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Srinivasa BT, Alizadehfar R, Desrosiers M, Shuster J, Pai NP, Tsoukas CM. Adult primary immune deficiency: what are we missing? Am J Med 2012; 125:779-86. [PMID: 22682795 DOI: 10.1016/j.amjmed.2012.02.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 01/31/2012] [Accepted: 02/03/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND More than 200 primary immune deficiencies have been described. In adults, their identification can be difficult. The lack of timely referrals, diagnostic facilities, and available expertise often delay appropriate treatment. Because an increasing number of adults are now diagnosed with immune deficiencies, there is a need to better understand the immune deficits in this age group. The study objective was to analyze the diagnostic spectrum of adults with primary immune deficiency and to determine the presumptive diagnostic accuracy of the referring physicians. METHODS We conducted a retrospective chart review over a 10-year period of all individuals referred to a dedicated center for adults with primary immune deficiency. Suspected cases were confirmed using standard clinical criteria and state of the art immune assays. RESULTS Of the 381 individuals studied, 244 were diagnosed as immune deficient. Of these, 210 had primary immune deficiency classified as novel, defined, and undefined. Forty-three patients had a prior diagnosis and were referred for follow-up care, and 201 patients were newly diagnosed. Most patients had common variable immune deficiency. Despite an apparent high index of suspicion in initiating the referrals, only one third of these patients had a prior quantitative assessment of serum immunoglobulins. CONCLUSIONS In this first known analysis of a large cohort of adults with suspected immune deficiency using established diagnostic criteria, we confirmed the diagnosis in two thirds of all patients. Our findings highlight the wide spectrum of primary immune deficiency states seen in adult medical practices and the need for increased awareness of their existence.
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Affiliation(s)
- Bharat T Srinivasa
- Division of Allergy and Clinical Immunology, McGill University Health Centre, Montreal, Quebec, Canada
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302
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Cunningham-Rundles C, Maglione PJ. Common variable immunodeficiency. J Allergy Clin Immunol 2012; 129:1425-1426.e3. [PMID: 22541363 DOI: 10.1016/j.jaci.2012.03.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/20/2012] [Accepted: 03/22/2012] [Indexed: 10/28/2022]
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303
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Gold PW, Pavlatou MG, Carlson PJ, Luckenbaugh DA, Costello R, Bonne O, Csako G, Drevets WC, Remaley AT, Charney DS, Neumeister A, Kling MA. Unmedicated, remitted patients with major depression have decreased serum immunoglobulin A. Neurosci Lett 2012; 520:1-5. [PMID: 22579817 PMCID: PMC10064982 DOI: 10.1016/j.neulet.2012.04.072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 04/11/2012] [Accepted: 04/29/2012] [Indexed: 11/29/2022]
Abstract
Patents with major depression have evidence of a proinflammatory state with consistent elevations in acute phase proteins and in the levels of inflammatory mediators such as interleukin-6 and tumor necrosis factor-α. We report here a study of the serum levels of immunoglobulin A (IgA) in medication-free patients with major depression in the remitted state (ruMDD). Selective IgA deficiency is the most common form of immunoglobulin abnormality, and is often associated with a higher than expected incidence of proinflammatory and autoimmune phenomena. We measured serum IgG, IgM, and IgA in 28 ruMDD patients and 27 healthy subjects (Ctrl) at 0 (pretreatment), 7, and 24h following sham depletion and tryptophan (TrpD) depletion conducted at least 8 days apart under balanced, randomized, blinded conditions. Immunoglobulins were measured by automated immunonephelometry. Data were analyzed by repeated measures ANOVA with diagnosis as a fixed effect and drug (TrpD vs. sham), and time as repeated measures factors. Serum IgA was consistently lower in ruMDD patients vs. Ctrl at all time points examined (p<0.04 for main effect of diagnosis). Serum IgG and IgM levels did not show significant differences by diagnosis. Medication-free patients with major depression in the remitted state have a significant reduction in serum IgA levels measured on multiple occasions. In the light of the fact that IgA serves many immunomodulatory, anti-inflammatory roles, this finding supports the concept that major depressive illness represents a proinflammatory state.
