood samples in 2021 from 1,090 participants of 2,404 who provided samples in 2020, and we included 927 participants in this analysis. We measured immunoglobulin M (IgM), IgG, and IgA antibodies against five viral-target antigens, including receptor-binding domain (RBD), spike-protein (S), and segment spike-protein (S2) triggered by vaccines available in Spain. We estimated prepandemic (2018-2019) exposure to fine particulate matter [PM in aerodynamic diameter ()], nitrogen dioxide (), black carbon (BC), and ozone () using Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) models. We adjusted estimates for individual- and area-level covariates, time since vaccination, and vaccine doses and type and stratified by infection status. We used generalized additive models to explore the relationship between air pollution and antibodies according to days since vaccination. Among vaccinated persons not infected by SARS-CoV-2 (), higher prepandemic air pollution levels were associated with a lower vaccine antibody response for IgM (1 month post vaccination) and IgG. Percentage change in geometric mean IgG levels per interquartile range of () were (95% CI: , 0.4) for RBD, (, ) for S, and (, ) for S2. We observed a similar pattern for and BC and an inverse pattern for . Differences in IgG levels by air pollution levels persisted with time since vaccination. We did not observe an association of air pollution with vaccine antibody response among participants with prior infection (). Exposure to air pollution was associated with lower COVID-19 vaccine antibody response. The implications of this association on the risk of breakthrough infections require further investigation. https://doi.org/10.1289/EHP11989.

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.

Immunoglobulin G antibody immune response profile following infection with SARS-CoV-2 in COVID-19 Egyptian patients

This study aimed to report the dynamic profile of IgG-specific antibodies to SARS-CoV-2 infection for 6 months after infection. We conducted a prospective study, recruited 33 recently confirmed covid -19 patients and collected 6 samples from each patient. The first samples were collected one month from the start of symptoms and subsequent samples collected at 30 days interval. We measured the IgG by chemiluminescent immunoassay (CLIA). According to the disease severity, patients were categorized as asymptomatic 4 (12.1%), mild 14 (42,4%), moderate 9 (27.3%), and severe 6 (18.2%). Patients were 12 (35.3%) females and 21 (64.7%) males. The mean IgG levels maintained a high level till the second month (92.81 ± 110.15 AU/ml) from the onset of symptoms followed by a gradual decrease till the sixth month after infection (17.42 ± 22.61 AU/ml). The patients with severe symptoms significantly exhibited the highest IgG levels, reached the highest level (mean=237.44 ± 164.13 AU/ml) at the second month. While the lowest levels were detected among the asymptomatic patients (mean= 3.04 ± 2.94 AU/ml) at the second month. Older age correlated with higher IgG antibody level (r= 0.350 p=0.046); however, sex was not related to IgG level. In conclusion, Symptomatic COVID-19 disease is followed by protective immunity for more than 6 months. Immunity in asymptomatic patients is low and fades rapidly than symptomatic cases. Patients with severe disease had significantly higher IgG levels compared to mild, moderate, or asymptomatic patients.