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Celiac disease is an autoimmune enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. In patients with suspected celiac disease, measurement of serum IgA antibodies to tissue transglutaminase-2 has a high sensitivity and specificity and is the first screening test that should be ordered. The diagnosis of celiac disease is based on the presence of mucosal damage in small intestinal biopsies in patients having circulating celiac disease-specific antibodies. Celiac disease management includes lifelong adherence to a gluten-free diet and continuous long-term follow-up.

Актуальность. Новые рекомендации Всемирной организации здравоохранения по лечению диареи касаются применения цинка (Zn). Zn при диарее улучшает абсорбцию воды в кишечнике, ускоряет регенерацию энтероцитов, увеличивает количество кишечных ферментов, улучшает иммунный ответ, важным звеном которого является иммуноглобулин А (IgA). Целью было определить уровни Zn и IgA в сыворотке крови детей раннего возраста в динамике острой инфекционной диареи (ИД) бактериальной и вирусной этиологии. Материалы и методы. Под наблюдением находились 36 детей в возрасте от 4 месяцев до 15 лет с инфекционной диареей. Дети были разделены на три группы: I — 14 детей в возрасте до двух лет с ИД бактериальной этиологии, II — 9 детей соответствующего возраста с ИД ротавирусной этиологии, III — 13 детей с диареей в возрасте старше двух лет. У детей были определены уровни Zn и IgA в сыворотке крови на 1-й и 5-й день лечения. Результаты. Установлено, что у 19,44 % больных ИД отмечается низкий уровень Zn сыворотки крови в 1-й день стационарного лечения, а у 25 % — выше нормы. У больных I и II группы низкий уровень Zn был у 26,09 %, выше нормы — у 13,04 % (6,78–35,5 мкмоль/л), а у детей группы III — у 11,11 % был ниже нормы и у 66,67 % — высоким (7,9–9,5 мкмоль/л). Разницы в частоте гипоцинкемии у детей раннего возраста с ИД ротавирусной и бактериальной этиологии выявлено не было. Также было определено снижение уровня сывороточного IgA у каждого 8-го больного среди детей раннего возраста в первые дни стационарного лечения при отсутствии относительных изменений в старшей возрастной группе. На 5-й день стационарного лечения произошла нормализация показателей цинка и сывороточного IgА у всех детей. Выводы. Таким образом, у четверти детей раннего возраста в остром периоде ИД вирусной или бактериальной этиологии наблюдается дефицит цинка и недостаточность сывороточного IgА, что требует проведения дальнейших клинико-лабораторных обследований.

lt;bgt;Background and Objective:lt;/bgt; A well-established treatment for childhood epilepsy, the Ketogenic Diet (KD) is increasingly gaining acceptance as a preventative tool for obesity. The current study aims to compare the effects of a ketogenic diet on some of the immunological parameters among obese individuals and contrast them with non-obese individuals. This includes finding the absolute numbers of white blood cells and estimating the efficacy of phagocytic cells and serum IgA concentration.lt;bgt;Materials and Methods:lt;/bgt; Twenty healthy persons were chosen for the study, with an age range between 18-45 years, a weight range before the ketogenic diet of 80-115 kg and after the ketogenic diet 60-80 kg with a height range between 155-180 cm during a period between 8-16 weeks. Their daily food was composed of high fats (80%), moderate protein (15%) and small amounts of carbohydrates (5%). The control sample included twenty healthy subjects, their food consisted of different types of food carbohydrates (75-80%), proteins (10%) and fats (10%).lt;bgt;Results:lt;/bgt; The results showed a significant increase in the White Blood Cells (WBC) count in KD individuals. Additionally, no significant difference was noticed in the absolute number of neutrophils and lymphocytes. Conversely, a significant increase in the absolute number of monocytes was observed. Moreover, the study showed a significant decrease in IgA concentration in KD individuals compared with control.lt;bgt;Conclusion:lt;/bgt; In the ketogenic system users indicated a rise in the number of monocytes and a decrease in the concentration of IgA. This provides a strong sign that autoimmune disorders are emerging.

Organic acids (OA) and their blends have been shown to positively affect performance and health of broilers. However, the data in the literature are not consistent. This study examined the potential of blended short-chain fatty acids (SCFA) with medium-chain fatty acids (MCFA) as alternatives to antibiotic growth promoters (AGP) on performance, health and welfare of broilers infected with necrotic enteritis (NE). The additives used were: A) a blend of SCFA, MCFA, and a phenolic compound (SMP); B) a blend of free and buffered SCFA with MCFA (SMF); C) a blend of free and buffered SCFA with a high concentration of MCFA (SHM). A total of 1,404 Ross 308 one-day-old male parental chicks were randomly distributed into 78-floor pens with 13 replicates of 18 birds each. Six treatments were the following: T1, unchallenged control (UCC); T2, challenged control (CHC); T3, challenged group plus zinc bacitracin (BAC); T4, challenged group plus additive SMP; T5, challenged group plus additive SMF; T6, challenged group plus additive SHM. Challenged birds were gavaged with Eimeria spp. on d 9 and Clostridium perfringens EHE-NE18 on d 14. Post NE challenge and cumulatively, BWG, FCR, and nutrient digestibility of birds were compromised (P 0.05). All the 3 additive groups had lower FCR compared to CHC (P = 0.001; d 0 to 35), and exhibited similar jejunal lesions (d 16) compared to BAC and apparent ileal protein digestibility (d 21) compared to UCC and BAC groups (P > 0.05). Birds in additive SHM group had a higher concentration of serum IgA compared to all groups (P = 0.001) except additive SMF (P > 0.05; d 21). All the additive groups had lower footpad dermatitis and hock burns compared to CHC (P