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Affiliation(s)
- Philip W. Gold
- Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Maria G. Pavlatou
- Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Paul J. Carlson
- Department of Psychiatry, University of Utah, School of Medicine and Salt Lake VA Medical Center, 50 North Medical Drive, Salt Lake City, UT, 84132, USA
| | - David A. Luckenbaugh
- Experimental Therapeutics and Pathophysiology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Rene Costello
- Department of Laboratory Medicine, NIH Clinical Center, 10 Center Drive, Bethesda, MD, 20892
| | - Omer Bonne
- Department of Psychiatry, Hadassah-Hebrew-University Medical Center, Jerusalem, Israel, 91120
| | - Gyorgy Csako
- Department of Laboratory Medicine, NIH Clinical Center, 10 Center Drive, Bethesda, MD, 20892
| | - Wayne C. Drevets
- Laureate Institute for Brain Research, 6655 S. Yale Avenue, Tulsa, Oklahoma, 74136, USA
| | - Alan T. Remaley
- Department of Laboratory Medicine, NIH Clinical Center, 10 Center Drive, Bethesda, MD, 20892
| | - Dennis S. Charney
- Office of the Dean, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Alexander Neumeister
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Mitchel A. Kling
- Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD, 20892, USA
- Behavioral Health Service, Philadelphia VA Medical Center, Philadelphia, PA and Department of Psychiatry, University of Pennsylvania School of Medicine, 3615 Chestnut Street, Philadelphia, PA, 19104, USA
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304
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Aytekin C, Tuygun N, Gokce S, Dogu F, Ikinciogullari A. Selective IgA Deficiency: Clinical and Laboratory Features of 118 Children in Turkey. J Clin Immunol 2012; 32:961-6. [DOI: 10.1007/s10875-012-9702-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Accepted: 04/21/2012] [Indexed: 01/04/2023]
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305
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Abstract
The lumen of the gastrointestinal (GI) tract is home to an enormous quantity of different bacterial species, our microbiota, that thrive in an often symbiotic relationship with the host. Given that the healthy host must regulate contact between the microbiota and its immune system to avoid overwhelming systemic immune activation, humans have evolved several mechanisms to attenuate systemic microbial translocation (MT) and its consequences. However, several diseases are associated with the failure of one or more of these mechanisms, with consequent immune activation and deleterious effects on health. Here, we discuss the mechanisms underlying MT, diseases associated with MT, and therapeutic interventions that aim to decrease it.
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Affiliation(s)
- Jason M Brenchley
- Program in Barrier Immunity and Repair and Immunopathogenesis Unit, Lab of Molecular Microbiology, NIAID, NIH, Bethesda, Maryland, USA.
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306
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Amanzadeh A, Amirzargar AA, Mohseni N, Arjang Z, Aghamohammadi A, Shokrgozar MA, Shokri F. Association of HLA-DRB1, DQA1 and DQB1 Alleles and Haplotypes with Common Variable Immunodeficiency in Iranian Patients. Avicenna J Med Biotechnol 2012; 4:103-12. [PMID: 23408509 PMCID: PMC3558207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 02/25/2012] [Indexed: 11/29/2022] Open
Abstract
Common Variable Immunodeficiency (CVID) is an antibody deficiency syndrome that often co-occurs in families with selective IgA deficiency (IgAD). This study was designed to investigate the frequency of DR and DQ loci of HLA class II region in common variable immunodeficiency (CVID) patients. Fifteen Iranian patients with CVID or IgAD (mean age 14.6±5.4, range 4-25 years; 9 male and 6 female) and 63 healthy controls were studied. Establishment of B-lymphoblastoid cell lines was performed using Epstein-Barr-virus (EBV) immortalization technique and HLA alleles were typed using polymerase chain reaction based on sequence specific primers (PCR-SSP). DRB1 alleles including DRB1 *04 (p=0.03) and DRB1 *11 (p=0.01) significantly showed higher frequency in the studied subjects. In contrast, DRB1 *301 (p=0.04) and DRB1 *07 (p=0.02) alleles were negatively associated with CVID. For DQB1 and DQA1 loci, DQB1 *0302 (p=0.047) and DQA1 *03011 (p=0.001) demonstrated high frequency in cases, while DQB1 *0201 (p=0.02) and DQA1 *0201 (p=0.01) were detected to be low when compared to controls. Haplotype analysis indicated that frequency of DRB1*04-DQB1*03011-DQA1 *03011 (p=0.02), DRB1 *11-DQB1 *03011-DQA1 *0505 (p=0.047), DRB1 *11-DQA1 *0505 (p=0.04) and DRB1*04-DQA1*03011 (p=0.02) haplotypes were significantly higher in patient group, while only the frequency of the DRB1 *07-DQA1 *0201 haplotype gene was statistically lower in control group (p=0.02). According to the results, it could be deduced that the HLA-DR and DQ loci may contribute to the pathogenesis of CVID or they might be considered as suitable markers for the possibility of the occurrence of this genetic defect.
