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Relationship of selective IgE deficiency with autoimmune diseases

Year 2023, Volume: 13 Issue: 5, 918 - 922, 30.09.2023

Nurhan Sayaca

https://doi.org/10.16899/jcm.1350196

Abstract

Abstract
Introduction and Aim: Selective IgE deficiency (SIgED) is currently defined as a significant decrease in serum levels of IgE (≤2 kIU/L) in a patient whose other immunoglobulin levels are normal. The clinical spectrum of SIgED is unknown still. This study aimed to determine the relationship between SIgED and autoimmune diseases in an allergy and immunology clinic of a university hospital.
Methods: A retrospective study of the data obtained from medical records of 40 patients, 27 were female (67.5%), and the mean age was 39 years (range 20–69 years) and IgE levels of ≤2.0 kIU/L with normal immunoglobulin (Ig) IgG, IgA, and IgM levels.
Results: A total of 40 patients , 27 females (67.5 %) and 13 males (32.5%), were included in the study. The mean age of the patients was 39 ±13.06 years (range 20–69). In the present study, 35% of patients had an autoimmune disease (N:14), however 65% of patients did not have any autoimmune disease (N:26). Hashimoto’s thyroiditis being the most frequent (N:6) in 15% which is followed by systemic lupus erythematosus (SLE) (N:3) in 7.5%, celiac disease (N: 2) in 5%, chronic spontaneous urticaria (CSU) (N:1) in 2.5%, vitiligo (N:1) in 2.5%, type 1 diabetes mellitus (DM) (N:1) in 2.5%.
Conclusion: SIgED, should be defined clearly with cut-off values of IgE. Physicians should show more attention to the low IgE values and investigate patients about autoimmune diseases which can be seen together with SIgED. More studies should be conducted to investigate associated diseases with SIgED.

