Clinical applications of immunoglobulin: update: [review]

Human immunoglobulin is the most used blood product in the clinical practice. Immunoglobulin applications have increased quickly since the elucidation of its immunomodulatory and antiinflammatory properties which turned this blood product into a precious tool in the treatment of numerous diseases that present with humoral immune deficiency or that cause immune system dysfunction. Currently, the approved indications for Ig are: primary immunodeficiencies, secondary immunodeficiencies (multiple myeloma or chronic lymphoid leukemia), Kawasaki syndrome, immune thrombocytopenic purpura, Guillain Barré syndrome, graft-versus-host disease following bone marrow transplantation and repeat infections in HIV children. On the other hand, there are numerous "off-label" indications of immunoglobulin, which represent 20-60 percent of all clinical applications of this drug. It is important to study all these indications and, above all, the scientific evidence for its use, in order to provide patients with a new therapeutic option without burdening the health system. This review results from a wide selection of papers identified in the Pubmed and Lilacs scientific electronic databases. A group of descriptors were used from human immunoglobulin to the names of each disease that immunoglobulin is clinically applied. Our main objective is to list the numerous indications of immunoglobulin, both authorized and "off-label" and to analyze these indications in the light of the most recent scientific evidence.

Deficiência de anticorpos anti-polissacarídicos: relato de casos / Impaired polysaccharide responsiveness: cases report

Introdução: A deficiência de anticorpos antipolissacaride ou deficiência parcial de anticorpos é considerada uma dasquatro imunodeficiências mais comuns da infância e sua principal manifestação são as infecções bacterianas repetitivas das vias aéreas.Descrição: São relatados casos de três pacientes com historta de infecções de repetição de diferentes evoluções cujaavaliação imunológica demonstrou uma produção alterada de anticorpos ao Streptococcus pneumoniae após imunização para os sorotipos testados, embora apresentasse níveis normais deimunoglobulinas, cuja instalação de um tratamento adequado promoveu a redução nas infecções bem como da qualidade de vida desses pacientes.Comentários: A grande maioria dos pacientes com deficiência de anticorpos antipolissacaride necessita de tratamento antibiótico agressivo nas infecções, cursos de antibióticos profiláticos, e em alguns casos, de terapia de reposição de imuneglobulinas.Alguns pacientes podem se beneficiar da vacinação heptavalente conjugada para o S.pneumoniae. É necessárioampliar a informação médica com relação ao diagnóstico apresentadonessa série, bem como, melhorar a rede laboratorial de propedêutica diagnóstica para permitir a identificação dessa patologia.

Introduction: Impaired polysaccharide responsiveness or partial antibodies defect is considered one of the four mostcommon immunodeficiencies in pediatric patients and is characterized by recurrent bacterial respiratory infectlons.Description: Three cases are related with a recurrent infections history with different evaluations, which immunological evaluations showed impaired antibodies response againstStreptococcus pneumoniae after immunization for tested serotypes,although presented normal leveis of immunoglobulin. The adequate treatment reduced the number and severity of infections and improved the patient's quality of life.Comments: The majority of patients with impaired polysaccharide responsiveness require aggressive antibiotic treatmentduring infections, serres of prophylactic antibiotics, and, rarely, IgG replacement. Some patients may clinicai benefit from írnmunization with the conjugate vaccine to S.pneumoniae. It'simportant to improve the medical information about the presenteddiagnosis, in addition to amplify the number of practiced laboratories to better identification of this disease.

Porque usamos imunoglobulina anti-D em excesso no abortamento precoce? / Why do we waste anti-D immunoglobulin in early miscarriage?

OBJETIVO: avaliação da hemorragia feto-materna (HFM) nas pacientes que receberiam profilaxia da aloimunização Rh com emprego de imunoglobulina anti-D (300 mig), pós-aborto precoce. MÉTODO: foram admitidas no estudo pacientes do grupo sanguíneo Rh negativo, com parceiro Rh positivo ou ignorado, com quadro de aborto até 12 semanas de gestação internadas para curetagem uterina. Uma amostra de 5 ml de sangue venoso destas pacientes foi obtida após o procedimento, na qual realizamos o teste qualitativo de roseta para detectar quais casos necessitariam determinação quantitativa do volume de sangue fetal transferido para circulação materna, que foi então apurado pelo teste de Kleihauer-Betke (K-B). RESULTADOS: das 26 pacientes avaliadas, em uma o teste de roseta foi positivo, e o teste de K-B apontou HFM de 1,5 ml. CONCLUSÕES: a dose de imunoglobulina anti-D nos casos de abortamento até a 12ª semana de gestação deveria ser substancialmente reduzida, parecendo-nos oportuna a disponibilização no mercado nacional de apresentação com 50 mig, que representaria além da economia, maior racionalidade.

Is the prevalence of celiac disease increased among epileptic patients?

OBJECTIVE: To assess the prevalence of celiac disease (CD) among a group of epileptic patients attending the Epilepsy Clinics of two general hospitals in the city of Brasilia (DF), Brazil. METHOD: Serum samples were collected from 255 epileptic patients (119 children, 136 adults) originating from Epilepsy Clinics, and from a control group composed by 4405 individuals (2034 children, 2371 adults) attending the Laboratory of Clinical Analysis, for routine blood testing. The diagnosis of CD was determined by the antiendomysium antibody (IgA-EMA) test and by small intestine biopsy. RESULTS: two of the 255 epileptic patients (1:127) and fifteen subjects from the control group (1:293) tested positive for the IgA-EMA assay. CONCLUSION: the prevalence of CD was 2.3 times higher in epileptic patients than in controls (7.84 per 1000 versus 3.41 per 1000). Although still not statistically significant, this result is highly suggestive of an increased prevalence of CD among epileptic patients

Development of PCR Technology for Identification of the Restriction Fragment Length Polymorphism(RFLP) of the Immunoglobulin Allotypes in Periodontal Patients / 대한치주과학회지

The present study has been performed to develop a PCR technology to identify human immunoglobulin(Ig) allotypes with restriction fragment length polymorphism(RFLP) using a probe. Genomic DNA were ampilified with PCR tecnology using primers from peripheral blood lymphocytes of 10 periodontal patiens, whose Ig allotypes have been pre-determined by serological tecnique using heagglutination technique. The result indicated that the RFLP patterns could successfully differentiate the Ig allotypes, which suggests that this technology can be developed as a tool useful for population genetics studies.

Immunogenetic Study on the IgG Subclass Responses in the Phenotypic Subsets of the Early-Onset Periodontitis / 대한치주과학회지

No abstract available.

clinical and immunological study of slipped upper femoral epiphysis

Sixteen patients with 18 hips affected by SUFE with a mean age of 13.7 years were included in this study. IgM, IgG and IgA were measured by radial immunodiffusion. SUFE was treated with Moore's pins fixation. IgM was raised in 100% of cases, IgG in 87.5% and IgA in 75%. The overall results were satisfactory in 14 hips [77.8%]. Immunological mechanisms may play a role in SUFE. Results of surgical treatment of SUFE are affected by age, sex, degree of slipping, timing of surgery and period of follow up. Complications were chondrolysis, avascular necrosis, pin problems and shortening

Some immunological studies on amoebiasis

Studies of immunoglobulins pattern in 64 patients with different clinical symptoms of amoebiasis revealed that IgG showed no rise in patients with acute amoebic dysentery and asymptomatic cyst passers, while it was significantly increased in patients with active hepatic amoebiasis. IgM, IgA and IgE were significantly increased in both acute amoebic dysentery and active hepatic amoebiasis, but no significant changes in asymptomatic cyst passers. ELISA [depended on level of IgG] was valid and reliable in diagnosis of active hepatic amoebiasis [100%], IHAT [depended on level of IgM] gave 72.7% and 46.9% in patients with acute amoebic dysentery and active hepatic amoebiasis, respectively

Obtención de anticuerpos especifícos para la IgG de ratón / Production of specific antibodies to mouse IgG

Se llevó a cabo la purificación de IgG de ratón, con la que se preparó un antisuero en cabra. A partir de este antísuero se aislaron los anticuerpos específicos por cromatrografía de afinidad, con el empleo de la IgG de ratón purificada acoplada a la Sepharosa C1-4B. Se obtuvo una concentración de los ancuerpos aislados de 1,5 mg/mL, con una cantidad que representó aproximadamente el 3 por ciento del total de anticuerpos. Se evaluó la pureza, la reactividad y la especificidad de estos anticuerpos

Uso clinico de imunoglobulinas / Clinical uses of immunoglobulins

Este artigo e resultado de revisao de literatura sobre o uso clinico de imunoglobulinas e tem como objetivo principal o de orientar e atualizar aqueles que utilizam essas preparacoes. Foram analisadas e discutidas as indicacoes profilaticas e terapeuticas desses compostos, as complicacoes e o risco de infeccoes associadas ao uso de imunoglobulinas.