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Affiliation(s)
- Amir Amanzadeh
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran
| | - Ali Akbar Amirzargar
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran,Department of Immunology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nilufar Mohseni
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran
| | - Zohreh Arjang
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran
| | - Asghar Aghamohammadi
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Shokrgozar
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran,Corresponding author: Mohammad Ali Shokrgozar, Ph.D., National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran. Tel: +98 21 66492595. Fax: +98 21 66492595. E-mail:
| | - Fazel Shokri
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran,Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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307
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Shakkottai A, Bupathi K, Patel AP, Chalom E, Chamarthi S, Lehman TJA, Peterson MGE, Gaur S, Moorthy LN. Children with partial IgA deficiency: clinical characteristics observed in the pediatric rheumatology clinic. Clin Pediatr (Phila) 2012; 51:46-50. [PMID: 21868598 DOI: 10.1177/0009922811417287] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Literature is lacking on partial IgA deficiency. In this study, the authors propose to describe the clinical manifestations of patients with partial IgA deficiency. Methods. The authors conducted a retrospective chart review of 13 patients with partial IgA deficiency followed at the pediatric rheumatology clinic at Robert Wood Johnson Medical School. They looked for the presence of rashes, joint pain, joint swelling, and morning stiffness. The authors also examined charts for a history of frequent infections, allergies, and the presence of elevated antinuclear antibody. Results. Eleven out of the 13 patients complained of joint pain, joint swelling, or morning stiffness. Six patients carried a diagnosis of a definitive rheumatic disease. Four patients suffered from frequent infections and 2 patients reported allergies. Conclusion. Partial IgA deficiency appears to be associated with rheumatic diseases and complaints of joint pain, joint swelling, and morning stiffness. A larger study is needed to confirm these results.
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308
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Schejbel L, Rasmussen EM, Kemp HB, Lundstedt AC, Nielsen KR, Obel N, Marquart H, Andersen AB. Combined IL-12 receptor and IgA deficiency in an adult man intestinally infested by an unknown, non-cultivable mycobacterium. Scand J Immunol 2011; 74:548-53. [PMID: 21812800 DOI: 10.1111/j.1365-3083.2011.02603.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Interleukin-12 receptor deficiency is a well-described cause of human susceptibility to infection with low-virulent mycobacteria and Salmonella species. We identified a male patient presenting in his late forties with severe gastroenteropathy because of outbred infestation by a previously unknown mycobacterium. In addition to selective IgA deficiency, the patient was found to carry a not previously described R283X homozygous mutation in his IL12RΒ1 gene. Two of his sisters, a brother, and his four children were healthy, heterozygous carriers of the mutation. In this patient, the combination of two deficiencies could promote illness. Even though the IgA deficiency in itself does not predispose to mycobacterial disease, the lack of secreted IgA may have disturbed the intestinal homoeostasis and increased the susceptibility to the low-virulent mycobacterium that the patient was not able to clear because of his IL12R deficiency. Antimycobacterial chemotherapy and interferon-γ treatment for 2 years significantly improved his condition. This is the first description of IL12RΒ1 deficiency combined with another immunodeficiency, and we suggest that combinatory defects may circumvent the otherwise low penetrance of IL12RB1 deficiency.
