title: Clinical and immunological evaluation of patients with mild IgG1 deficiency.
abstract: Serum IgG subclass concentrations were determined in patients visiting, the pulmonology out-patient clinic with chronic respiratory tract problems. A total of 24 patients with a serum IgG1 concentration < 4.9 g/l (i.e. below the reference range) and normal values for IgG2, IgM and IgA were included. Patients with a selective IgG1 deficiency were vaccinated with a 23-valent pneumococcal polysaccharide vaccine. There were nine patients with a poor antibody response to pneumococcal capsular polysaccharide antigens. Responsiveness to protein antigens was intact in all patients. Patients with pneumonia showed a significantly lower anti-polysaccharide response in the IgG2 subclass than patients without pneumonia. Patients with recurrent sinusitis showed a significantly lower response in the IgA isotype after vaccination with pneumococcal polysaccharide vaccine compared with non-sinusitis patients. It can be concluded that patients with recurrent sinopulmonary infections and a mild IgG1 subclass deficiency have an impaired IgG1 anti-polysaccharide response, which can extend to decreased IgG2 and IgA anti-polysaccharide responses.
authors.affiliation: Department of Pulmonology, Sint Antonius Hospital Nieuwegein, The Netherlands.
authors.forename: D A
authors.initials: DA
authors.lastname: Van Kessel
authors.forename: P E
authors.initials: PE
authors.lastname: Horikx
authors.forename: A J
authors.initials: AJ
authors.lastname: Van Houte
authors.forename: C S
authors.initials: CS
authors.lastname: De Graaff
authors.forename: H
authors.initials: H
authors.lastname: Van Velzen-Blad
authors.forename: G T
authors.initials: GT
authors.lastname: Rijkers
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D001428:Bacterial Vaccines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017099:IgG Deficiency / Q000150:complications / Q000276:immunology*; D007114:Immunization; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology*; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial / Q000276:immunology; D012141:Respiratory Tract Infections / Q000097:blood / Q000150:complications / Q000276:immunology / Q000517:prevention & control; D012698:Serologic Tests
chemical_list: D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial