title: Increased serum IgA and decreased IgG3 strongly correlate with increased serum TGF-beta1 levels in patients with nonimmune chronic idiopathic neutropenia of adults.
abstract: OBJECTIVE
  To study the changes in serum immunoglobulins and some closely related pro-inflammatory cytokines in patients with nonimmune chronic idiopathic neutropenia of adults (NI-CINA).
  
  
  METHODS
  Serum levels of gamma-globulins, IgG, IgA, IgM, IgG subclasses, interleukin-4 (IL-4), interferon-gamma (IFN-gamma) and transforming growth factor-beta1 (TGF-beta1) were evaluated in 83 NI-CINA patients and 65 normal controls using the respective conventional methods.
  
  
  RESULTS
  We found that serum gamma-globulin, IgG and IgG1 levels were all significantly increased in the entire group of patients studied, compared to controls (p<0.001, p<0.01 and p<0.01, respectively), while the levels of IgG3 were significantly reduced (p<0.001). Serum IgA were increased in patients with severe neutropenia (p<0.001). No significant changes were noted in serum IgM, IgG2 and IgG4 levels. The infrequent occurrence of detectable amounts of IL-4 and IFN-gamma in the serum was similar in both, patients and control subjects. Serum levels of TGF-beta1 were increased in all groups of patients studied and they correlated inversely with the levels of IgG3 (p<0.001) and positively with the levels of IgA (p<0.001), suggesting the possible involvement of the cytokine in immunoglobulin class switching.
  
  
  CONCLUSIONS
  Patients with NI-CINA have significant changes in serum immunoglobulins and some inflammation-related cytokines. These findings provide additional evidence for the existence of an unrecognized low-grade chronic inflammatory process in NI-CINA patients and coroborate our previously reported suggestion for the possible involvement of this inflammation in the pathogenesis of neutropenia in the affected subjects.
authors.affiliation: Department of Haematology of the University of Crete School of Medicine, University Hospital of Heraklion, Greece.
authors.forename: H A
authors.initials: HA
authors.lastname: Papadaki
authors.forename: J
authors.initials: J
authors.lastname: Palmblad
authors.forename: V
authors.initials: V
authors.lastname: Kapsimali
authors.forename: N P
authors.initials: NP
authors.lastname: Anagnou
authors.forename: G D
authors.initials: GD
authors.lastname: Eliopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood*; D007249:Inflammation / Q000097:blood; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood / Q000209:etiology*; D012044:Regression Analysis; D016212:Transforming Growth Factor beta / Q000097:blood* / Q000145:classification; D053773:Transforming Growth Factor beta1; D005719:gamma-Globulins / Q000378:metabolism
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D005719:gamma-Globulins; D015847:Interleukin-4; D007371:Interferon-gamma