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Affiliation(s)
- L Schejbel
- Department of Clinical Immunology, University of Copenhagen, Copenhagen, Denmark
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309
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Ganoderma lucidum polysaccharides reduce methotrexate-induced small intestinal damage in mice via induction of epithelial cell proliferation and migration. Acta Pharmacol Sin 2011; 32:1505-12. [PMID: 22019957 DOI: 10.1038/aps.2011.126] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AIM To study the effects of Ganoderma lucidum polysaccharides (Gl-PS) on methotrexate (MTX)-induced small intestinal damage in mice and the underlying mechanisms. METHODS BALB/c mice were used for in vivo study. The mice were administered with Gl-PS (50, 100, or 200 mg/kg, ig) for 10 d, and injected with MTX (50 mg/kg, ip) on d 7 and 8 to induce intestinal damage, and then sacrificed on d 11 for morphological study and tissue malondialdehyde (MDA) and superoxide dismutase (SOD) measurements. Before sacrificing, blood samples were collected to analyze immunoglobulin A (IgA). Rat intestinal IEC-6 cells were used for in vitro study. Cell proliferation and migration were assessed using MTT method and an in vitro wounding model, respectively. Transforming growth factor β (TGFβ) protein expression was determined using ELISA assay. Ornithine decarboxylase (ODC) and c-Myc mRNA expression profiles were determined using RT-PCR. RESULTS MTX treatment caused severe mucosal damage, significantly increased small intestine MDA levels, and decreased SOD and serum IgA levels in BALB/c mice. Gl-PS (100 and 200 mg/kg) markedly reversed the MTX effects. In IEC-6 cells, Gl-PS (0.1, 1, and 10 μg/mL) significantly stimulated the cell proliferation. Furthermore, Gl-PS (10 μg/mL) significantly stimulated the cell migration. In addition, Gl-PS (10 and 20 μg/mL) significantly increased the expression of ODC and c-Myc mRNAs. However, Gl-PS (up to 20 μg/mL) had no effect on the expression of TGFβ protein. CONCLUSION The results suggest that Gl-PS protects small intestine against MTX-induced injury via induction of epithelial cell proliferation and migration.
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310
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Lewis WG, Robinson LS, Perry J, Bick JL, Peipert JF, Allsworth JE, Lewis AL. Hydrolysis of secreted sialoglycoprotein immunoglobulin A (IgA) in ex vivo and biochemical models of bacterial vaginosis. J Biol Chem 2011; 287:2079-89. [PMID: 22134918 DOI: 10.1074/jbc.m111.278135] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Bacterial vaginosis (BV) is a common polymicrobial imbalance of the vaginal flora associated with a wide variety of obstetric and gynecologic complications including serious infections and preterm birth. As evidenced by high recurrence rates following treatment, interventions for BV are still lacking. Several hydrolytic activities, including glycosidases and proteases, have been previously correlated with BV and have been hypothesized to degrade host sialoglycoproteins that participate in mucosal immune functions. Sialidase activity is most predictive of BV status and correlates strongly with adverse health outcomes. Here we combine clinical specimens with biochemical approaches to investigate secretory immunoglobulin A (SIgA) as a substrate of BV-associated glycosidases and proteases. We show that BV clinical specimens hydrolyze sialic acid from SIgA, but not in the presence of the sialidase inhibitor dehydro-deoxy-sialic acid. The collective action of BV-associated glycosidases exposes underlying mannose residues of SIgA, most apparent on the heavily N-glycosylated secretory component of the antibody. Terminal sialic acid residues on SIgA protect underlying carbohydrate residues from exposure and hydrolysis by exoglycosidases (galactosidase and hexosaminidase). It is known that both IgG and SIgA are present in the human reproductive tract. We show that the IgG heavy chain is more susceptible to proteolysis than its IgA counterpart. Gentle partial deglycosylation of the SIgA secretory component enhanced susceptibility to proteolysis. Together, these data support a model of BV in which SIgA is subject to stepwise exodeglycosylation and enhanced proteolysis, likely compromising the ability of the reproductive mucosa to neutralize and eliminate pathogens.
