J. Vivian Wells

Anaphylactic reactions to plasma infusions in patients with hypogammaglobulinemia and anti-IgA antibodies☆

Abstract Two patients with common variable hypogammaglobulinemia developed anaphylactic reactions when given very small infusions of normal human plasma containing IgA. Their sera were examined for antibodies to human IgA by passive hemagglutination against human erythrocytes coated by the chromic chloride method with a panel of purified IgA myeloma and normal proteins, and specificity was determined by inhibition of agglutination. Both patients were found to have IgG anti-IgA antibodies of multiple specificity. Differential absorption studies in the second case showed antibodies to IgA 1 and IgA 2 and to A2m(1) and A2m(2). To our knowledge, this is the first report of anti-IgA antibodies with multiple specificities in a single patient. These two cases illustrate the possibility of sensitization to human IgA in patients with severe humoral antibody deficiency syndromes, who might not be expected to form antibodies to new antigens. Presumably and kind of anti-IgA, regardless of specificity, can cause severe anaphylactic reaction.

Correlation of Gm allotype, antibody response, and mortality

Abstract Sera were typed for Gm allotypes a, g, f, b from 135 persons, healthy or with various illnesses, who could be classified as high responders or low responders to the antigen monomeric flagellin. In a retrospective analysis after 6 yr, the mortality experience differed according to Gm type and responder status. The group of 87 Gm (a,g) subjects, homozygotes and heterozygotes, contained proportionately more high responders than did the group of 48 Gm (−a, −g) subjects, and the former group contained 71 survivors (82%), whereas the latter contained 28 survivors (56%) (P = 0.006). Also there were more survivors among high responders than low responders Gm (−a, −g) subjects were assumed to have either a lower immune responsiveness to certain bacterial antigens, or a greater predisposition to certain of the illnesses represented in the subjects studied.

Immunobiology of human anti-IgM iso-antibodies. I. Clinical and serological studies☆

Abstract Antibodies against human IgM were sought by hemagglutination with a panel of proteins including 19 Waldenstrom macroglobulins. The 620 sera tested included normal blood donors of different races and patients with various forms of immune deficiency and their relatives. Anti-IgM antibodies were detected in 50 subjects (8.1%) at a titer of 1:4 or greater; they included 30 subjects who were clinically normal, 9 with recurrent infections, 4 with ataxia telangiectasia, 3 with Wiskott-Aldrich syndrome, 2 with acquired hypogammaglobulinemia, and one each with chronic active hepatitis, hemophilia, and reactions to immune serum globulin. Anti-IgM antibodies were found in 23.8% of immunodeficient subjects and 1.6% of normal blood donors; 30 subjects with anti-IgM antibodies had a decrease in at least one serum immunoglobulin. There was no association between anti-IgM antibodies and other autoantibodies and the biological significance of these antibodies is not clear.