Keywords

Immunoglobulin E Autoimmune disease Selective Immunglobulin E deficiency

References

  • 1. Olewicz-Gawlik A, Kowala-Piaskowska A. Self-reactive IgE and anti-IgE therapy in autoimmune diseases. Front Pharmacol. 2023;14:1–10.
  • 2. Fitzsimmons CM, Falcone FH, Dunne DW. Helminth allergens, parasite-specific IgE, and its protective role in human immunity. Front Immunol. 2014;5:1–12.
  • 3. D. Ferastraoaru, H. J. Bax, C. Bergmann, M. Capron, M. Castells, D. Dombrowicz, et. al. .AllergoOncology: Ultra-low IgE, a potential novel biomarker in cancer - A Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI). Clin Transl Allergy. 2020;10(1):1–16.
  • 4. Platts-Mills T A E, Schuyler A J, Erwin E A, Commins S P, Woodfolk J A . IgE in the diagnosis and treatment of allergic disease. J Allergy Clin Immunol. 2016;137(6):1662–1670.
  • 5. Bousfiha A, Jeddane L, Picard C, Al-Herz W, Ailal F, Chatila T et.al. Human Inborn Errors of Immunity: 2019 Update of the IUIS Phenotypical Classification. J Clin Immunol. 2020;40(1):66–81.
  • 6. Tangye SG, Al-Herz W, Bousfiha A, Chatila T, Cunningham-Rundles C, Etzioni A et. al. Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol. 2020;40(1):24–64.
  • 7. Megha KB, Mohanan P V. Role of immunoglobulin and antibodies in disease management. Int J Biol Macromol. 2021;169(1):28–38.
  • 8. Magen E, Schlesinger M, David M, Ben-Zion I, Vardy D. Selective IgE deficiency, immune dysregulation, and autoimmunity. Allergy Asthma Proc. 2014;35(2):27-33.
  • 9. Ameratunga R, Allan C, Woon ST. Defining Common Variable Immunodeficiency Disorders in 2020. Immunol Allergy Clin North Am. 2020;40(3):403–420.
  • 10. Chan AY, Torgerson TR. Primary immune regulatory disorders: A growing universe of immune dysregulation. Curr Opin Allergy Clin Immunol. 2020;20(6):582–590.
  • 11. Filion CA, Taylor-Black S, Maglione PJ, Radigan L, Cunningham-Rundles C. Differentiation of Common Variable Immunodeficiency From IgG Deficiency. J Allergy Clin Immunol Pract. 2019;7(4):1277–1284.
  • 12. Barton JC, Bertoli LF, Barton JC. Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients. J Immunol Res. 2014;2014.:542706. Epub 2014 Sep 11
  • 13. Parker AR, Skold M, Harding S, Clayborn Barton J, Bertoli LF, Barton JC. Pneumococcal vaccination responses in adults with subnormal IgG subclass concentrations. BMC Immunol. 2019;20(1):1–11.
  • 14. Elkuch M, Greiff V, Berger CT, Bouchenaki M, Daikeler T, Bircher A et. al. Low immunoglobulin E flags two distinct types of immune dysregulation. Clin Exp Immunol. 2017;187(3):345–352.
  • 15. Barton JC, Barton JC, Bertoli LF. Hypogammaglobulinemia E in 216 adults with IgG subclass deficiency and respiratory tract infections. Ann Allergy, Asthma Immunol. 2017;119(3):292–294.
  • 16. Polmar SH, Waldmann TA, Terry WD. IgE in immunodeficiency. Am J Pathol. 1972;69(3):499–512.
  • 17. Stites DP, Ishizaka K, Fudenberg H Serum Ige concentrations in hypogamma- globulinaemia and selective Iga deficiency. Clin. exp. Immunol. 1972;10;391–397.
  • 18. Unsworth DJ, Virgo PF, Lock RJ. Immunoglobulin E deficiency: A forgotten clue pointing to possible immunodeficiency? Ann Clin Biochem. 2011;48(5):459–461.
  • 19. McVicker S, Karim MY. IgE deficiency may indicate underlying hypogammaglobulinaemia? J Clin Pathol. 2014;67(9):832–833.
  • 20. Lawrence MG, Palacios-Kibler TV, Workman LJ, Schuyler AJ, Steinke JW, Payne SC et. al. Low Serum IgE Is a Sensitive and Specific Marker for Common Variable Immunodeficiency (CVID). J Clin Immunol. 2018;38:225–233.
  • 21. Smith JK, Krishnaswamy GH, Dykes R, Reynolds S, Berk SL. Clinical manifestations of IgE hypogammaglobulinemia. Ann Allergy, Asthma Immunol. 1997;78(3):313–318.
  • 22. Singh K, Chang C, Gershwin ME. IgA deficiency and autoimmunity. Autoimmun Rev. 2014;13(2):163–177.
  • 23. Swain S, Selmi C, Gershwin ME, Teuber SS. The clinical implications of selective IgA deficiency. J Transl Autoimmun. 2019;2:100025.
  • 24. Campochiaro C, Atay S, Clark KEN, Ong V, Denton CP. Autoimmunity and immunodeficiency at the crossroad: Autoimmune disorders as the presenting feature of selective IgM deficiency. BMJ Case Rep. 2019;12(1):2017–2019.
  • 25. Gupta S, Gupta A. Selective IgM deficiency-An underestimated primary immunodeficiency. Front Immunol. 2017;8;1–7.
  • 26. Janssen LMA, van der Flier M, de Vries E. Lessons Learned From the Clinical Presentation of Common Variable Immunodeficiency Disorders: A Systematic Review and Meta-Analysis. Front Immunol. 2021;12;1–16.
  • 27. Lucuab-Fegurgur D, Gupta S. Comprehensive Clinical and Immunological Features of Adult Selective Primary Igm Deficiency: Response To Immunoglobulin Therapy. Ann Allergy, Asthma Immunol. 2018;121(5):10.
  • 28. Goldstein MF, Goldstein AL, Dunsky EH, Dvorin DJ, Belecanech GA, Shamir K. Selective IgM immunodeficiency: Retrospective analysis of 36 adult patients with review of the literature. Ann Allergy, Asthma Immunol. 2006;97(6):717–30.
  • 29. Khokar A, Gupta S. Clinical and Immunological Features of 78 Adult Patients with Primary Selective IgG Subclass Deficiencies. Arch Immunol Ther Exp (Warsz) [Internet]. 2019;67(5):325–334.
  • 30. Schussler E, Beasley MB, Maglione PJ. Lung Disease in Primary Antibody Deficiencies. J Allergy Clin Immunol Pract. 2016;4(6):1039–1052.
  • 31. Picado C, Ortiz de Landazuri I, Vlagea A, Bobolea I, Arismendi E, Amaro R et. al. Spectrum of disease manifestations in patients with selective immunoglobulin E deficiency. J Clin Med. 2021;10(18).

