IgG-related diseases
https://doi.org/10.18093/0869-0189-2017-27-3-311-319
Abstract
Recent investigations in immunology resulted in recognition of diseases related to abnormal synthesis of immunoglobulin G (IgG). IgG plays the key role for human defense from pathogens and foreign particles. The biological function of IgG is to initiate opsonisation of pathogens. Another important function of IgG is activation of the complement. As a biological marker, IgG could be used for diagnosis of recurrent infections of lower and upper airways, asthma, bronchiectasis, vasculitis, multiple myeloma, etc. This review is aimed at a role of both IgG deficiency and hyperproduction for diagnosis and treatment of various diseases. Prevalence of IgG deficiency was investigated in epidemiological studies, both in population level and in selected groups of patients with recurrent respiratory infections. The results showed susceptibility to Streptococcus pneumoniae, Haemophilus influenzae-b, and Neisseria meningitidis, infections in patients with IgG2 deficiency. The most common diseases were of it media, sinusitis, and recurrent bronchitis. Pneumonia and meningococcemia occurred in severe cases. Bronchiectasis occurred in patients with frequent episodes of respiratory infection. A selective increase in IgG4 level is particularly important as it is associated with development of idiopathic fibrosis. Retroperitoneal fibrosis, autoimmune pancreatitis, sclerosing cholangitis, salivary gland hypertrophy, sialadenitis, interstitial pneumonias, etc., were reported. This is the first article in a series of publications about IgG-related diseases. Pathogenesis, clinical symptoms and therapy of fibrosis associated with IgG4 hyperproduction have been described in the review. Further publications will discuss other IgG-related diseases.
About the Author
Aleksandr G. Chuchalin
N.I.Pirogov Russian State National Research Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Professor, Academician of Russian Science Academy, Head of Department of Hospital Internal Medicine. Pediatric Faculty, N.I.Pirogov Russian State National Research Medical University;ul. Ostrovityanova 1, Moscow, 117997, Russ; Healthcare Ministry of Russia; President of Russian Respiratory Society; tel.: (499) 780-08-50;
Competing Interests: The author declare no conflict of interest.
Russian Federation
Doctor of Medicine, Professor, Academician of Russian Science Academy, Head of Department of Hospital Internal Medicine. Pediatric Faculty, N.I.Pirogov Russian State National Research Medical University;ul. Ostrovityanova 1, Moscow, 117997, Russ; Healthcare Ministry of Russia; President of Russian Respiratory Society; tel.: (499) 780-08-50;
Competing Interests: The author declare no conflict of interest.
References
1. Pan Q., Hammarström L. Molecular basis of IgG subclass deficiency. J. Immunol. Rev. 2000; 178: 99–110.
2. Burton D.R., Gregory L., Jefferis R. Aspects of the molecular structure of IgG subclasses. Monogr. Allergy. 1986; 19: 7–35.
3. van der Berg M., Weemaes C.M.R., Cunningham-Rundles C. Isotype defects. In: Sullivan K.E., Stiehm E.R., eds. Immune Deficiencies. Amsterdam: Academic Press Elsevier; 2014.
4. Jefferis R., Pound J., Lund J., Goodall M. Effector mechanisms activated by human IgG subclass antibodies: clinical and molecular aspects. Ann. Biol. Clin. (Paris). 1994; 52 (1): 57–65.
5. Pumphrey R.S. Computer models of the human immunoglobulins shape and segmental flexibility. Immunol. Today. 1986; 7 (6): 17457.
6. Lee S.I., Heiner D.C., Wara D. Development of serum IgG subclass levels in children. Monogr. Allergy. 1986; 19: 108–121.
7. Morell A., Terry W.D., Waldmann T.A. Metabolic properties of IgG subclasses in man. J. Clin. Invest. 1970; 49 (4): 673–680.
8. Jefferis R., Reimer C.B., Skvaril F. et al. Evaluation of monoclonal antibodies having specificity for human IgG sub-classes: results of an IUIS/WHO collaborative study. Immunol. Lett. 1985; 10 (3–4): 223–252.
9. Braconier J.H., Nilsson B., Oxelius V.A., Karup-Pedersen F. Recurrent pneumococcal infections in a patient with lack of specific IgG and IgM pneumococcal antibodies and deficiency of serum IgA, IgG2 and IgG4. Scand. J. Infect. Dis. 1984; 16 (4): 407.
10. Hammarström L., Smith C.I. IgG subclasses in bacterial infections. Monogr. Allergy. 1986; 19: 122.
11. Briere E.C., Rubin L., Moro P.L. et al. Prevention and control of Haemophilus influenzae type b disease: recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm. Rep. 2014; 63 (RR-01): 1–14.
12. Stone J.H., Zen Y., Deshpande V. IgG4-related disease. N. Engl. J. Med. 2012; 366 (6): 539–51. DOI: 10.1056/NEJMra1104650.
13. Kamisawa T., Zen Y., Pillai S., Stone J H. IgG4-related disease. Lancet. 2015; 385 (9976): 1460–1471. DOI: 10.1016/S0140-6736(14)60720-0.
14. Khosroshahi A., Stone J.H. A clinical overview of IgG4-related systemic disease. Curr. Opin. Rheumatol. 2011; 23 (1): 57–66. DOI: 10.1097/BOR.0b013e3283418057.
15. Okazaki K., Uchida K., Koyabu M. et al. Recent advances in the concept and diagnosis of autoimmune pancreatitis and IgG4-related disease. J. Gastroenterol. 2011; 46 (3): 277–288. DOI: 10.1007/s00535-011-0386-x.
16. Umehara H., Okazaki K., Masaki Y. et al. A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details. Mod. Rheumatol. 2012; 22 (1): 1–14. DOI: 10.1007/s10165-011-0508-6.
17. Aalberse R.C., Stapel S.O., Schuurman J., Rispens T. Immunoglobulin IG4: an odd antibody. Clin. Exp. Allergy. 2009; 39 (4): 469–477. DOI: 10.1111/j.1365-2222.2009.03207.x.
18. Zen Y., Nakanuma Y. Pathogenesis of IgG4-related disease. Curr. Opin. Rheumatol. 2011; 23 (1): 114–118. DOI: 10.1097/BOR.0b013e3283412f4a.
19. Sah R.P., Chari S.T., Pannala R. et al. Differences in clinical profile and relapse rate of type 1 versus type 2 autoimmune pancreatitis. Gastroenterology. 2010; 139 (1): 140–148. DOI: 10.1053/j.gastro.2010.03.054.
20. Matsui S., Yamamoto H., Minamoto S. et al. Proposed diagnostic criteria for IgG4-related respiratory disease. Respir. Invest. 2016; 54 (2): 130–132. DOI: 10.1016/j.resinv.2015.09.002.
21. Saeki T., Nishi S., Imai N. et al. Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis. Kidney Int. 2010; 78 (10): 1016–1023. DOI: 10.1038/ki.2010.271.
22. Hao M., Liu M., Fan G. et al. Diagnostic value of serum IgG4 for IgG4-related disease: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2016; 95 (21): e3785. DOI: 10.1097/MD.0000000000003785.
23. Khosroshahi A., Wallace Z.S., Crowe J.L. et al. International consensus guidance statement on the management and treatment of IgG4-related disease. Arthrit. Rheumatol. 2015; 67 (7): 1688–1699. DOI: 10.1002/art.39132.
Review
For citations:
Chuchalin A.G. IgG-related diseases. PULMONOLOGIYA. 2017;27(3):311-319. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-3-311-319
Views:
5110
Email this article 