Normal Serum IgG4 Levels Research Articles

Increase of serum immunoglobulin level into the normal range in primary hypogammaglobulinaemia by dosage individualization of intravenous immunoglobulin.

The effect of varying the dose or the frequency or of both dose and frequency of immunoglobulin administration was evaluated in 17 patients with primary hypogammaglobulinaemia treated with Scottish National Blood Transfusion Service intravenous immunoglobulin (SNBTS IV IgG), an intravenous immunoglobulin preparation manufactured by the pH 4/mild pepsin method. Individualised dosage of SNBTS IV IgG resulted in trough serum IgG levels of greater than 4.0 g/l in 13 of the 17 patients studied. 6 of the 17 patients had trough serum IgG levels in the normal range (5.0 g/l). In 2 patients, more frequent infusions were required to achieve normal trough serum IgG levels because of their clinical conditions. In 1 of these 2 patients, the frequency could be reduced to three weekly when the gastrointestinal loss of IgG was reduced. There was a low incidence of adverse reactions (6.4%) which occurred mainly during the initial infusions. Most patients benefited from an increased serum IgG level, but the frequency of diarrhoea was unaffected. One patient with severe bronchiectasis continued to suffer from respiratory infections despite normal serum IgG levels.

Effects of neonatal anti-delta antibody treatment on the murine immune system. I. Suppression of development of surface IgD+ B cells and expansion of a surface IgM+ IgD- B lymphocyte population.

Lymphocytes that bear surface (s) IgD make up the majority of B cells in mature mice and are the precursors of most antibody secreting cells in primary immune responses made by these mice. In order to study the functional capabilities of the minority sIgD- B lymphocyte population and to gain insight into the possible roles of sIgD, we attempted to abort the development of sigD+ B cells and to expand the sigM+IgD- B cell population by treating mice from birth with affinity-purified rabbit antibodies specific for mouse IgD (RaM delta). RaM delta-suppressed mice had no detectable sIgD+ spleen, lymph node, or bone marrow cells and, on average, only 20% as many sIgM+Ia+ splenic B cells as control mice but had normal numbers of splenic T cells. Lymph nodes from anti-delta suppressed mice were even more depleted of B cells than were spleens from these mice, whereas the percentage of bone marrow B cells in these mice was relatively normal. Germinal centers of anti-delta suppressed mice were fairly normal in appearance, whereas follicular mantle layers, the locus of most sIgD+ B cells in normal mice, were greatly depleted. In addition to their lack of sIgD, splenic B cells of anti-delta suppressed mice differed from those found in control mice in that they bore, on average, twice as much sIgM as control cells, and in that they included an increased percentage of large, DNA synthesizing cells as compared with spleen cells from control mice. However, most sIgM+IgD- splenic B cells from anti-delta suppressed mice were small, nonproliferating cells. B cells from anti-delta suppressed mice insert little or no sIgD into their cell membranes since they continued to bear no detectable sIgD 2 days after in vivo neutralization of RaM delta and since, unlike B cells from control mice, they failed to be activated by a single in vitro injection of a goat anti-mouse delta antibody. Despite their lack of sIgD+ B cells, anti-delta suppressed mice had relatively normal levels of serum IgG as well as normal to increased levels of serum IgM. Thus, sIgM+IgD- B cells appear to have the potential of differentiating into Ig secreting cells in vivo without acquiring sIgD.

High-dose immunoglobulin replacement therapy by slow subcutaneous infusion during pregnancy

The slow, subcutaneous infusion method of immune human serum globulin replacement was used during pregnancy in a woman with common variable immunodeficiency and splenectomy. Since this method allows high doses of immune human serum globulin to be given with little pain or morbidity, as much as 20 mL/day of immune human serum globulin was tolerated, normal serum IgG levels were maintained, and the patient was free from serious infection throughout her pregnancy. The infant also had a normal IgG level at birth and had no evidence of intrauterine infection. This may be a preferable route of immune human serum globulin administration, especially during pregnancy and in other situations where high-dose therapy is advantageous. (<i>JAMA</i>1982;247:2824-2825)

High-Dose Immunoglobulin Replacement Therapy by Slow Subcutaneous Infusion During Pregnancy

The slow, subcutaneous infusion method of immune human serum globulin replacement was used during pregnancy in a woman with common common variable immunodeficiency and splenectomy. Since this method allows high doses of immune human serum globulin to be given with little pain or morbidity, as much as 20 mL/day of immune human serum globulin was tolerated, normal serum IgG levels, were maintained, and the patient was free from serious infection throughout her pregnancy. The infant also had a normal IgG level at birth and had no evidence of intrauterine infection. This may be a preferable route of immune human serum globulin administration, especially during pregnancy and in other situations where high-dose therapy is advantageous.

Immunoglobulins after Surgical Bursectomy in Chickens

Summary Surgically bursectomized chickens have normal serum IgG levels as late as 12 weeks after hatching. At the age of 6 months they show gross IgG deficiency. IgM levels are normal as late as 6 months after hatching in bursectomized birds. Bursectomized birds lack natural heteroagglutinins to human “O” red blood cells. After immunization followed by boosting, mercaptoethanol (ME)-sensitive antibodies to human “O” cells appear in bursectomized birds. Normal birds after immunization with human “O” red cells make ME-resistant antibodies even before boosting.