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Affiliation(s)
- Warren G Lewis
- Departments of Medicine, Gynecology, Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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311
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Mantis NJ, Rol N, Corthésy B. Secretory IgA's complex roles in immunity and mucosal homeostasis in the gut. Mucosal Immunol 2011; 4:603-11. [PMID: 21975936 PMCID: PMC3774538 DOI: 10.1038/mi.2011.41] [Citation(s) in RCA: 804] [Impact Index Per Article: 61.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Secretory IgA (SIgA) serves as the first line of defense in protecting the intestinal epithelium from enteric toxins and pathogenic microorganisms. Through a process known as immune exclusion, SIgA promotes the clearance of antigens and pathogenic microorganisms from the intestinal lumen by blocking their access to epithelial receptors, entrapping them in mucus, and facilitating their removal by peristaltic and mucociliary activities. In addition, SIgA functions in mucosal immunity and intestinal homeostasis through mechanisms that have only recently been revealed. In just the past several years, SIgA has been identified as having the capacity to directly quench bacterial virulence factors, influence composition of the intestinal microbiota by Fab-dependent and Fab-independent mechanisms, promote retro-transport of antigens across the intestinal epithelium to dendritic cell subsets in gut-associated lymphoid tissue, and, finally, to downregulate proinflammatory responses normally associated with the uptake of highly pathogenic bacteria and potentially allergenic antigens. This review summarizes the intrinsic biological activities now associated with SIgA and their relationships with immunity and intestinal homeostasis.
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Affiliation(s)
- Nicholas J. Mantis
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY 12208,Biomedical Sciences Program, University at Albany School of Public Health, Albany, NY 12201,To whom correspondence should be addressed: and
| | | | - Blaise Corthésy
- R&D Laboratory of the Division of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland,To whom correspondence should be addressed: and
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312
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Wines BD, Ramsland PA, Trist HM, Gardam S, Brink R, Fraser JD, Hogarth PM. Interaction of human, rat, and mouse immunoglobulin A (IgA) with Staphylococcal superantigen-like 7 (SSL7) decoy protein and leukocyte IgA receptor. J Biol Chem 2011; 286:33118-24. [PMID: 21784854 PMCID: PMC3190891 DOI: 10.1074/jbc.m111.272252] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 07/17/2011] [Indexed: 11/06/2022] Open
Abstract
Host survival depends on an effective immune system and pathogen survival on the effectiveness of immune evasion mechanisms. Staphylococcus aureus utilizes a number of molecules to modulate host immunity, including the SSL family of which SSL7 binds IgA and inhibits Fcα receptor I (FcαRI)-mediated function. Other Gram-positive bacterial pathogens produce IgA binding proteins, which, similar to SSL7, also bind the Fc at the CH2/CH3 interface (the junction between constant domains 2 and 3 of the heavy chain). The opposing activities of the host FcαRI-IgA receptor ligand pair and the pathogen decoy proteins select for host and pathogen variants, which exert stronger protection or evasion, respectively. Curiously, mouse but not rat IgA contains a putative N-linked glycosylation site in the center of this host receptor and pathogen-binding site. Here, we demonstrate that this site is glycosylated and that the effect of amino acid changes and glycosylation of the CH2/CH3 interface inhibits interaction with the pathogen IgA binding protein SSL7, while maintaining binding of pIgR, essential to the biosynthesis and transport of SIgA.
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Affiliation(s)
- Bruce D. Wines
- From the Centre for Immunology, The Burnet Institute, 85 Commercial Road, Melbourne 3004, Australia
| | - Paul A. Ramsland
- From the Centre for Immunology, The Burnet Institute, 85 Commercial Road, Melbourne 3004, Australia
| | - Halina M. Trist
- From the Centre for Immunology, The Burnet Institute, 85 Commercial Road, Melbourne 3004, Australia
| | - Sandra Gardam
- the Immunology Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst 2010, Australia, and
| | - Robert Brink
- the Immunology Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst 2010, Australia, and
| | - John D. Fraser
- the Maurice Wilkins Centre and School of Medical Sciences, The University of Auckland, Auckland 1020, New Zealand
| | - P. Mark Hogarth
- From the Centre for Immunology, The Burnet Institute, 85 Commercial Road, Melbourne 3004, Australia
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313
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Klimovich VB. IgM and its receptors: structural and functional aspects. BIOCHEMISTRY (MOSCOW) 2011; 76:534-49. [PMID: 21639833 DOI: 10.1134/s0006297911050038] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This review combines the data obtained before the beginning of the 1990s with results published during the last two decades. The predominant form of the IgM molecule is a closed ring composed of five 7S subunits and a J chain. The new model of spatial structure of the pentamer postulates nonplanar mushroom-shaped form of the molecule with the plane formed by a radially-directed Fab regions and central protruding portion consisting of Cµ4 domains. Up to the year 2000 the only known Fc-receptor for IgM was pIgR. Interaction of IgM with pIgR results in secretory IgM formation, whose functions are poorly studied. The receptor designated as Fcα/µR is able to bind IgM and IgA. It is expressed on lymphocytes, follicular dendritic cells, and macrophages. A receptor binding IgM only named FcµR has also been described. It is expressed on T- and B-lymphocytes. The discovery of new Fc-receptors for IgM requires revision of notions that interactions between humoral reactions involving IgM and the cells of the immune system are mediated exclusively by complement receptors. In the whole organism, apart from IgM induced by immunization, natural antibodies (NA) are present and comprise in adults a considerable part of the circulating IgM. NA are polyreactive, germ-line-encoded, and emerge during embryogenesis without apparent antigenic stimuli. They demonstrate a broad spectrum of antibacterial activity and serve as first line of defense against microbial and viral infections. NA may be regarded as a transitional molecular form from invariable receptors of innate immunity to highly diverse receptors of adaptive immunity. By means of interaction with autoantigens, NA participate in maintenance of immunological tolerance and in clearance of dying cells. At the same time, NA may act as a pathogenic factor in atherosclerotic lesion formation and in development of tissue damage due to ischemia/reperfusion.
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Affiliation(s)
- V B Klimovich
- Russian Research Center for Radiology and Surgical Technologies, St. Petersburg.
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314
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Patıroğlu T, Kondolot M. The effect of bovine colostrum on viral upper respiratory tract infections in children with immunoglobulin A deficiency. CLINICAL RESPIRATORY JOURNAL 2011; 7:21-6. [PMID: 21801330 DOI: 10.1111/j.1752-699x.2011.00268.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Immunoglobulin A (IgA)-deficient patients predominantly suffer from respiratory and gastrointestinal infections since secretory IgA has important functions to protect mucosal surfaces. OBJECTIVE To evaluate the effect of bovine colostrum, rich in IgA, on the treatment of viral upper respiratory tract (URT) infections in IgA-deficient children. METHODS Thirty-one IgA-deficient children with viral URT infections were included in this double-blind, placebo-controlled study, and randomly oral bovine colostrum or placebo was given three times a day for 1 week. Samples of saliva IgA were collected before treatment, after the administration of the first dose, and after the last dose. Mothers of the children completed a daily questionnaire regarding the severity of the infection and any adverse effects. RESULTS The bovine colostrum group had a lower infection severity score than the placebo group after 1 week (respectively 0.81±0.83, 3.00±1.85; P=0.000), but there was no difference between the salivary IgA levels of the groups. CONCLUSION This is the first study to evaluate the effect of bovine colostrum in IgA-deficient children, and no adverse effects were observed. However, further studies are needed to confirm the efficacy and safety of bovine colostrum in IgA-deficient patients.