Alotipos del complemento (BF y C4) y haplotipos HLA extendidos en familias venezolanas con diabetes mellitus insulino dependiente / Allotypes of complement (BF y C4) and haplotypes HLA extended in venezuelan family with diabetes mellitus insulin dependent

Se estudiaron 25 familias venezolanas que incluían cada una al paciente y ambos padres, cuyos haplotipos HLA habían sido determinados en el laboratorio. La alotipificación del complemento se realizó por la técnica de electroforésis de alto voltaje (EFAV) en agarosa seguida de inmunofijación con un antisuero específico para el factor B y de EFAV en agarosa seguida de inmunofijación y/o revelado hemolítico en el caso de C4. Se encontró entre nuestros pacientes frecuencia aumentada de manera significativa de alelos clase II, seguidos por clase III y clase I: DR3,DR4,DQW2,BF*F1,C4A*B3BQ,C4*B2,B8,B18 y CW7. Al considerar combinaciones de alelos el mayor riesgo relativo estuvo asociado a heterocigotos DR3/DR4 y al haplotipo B18,BFF1,C4A3B QO/DR3,DQW2. Las asociaciones concuerdan en gran parte con las reportadas para diabeticos causoides del sur de Europa, especificamente para diabeticos españoles, lo cual era de esperarse si se tiene en cuenta que de allí se originó nuestra carga genética caucasoide

Lack of efficacy of the standard potency Edmonston-Zagreb live, attenuated measles vaccine in African infants

The efficacy of standard potency Edmonston-Zagreb (E-Z) measles vaccine was tested in a randomized trial of Black infants in a rural area of South Africa where a measles epidemic was occurring. The following immunization schedules were used: 48 infants aged 4-8.5 months who received 3.9 log 50 infectious units of E-Z vaccine (group A); 48 infants aged 4-8.5 months who received 3.28 log 50 infectious units of Schwarz vaccine (group B); and 28 infants aged greater than 9 months who received 3.28 log 50 infectious units of Schwarz vaccine and served as controls (group C). For infants aged less than 23 weeks who were given either the E-Z or Schwarz vaccine, the number of seropositives was low (28%), irrespective of the pre-vaccination level of measles antibody. There was a higher number of seropositives (68%) among those in the age range greater than 23 weeks to less than 36 weeks who received the E-Z vaccine rather than the Schwarz vaccine (36%). When administered to children aged greater than 36 weeks, the Schwarz vaccine produced a satisfactory, though suboptimal response rate (61%). There was no correlation between seropositivity and pre-vaccination measles antibody status. Use of the standard dose of E-Z vaccine may have been one of the factors for this poor response, and this supports the WHO recommendation that titres higher than the standard potency vaccine are needed if 6-month-old infants are to be successfully immunized against measles

Quantitation of isotype specific Haemophilus influenzae antibody in serum and saliva of normal subjects and chronic bronchitics.

An immunoglobulin isotype specific radioimmunoassay procedure has been developed to assess the antibody response to Haemophilus influenzae somatic antigens in serum and mucosal secretions. This assay was reproducible (between assay CV% 13.9; within assay CV% 4.5 IgG, 3.9 IgA, 3.0 IgM) and specific for H1/H2 antigens. Different patterns of antibody were observed in healthy children (aged 5-10 years), adults and patients with chronic bronchitis. In serum, 20% of chronic bronchitics had antibody levels greater than those observed in healthy adults. In saliva, the proportion of chronic bronchitic patients with high levels (greater than 12% binding) of IgG specific antibody was significantly greater (P less than 0.05) than in healthy adults or children. The proportion of children and chronic bronchitics which had antibody levels of up to 4% binding was significantly greater (P less than 0.05) than that observed in healthy adults. A similar pattern was observed for IgM specific antibody. The occurrence of IgA specific antibody in the saliva in children and chronic bronchitics was consistently greater than that observed in adults for all levels of antibody (P less than 0.05). Chronic bronchitics with high levels of antibody had greater infection and mortality rates.