Immune system modulators
Gabriel Virella in Medical Immunology, 2019
Gamma globulins represent one of the oldest forms of immunopotentiation, providing a means to easily transfer passive immunity. Intravenous immunoglobulin (IVIG) consists of concentrated polyclonal immunoglobulins, of which over 90% are IgG. IVIG is used in a number of medical conditions. For patients suffering from primary or secondary immune deficiencies, IVIG restores the circulating IgG concentrations. IVIG also helps to modulate the immune response for autoimmune disorders, e.g., immune thrombocytopenic purpura, severe polymyositis, dermatomyositis, and Kawasaki syndrome. In these conditions, autoantibodies bind to cells or tissues and activate complement and phagocytic cells, causing cell death and/or tissue damage. IVIG can help modulate the immune response by saturating Fc receptors on phagocytes, preventing them from engaging in phagocytosis, as well as providing anti-idiotype antibodies against the paratopes of autoantibodies, thus inhibiting the autoantibodies from binding to their targets.
B Cells and Humoral Immunity
Constantin A. Bona, Francisco A. Bonilla in Textbook of Immunology, 2019
Described by Bruton in the 1950’s (and often called Bruton’s agammaglobulinemia) this disease is limited to males, manifests 6 to 10 months after birth, and is characterized by recurrent pyogenic infections (S. pyogenes, S. aureus, H. influenzae). B lymphocytes are rare or absent, as are serum immunoglobulins; plasma cells are not found. Without antibody replacement, sepsis is frequent and often fatal. Periodic infusions of gamma globulin greatly reduce the incidence of infection and some patients survive to adulthood. Replacement is not entirely adequate, however, since secretory IgA cannot be supplied. Pulmonary infection is still a common cause of death. Patients have normal numbers of bone marrow pre-B cells, but most of them lack surface Ig and have cytoplasmic μ chains lacking variable regions. A very small (but detectable) number of normal surface Ig-bearing B cells give rise to the minuscule amounts of antibody sometimes found in these patients. The XLA gene has been mapped to the proximal portion of the long arm of the X chromosome (Xq22); the genetic defect has recently been identified: the mutated gene encodes a tyrosine kinase called btk (Bruton’s tyrosine kinase) which clearly must play an important (but still unclear) role in development of the B cell lineage.
The Influence of Pituitary-Adrenal Axis on the Immune System
Istvan Berczi in Pituitary Function and Immunity, 2019
Twelve children with asthma, six receiving prednisone therapy, were immunized with keyhole limpet hemocyanin (KLH). Prednisone treatment tended to enhance the primary IgG and IgM antibody response, but had no effect on antibody levels formed after a second injection of KLH.385 Groups of six patients with classic rheumatoid arthritis, unresponsive to conventional therapy, were given 1 g i.v. doses of MP daily, and the immune response and clinical activity were followed for 16 weeks. Skin test reactivity to recall antigens, such as PPD and histoplasmin, were preserved. The primary antibody response to KLH, and secondary antibody responses to tetanus and typhoid vaccines, were similar in both the prednisolone treated and nontreated groups. Serum gamma globulin concentrations were unchanged.386
Albumin-Globulin Ratio Indicates the Survival Outcome of Pancreatic Cancer Cases Who Underwent Preoperative Treatment and Curative Surgical Resection
Published in Nutrition and Cancer, 2023
Masamichi Hayashi, Daigo Kobayashi, Hideki Takami, Yoshikuni Inokawa, Nobutake Tanaka, Keisuke Kurimoto, Koki Nakanishi, Shinichi Umeda, Dai Shimizu, Norifumi Hattori, Mitsuro Kanda, Chie Tanaka, Goro Nakayama, Yasuhiro Kodera
The inflammatory status also produces acute-phase protein and immunoglobulin aggregation, leading to increased serum globulin (16). Additional analysis in Supplementary Table 2 indicated that high globulin level was significantly associated with the histological result of cancer invasion of the duodenum (P = 0.032). Generally, gamma-globulin, deeply related to immune function among the globulins, is called immunoglobulin. There are five types of immunoglobulins: G, M, A, D, and E. Immunoglobulin A (IgA) is mainly responsible for gut immunity. Peyer’s patches are unique and vital immune organs localized in the intestinal wall. Primary immune cells such as dendritic cells, T cells, and B cells are concentrated in the Peyer’s patch region. These intestinal immune cell groups work together to produce IgA against the invading antigen and prevent it from entering the body. Such a mechanism may affect the association between globulin and duodenum invasion.
IgA nephropathy in a child: Crohn’s disease-associated or adalimumab induced?
Published in Current Medical Research and Opinion, 2022
Francesco Graziano, Martina Busè, Nicola Cassata, Vincenzo Luca Lentini, Michele Citrano
Two years after diagnosis, when he was 11-year-old, the patient presented suddenly macroscopic hematuria. For this reason he was again admitted at our Unit. No infections or allergies were reported. Urinalysis at the time showed hematuria 3+, proteinuria 2+, dysmorphic RBCs and RBC casts. No stone formation was detected. Subsequent laboratory examinations showed acute renal failure, with important increases in BUN (138 mg/dL, normal 10–50 mg/dL) and in serum creatinine (4.58 mg/dL, normal 0.30–0.90 mg/dL). Estimate glomerular filtration rate (EGFR) was 20 ml/min/1.73 m2. CRP was 2 mg/dL (normal 0–0.5 mg/dL). Hb was 8.3 g/dL, PLT was 357.000/ul, white blood cells was 8300/ul (neutrophils: 68.2%; lymphocytes: 21.2%). Serum IgA was 285 mg/dL (normal 70-400 mg/dL). Serum IgG was 1319 (normal 360–1200 mg/dL). C3 and C4 were both normal. Serum Albumin was 3 g/dL (normal 3.5–4.8 g/dL). Serum protein electrophoresis showed increased gamma globulins without peak. Antinuclear antibodies (ANA), Extractable nuclear antigen (ENA), anti double–stranded DNA (anti ds-DNA) and antineutrophil cytoplasmic autoantibodies (p-ANCA and c-ANCA), anti–glomerular basement membrane (anti-GBM) antibody and IgG and IgM anticardiolipin antibodies were unremarkable. Screening for HBV, HCV and HIV was negative. No hypertension occurred.
Intravenous immunoglobulins modify relapsing membranous glomerulonephritis after kidney transplantation: a case report
Published in Acta Clinica Belgica, 2018
Sanne Steyaert, Jo Van Dorpe, Anne Hoorens, Wim Van Biesen, Steven Van Laecke
Idiopathic membranous glomerulonephritis (IMGN) is the second most common cause of nephrotic syndrome in the Western adult population and a possible cause of end stage renal disease. Although a kidney biopsy is still essential for diagnosis, both serum and podocyte anti-phospholipase 2-receptor antibodies (APLA2R) have emerged as an additive diagnostic and predictive aid, with potential use before and after kidney transplantation [1]. In patients with primary glomerulonephritis these antibodies are positive in 80–85% of cases. Another 3–5% will express thrombospondin type-1 domain containing 7A (THSD7A), a different transmembrane protein found in the podocyt, while in the remaining 10–15% to date no autoantigens are identified [2]. Initiation of immunosuppressive therapy is dependent on clinical criteria such as the degree and the evolution of kidney dysfunction and proteinuria. Treatment options are corticosteroids, alkylating agents, rituximab, calcineurin inhibitors, and mycophenolate mofetil (MMF) with variable remission rates [1]. In the literature, the role of intravenous gamma-globulins (IVIG) in the treatment of this disease has been explored and a potential role outlined by nonrandomized trials [3,4].
Related Knowledge Centers
- Antibody
- Globulin
- Hepatitis A
- Measles
- Serum Protein Electrophoresis
- Immunodeficiency
- X-Linked Agammaglobulinemia
- Hyper Igm Syndrome
- Vaccine
- Immune Thrombocytopenic Purpura