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Affiliation(s)
- Türkan Patıroğlu
- Department of Pediatrics, Division of Pediatric Hematology and Immunology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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315
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Privigen immune globulin intravenous (human), 10% liquid. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2011; 36:2-31. [PMID: 21935292 PMCID: PMC3171818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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316
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Biesalski HK, Aggett PJ, Anton R, Bernstein PS, Blumberg J, Heaney RP, Henry J, Nolan JM, Richardson DP, van Ommen B, Witkamp RF, Rijkers GT, Zöllner I. 26th Hohenheim Consensus Conference, September 11, 2010 Scientific substantiation of health claims: evidence-based nutrition. Nutrition 2011; 27:S1-20. [PMID: 21700425 DOI: 10.1016/j.nut.2011.04.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 04/06/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The objective was to define the term evidence based nutrition on the basis of expert discussions and scientific evidence. METHODS AND PROCEDURES The method used is the established Hohenheim Consensus Conference. The term "Hohenheim Consensus Conference" defines conferences dealing with nutrition-related topics. The major aim of the conference is to review the state of the art of a given topic with experts from different areas (basic science, clinicians, epidemiologists, etc.). Based on eight to 12 questions, the experts discuss short answers and try to come to a consensus. A scientifically based text is formulated that justifies the consensus answer. To discuss the requirements for the scientific substantiation of claims, the 26th Hohenheim Consensus Conference gathered the views of many academic experts in the field of nutritional research and asked these experts to address the various aspects of a claims substantiation process and the possibilities and limitations of the different approaches. RESULTS The experts spent a day presenting and discussing their views and arrived at several consensus statements that can serve as guidance for bodies performing claims assessments in the framework of regulatory systems. CONCLUSION The 26th Hohenheim Consensus Conference addresses some general aspects and describes the current scientific status from the point of view of six case studies to illustrate specific areas of scientific interest: carotenoids and vitamin A in relation to age-related macular degeneration, the quality of carbohydrates (as expressed by the glycemic index) in relation to health and well-being, probiotics in relation to intestinal and immune functions, micronutrient intake and maintenance of normal body functions, and food components with antioxidative properties and health benefits.
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Affiliation(s)
- Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany.
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317
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Unravelling the effects of the environment and host genotype on the gut microbiome. Nat Rev Microbiol 2011; 9:279-90. [PMID: 21407244 DOI: 10.1038/nrmicro2540] [Citation(s) in RCA: 989] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
To what extent do host genetics control the composition of the gut microbiome? Studies comparing the gut microbiota in human twins and across inbred mouse lines have yielded inconsistent answers to this question. However, candidate gene approaches, in which one gene is deleted or added to a model host organism, show that a single host gene can have a tremendous effect on the diversity and population structure of the gut microbiota. Now, quantitative genetics is emerging as a highly promising approach that can be used to better understand the overall architecture of host genetic influence on the microbiota, and to discover additional host genes controlling microbial diversity in the gut. In this Review, we describe how host genetics and the environment shape the microbiota, and how these three factors may interact in the context of chronic disease.
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318
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TNFRSF13B/TACI Alterations in Greek Patients with Antibody Deficiencies. J Clin Immunol 2011; 31:550-9. [DOI: 10.1007/s10875-011-9536-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 04/12/2011] [Indexed: 10/18/2022]
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319
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Bekou V, Büchau A, Flaig MJ, Ruzicka T, Hogardt M. Cutaneous infection by Mycobacterium haemophilum and kansasii in an IgA-deficient man. BMC DERMATOLOGY 2011; 11:3. [PMID: 21269422 PMCID: PMC3038168 DOI: 10.1186/1471-5945-11-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 01/26/2011] [Indexed: 11/20/2022]
Abstract
Background The prevalence of infections by nontuberculous mycobacteria (NTM) has steadily increased over the past decades, especially in immunocompromised patients. Case presentation We present a patient with IgA-deficiency and mixed cutaneous infection by two slowly growing mycobacteria, Mycobacterium (M.) haemophilum and M. kansasii. Conclusions Cutaneous M. haemophilum infections most often result from HIV or transplantation-associated immunosuppression. Rarely, M. haemophilum may also infect healthy patients or iatrogenically immunosuppressed patients without transplantation. M. kansasii is one of the most frequent NTM and large awareness exists about its involvement in human diseases. Mycobacterial diagnosis of cutaneous infections should be considered in long-lasting skin lesions.
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Affiliation(s)
- Vassiliki Bekou
- Department of Dermatology and Allergology, Ludwig-Maximilians-University, Munich, Germany.