Selektif IgE Eksikliği ve Otoimmun Hastalık İlişkisi

Year 2023, Volume: 13 Issue: 5, 918 - 922, 30.09.2023

Nurhan Sayaca

https://doi.org/10.16899/jcm.1350196

Abstract

Giriş ve Amaç: Selektif IgE eksikliği (SIgED), günümüzde diğer immünglobulin düzeyleri normal olan bir hastada serum IgE düzeylerinde (≤2 kIU/L) anlamlı bir azalma olarak tanımlanmaktadır. SIgED'in klinik spektrumu hala bilinmemektedir. Bu çalışmada bir üniversite hastanesinin alerji ve immünoloji kliniğinde SIgED ile otoimmün hastalıklar arasındaki ilişkinin belirlenmesi amaçlandı.
Metod: 27'si kadın (%67,5) yaş ortalaması 39 (dağılım 20-69) ve IgE düzeyi ≤2,0 kIU/L iken immünglobülin (Ig) IgG, IgA ve IgM seviyeleri normal olan 40 hastanın tıbbi kayıtlarından elde edilen veriler retrospektif olarak incelendi.
Bulgular: Çalışmaya 27'si kadın (%67,5) ve 13'ü erkek (%32,5) olmak üzere toplam 40 hasta dahil edildi. Hastaların yaş ortalaması 39±13,06 yıl (dağılım 20-69) idi. Çalışmamızda hastaların %35'inde otoimmün hastalık mevcuttu (N:14), ancak hastaların %65'inde herhangi bir otoimmün hastalık yoktu (N:26). Hashimoto tiroiditi %15 ile en sık görülen (N:6) olup, bunu %7,5 ile sistemik lupus eritematozus (SLE) (N:3), %5 ile çölyak hastalığı (N:2), kronik spontan ürtiker (KSU) (N:1) %2,5, vitiligo (N:1) %2,5, tip 1 diyabet (DM) (N:1) %2,5 takip etmektedir.
Sonuçlar: SIgED, IgE için belirlenecek eşik değerleri ile net bir şekilde tanımlanmalıdır. Hekimlerin düşük IgE değerlerine daha fazla dikkat etmesi ve hastaları SIgED ile birlikte görülebilen otoimmün hastalıklar açısından araştırmaları gerekmektedir. SIgED ile ilişkili hastalıkların araştırılması için daha fazla çalışma yapılmalıdır.

Keywords

İmmunglobulin E Otoimmun hastalık Selektif İmmunglobulin E eksikliği

References

  • 1. Olewicz-Gawlik A, Kowala-Piaskowska A. Self-reactive IgE and anti-IgE therapy in autoimmune diseases. Front Pharmacol. 2023;14:1–10.
  • 2. Fitzsimmons CM, Falcone FH, Dunne DW. Helminth allergens, parasite-specific IgE, and its protective role in human immunity. Front Immunol. 2014;5:1–12.
  • 3. D. Ferastraoaru, H. J. Bax, C. Bergmann, M. Capron, M. Castells, D. Dombrowicz, et. al. .AllergoOncology: Ultra-low IgE, a potential novel biomarker in cancer - A Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI). Clin Transl Allergy. 2020;10(1):1–16.
  • 4. Platts-Mills T A E, Schuyler A J, Erwin E A, Commins S P, Woodfolk J A . IgE in the diagnosis and treatment of allergic disease. J Allergy Clin Immunol. 2016;137(6):1662–1670.
  • 5. Bousfiha A, Jeddane L, Picard C, Al-Herz W, Ailal F, Chatila T et.al. Human Inborn Errors of Immunity: 2019 Update of the IUIS Phenotypical Classification. J Clin Immunol. 2020;40(1):66–81.
  • 6. Tangye SG, Al-Herz W, Bousfiha A, Chatila T, Cunningham-Rundles C, Etzioni A et. al. Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol. 2020;40(1):24–64.
  • 7. Megha KB, Mohanan P V. Role of immunoglobulin and antibodies in disease management. Int J Biol Macromol. 2021;169(1):28–38.
  • 8. Magen E, Schlesinger M, David M, Ben-Zion I, Vardy D. Selective IgE deficiency, immune dysregulation, and autoimmunity. Allergy Asthma Proc. 2014;35(2):27-33.
  • 9. Ameratunga R, Allan C, Woon ST. Defining Common Variable Immunodeficiency Disorders in 2020. Immunol Allergy Clin North Am. 2020;40(3):403–420.
  • 10. Chan AY, Torgerson TR. Primary immune regulatory disorders: A growing universe of immune dysregulation. Curr Opin Allergy Clin Immunol. 2020;20(6):582–590.
  • 11. Filion CA, Taylor-Black S, Maglione PJ, Radigan L, Cunningham-Rundles C. Differentiation of Common Variable Immunodeficiency From IgG Deficiency. J Allergy Clin Immunol Pract. 2019;7(4):1277–1284.
  • 12. Barton JC, Bertoli LF, Barton JC. Comparisons of CVID and IgGSD: Referring Physicians, Autoimmune Conditions, Pneumovax Reactivity, Immunoglobulin Levels, Blood Lymphocyte Subsets, and HLA-A and -B Typing in 432 Adult Index Patients. J Immunol Res. 2014;2014.:542706. Epub 2014 Sep 11
  • 13. Parker AR, Skold M, Harding S, Clayborn Barton J, Bertoli LF, Barton JC. Pneumococcal vaccination responses in adults with subnormal IgG subclass concentrations. BMC Immunol. 2019;20(1):1–11.
  • 14. Elkuch M, Greiff V, Berger CT, Bouchenaki M, Daikeler T, Bircher A et. al. Low immunoglobulin E flags two distinct types of immune dysregulation. Clin Exp Immunol. 2017;187(3):345–352.
  • 15. Barton JC, Barton JC, Bertoli LF. Hypogammaglobulinemia E in 216 adults with IgG subclass deficiency and respiratory tract infections. Ann Allergy, Asthma Immunol. 2017;119(3):292–294.
  • 16. Polmar SH, Waldmann TA, Terry WD. IgE in immunodeficiency. Am J Pathol. 1972;69(3):499–512.
  • 17. Stites DP, Ishizaka K, Fudenberg H Serum Ige concentrations in hypogamma- globulinaemia and selective Iga deficiency. Clin. exp. Immunol. 1972;10;391–397.
  • 18. Unsworth DJ, Virgo PF, Lock RJ. Immunoglobulin E deficiency: A forgotten clue pointing to possible immunodeficiency? Ann Clin Biochem. 2011;48(5):459–461.
  • 19. McVicker S, Karim MY. IgE deficiency may indicate underlying hypogammaglobulinaemia? J Clin Pathol. 2014;67(9):832–833.
  • 20. Lawrence MG, Palacios-Kibler TV, Workman LJ, Schuyler AJ, Steinke JW, Payne SC et. al. Low Serum IgE Is a Sensitive and Specific Marker for Common Variable Immunodeficiency (CVID). J Clin Immunol. 2018;38:225–233.
  • 21. Smith JK, Krishnaswamy GH, Dykes R, Reynolds S, Berk SL. Clinical manifestations of IgE hypogammaglobulinemia. Ann Allergy, Asthma Immunol. 1997;78(3):313–318.
  • 22. Singh K, Chang C, Gershwin ME. IgA deficiency and autoimmunity. Autoimmun Rev. 2014;13(2):163–177.
  • 23. Swain S, Selmi C, Gershwin ME, Teuber SS. The clinical implications of selective IgA deficiency. J Transl Autoimmun. 2019;2:100025.
  • 24. Campochiaro C, Atay S, Clark KEN, Ong V, Denton CP. Autoimmunity and immunodeficiency at the crossroad: Autoimmune disorders as the presenting feature of selective IgM deficiency. BMJ Case Rep. 2019;12(1):2017–2019.
  • 25. Gupta S, Gupta A. Selective IgM deficiency-An underestimated primary immunodeficiency. Front Immunol. 2017;8;1–7.
  • 26. Janssen LMA, van der Flier M, de Vries E. Lessons Learned From the Clinical Presentation of Common Variable Immunodeficiency Disorders: A Systematic Review and Meta-Analysis. Front Immunol. 2021;12;1–16.
  • 27. Lucuab-Fegurgur D, Gupta S. Comprehensive Clinical and Immunological Features of Adult Selective Primary Igm Deficiency: Response To Immunoglobulin Therapy. Ann Allergy, Asthma Immunol. 2018;121(5):10.
  • 28. Goldstein MF, Goldstein AL, Dunsky EH, Dvorin DJ, Belecanech GA, Shamir K. Selective IgM immunodeficiency: Retrospective analysis of 36 adult patients with review of the literature. Ann Allergy, Asthma Immunol. 2006;97(6):717–30.
  • 29. Khokar A, Gupta S. Clinical and Immunological Features of 78 Adult Patients with Primary Selective IgG Subclass Deficiencies. Arch Immunol Ther Exp (Warsz) [Internet]. 2019;67(5):325–334.
  • 30. Schussler E, Beasley MB, Maglione PJ. Lung Disease in Primary Antibody Deficiencies. J Allergy Clin Immunol Pract. 2016;4(6):1039–1052.
  • 31. Picado C, Ortiz de Landazuri I, Vlagea A, Bobolea I, Arismendi E, Amaro R et. al. Spectrum of disease manifestations in patients with selective immunoglobulin E deficiency. J Clin Med. 2021;10(18).
There are 31 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Research
Authors

Nurhan Sayaca 0000-0002-3081-9098

Publication Date September 30, 2023
Acceptance Date September 22, 2023
Published in Issue Year 2023 Volume: 13 Issue: 5

Cite

AMA Sayaca N. Relationship of selective IgE deficiency with autoimmune diseases. J Contemp Med. September 2023;13(5):918-922. doi:10.16899/jcm.1350196
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