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320
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Wang LL, Jin YY, Hao YQ, Wang JJ, Yao CM, Wang X, Cao RM, Zhang H, Chen Y, Chen TX. Distribution and Clinical Features of Primary Immunodeficiency Diseases in Chinese Children (2004–2009). J Clin Immunol 2011; 31:297-308. [DOI: 10.1007/s10875-010-9493-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 12/02/2010] [Indexed: 12/18/2022]
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321
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Aghamohammadi A, Abolhassani H, Biglari M, Abolmaali S, Moazzami K, Tabatabaeiyan M, Asgarian-Omran H, Parvaneh N, Mirahmadian M, Rezaei N. Analysis of Switched Memory B Cells in Patients with IgA Deficiency. Int Arch Allergy Immunol 2011; 156:462-8. [DOI: 10.1159/000323903] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 12/22/2010] [Indexed: 11/19/2022] Open
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322
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Fu JL, Wang ZH, Li GZ, Wang YR, Liu P. Decreased IgA+ plasma cells and IgA expression in acute liver necrosis mice. World J Gastroenterol 2010; 16:3827-33. [PMID: 20698046 PMCID: PMC2921095 DOI: 10.3748/wjg.v16.i30.3827] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the number of intestinal immunoglobulin A (IgA+) plasma cells and expression of intestinal IgA in mice with acute liver necrosis.
METHODS: A model of acute liver necrosis was established by intraperitoneal injection of galactosamine (GalN) and lipopolysaccharide (LPS). Sixty mice were randomly divided into one of 4 equal groups: normal control, acute liver necrosis, LPS, or GalN. Hematoxylin and eosin staining, immunohistochemistry, and an enzyme-linked immunosorbent assay were employed to assess liver and intestinal injury, count intestinal IgA+ plasma cells, and measure the expression level of IgA and interferon γ (IFN-γ) in the small intestinal mucosa of mice.
RESULTS: Injured intestinal mucosa was observed in the acute liver necrosis group but not in the normal, LPS or GalN groups. Compared with the normal group, intestinal IgA+ plasma cells were slightly decreased in the LPS and GalN groups [429 ± 20 per high power field (HPF), 406 ± 18/HPF, respectively], whereas they were markedly decreased in the acute liver necrosis group (282 ± 17/HPF vs 495 ± 26/HPF in normal group, P < 0.05). The expression of intestinal IgA was also slightly decreased in LPS and GalN groups, but was markedly reduced in the acute liver necrosis group as determined by enzyme-linked immunosorbent assay (P < 0.05). In contrast, the level of IFN-γ was slightly increased in LPS, GalN and acute liver necrosis groups, but with no statistical significance (P > 0.05).
CONCLUSION: Intestinal IgA+ plasma cells and IgA expression levels indicating that mucosal immune barrier dysfunction, does exist in acute liver necrosis.
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323
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Shkalim V, Monselize Y, Segal N, Zan-Bar I, Hoffer V, Garty BZ. Selective IgA deficiency in children in Israel. J Clin Immunol 2010; 30:761-5. [PMID: 20571893 DOI: 10.1007/s10875-010-9438-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Accepted: 06/02/2010] [Indexed: 11/24/2022]
Abstract
IgA deficiency is the most common human primary immune-deficiency. We evaluated the clinical and immunological characteristics of selective IgA deficiency in children in Israel. The study group included 63 children diagnosed with IgA deficiency from 1987 to 2005. Mean follow-up time per child was 10.6 years. Average age at diagnosis was 10.5 years. In one child, the IgA deficiency was transient. Infectious diseases, mainly recurrent pneumonia and ear infection, were common and occurred in 25 patients (39.7%). Allergic diseases were documented in 20 (31.7%) of our patients. Thirteen children (20.6%) had autoimmune diseases. Malignancies were diagnosed in three children (4.8%), an association that has not been reported in previous series. IgA deficiency appears to be a risk factor for infections, allergic diseases, autoimmune conditions, and malignancy.
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Affiliation(s)
- Vered Shkalim
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petah Tikva 49202, Israel
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