Common variable immunodeficiency (CVID) can be associated with a range of serum IgA concentrations, from absent, to variably reduced, and in some patients classified as 'possible CVID', even normal. The aim of this study was to assess the proportion of duodenal plasma cells in patients with CVID and determine whether there was an association with serum IgA concentration. Duodenal biopsies obtained at upper endoscopy from 35 patients with CVID were assessed for the presence of plasma cells and compared with serum IgA concentrations. A reduction or absence of duodenal plasma cells in 60% of patients with CVID and an association between the proportions of duodenal plasma cells and serum IgA concentrations was demonstrated. The presence of duodenal plasma cells associated with numbers of isotype switched memory B cells in the peripheral blood. A reduction in serum IgA over time was observed in 19% of CVID patients. The gastrointestinal tract provides a window into the immune system in CVID, and these results reinforce the association between gastrointestinal plasma cells and serum IgA concentrations. Preservation of gastrointestinal plasma cells and serum IgA in some patients with CVID, and the sequential decline of both in others, highlight the heterogeneity of this disorder.

Background and Aims ROTAVAC® (frozen formulation stored at −20 °C) and ROTAVAC 5D® (liquid formulation stable at 2–8 °C) are rotavirus vaccines derived from the 116E human neonatal rotavirus strain, developed and licensed in India. This study evaluated and compared the safety and immunogenicity of these vaccines in an infant population in Zambia. Methods We conducted a phase 2b, open-label, randomized, controlled trial wherein 450 infants 6 to 8 weeks of age were randomized equally to receive three doses of ROTAVAC or ROTAVAC 5D, or two doses of ROTARIX®. Study vaccines were administered concomitantly with routine immunizations. Blood samples were collected pre-vaccination and 28 days after the last dose. Serum anti-rotavirus IgA antibodies were measured by ELISA, with WC3 and 89–12 rotavirus strains as viral lysates in the assays. The primary analysis was to assess non-inferiority of ROTAVAC 5D to ROTAVAC in terms of the geometric mean concentration (GMC) of serum IgA (WC3) antibodies. Seroresponse and seropositivity were also determined. Safety was evaluated as occurrence of immediate, solicited, unsolicited, and serious adverse events after each dose. Results The study evaluated 388 infants in the per-protocol population. All three vaccines were well tolerated and immunogenic. The post-vaccination GMCs were 14.0 U/mL (95% CI: 10.4, 18.8) and 18.1 U/mL (95% CI: 13.7, 24.0) for the ROTAVAC and ROTAVAC 5D groups, respectively, yielding a ratio of 1.3 (95% CI: 0.9, 1.9), thus meeting the pre-set non-inferiority criteria. Solicited and unsolicited adverse events were similar across all study arms. No death or intussusception case was reported during study period. Conclusions Among Zambian infants, both ROTAVAC and ROTAVAC 5D were well tolerated and the immunogenicity of ROTAVAC 5D was non-inferior to that of ROTAVAC. These results are consistent with those observed in licensure trials in India and support use of these vaccines across wider geographical areas.

Objectives The aim of the present study is to evaluate the role of immunoglobulins (IgA, IgG, and IgM) and circulating immune complexes (CIC) as tumor marker in oral cancer and precancer patients. Materials and Methods The present study was performed on 45 individuals subdivided into three groups, that is, oral precancer, oral cancer and healthy individuals, and levels of immunoglobulins, and CIC was estimated by turbidometry and ELISA method. Results In the present study, the mean serum IgA levels in oral precancer were 161.00 ( ± 118.02) mg/dL, oral cancers were 270.67 ( ± 171.44) mg/dL, and controls were 133.73 ( ± 101.31) mg/dL. Mean serum levels of IgG in oral precancer were 1,430.87 ( ± 316) mg/dL, oral cancers were 1,234.27 ( ± 365.42) mg/dL, and controls were 593.87 ( ± 323.06) mg/dL. Conclusion We found that the levels of serum IgG and IgA were elevated consistently in precancer and cancer group, and Serum IgM levels were increased only in precancer. Also, significant increase in serum CIC levels were seen in oral precancer and cancer group on comparison with control.

Autoimmune disorders are reported as presenting signs in patients with immunoglobulin A (IgA) deficiency. Herein, we aim to evaluate serum IgA among patients with autoimmune polyendocrinopathy.Patients with two or more autoimmune endocrinopathies were selected and the serum IgA levels were measured. Patients with an isolated low serum IgA (7 mg/dL) after exclusion of other causes of hypogammaglobulinemia were considered as selective IgA deficiency (SIgAD), while partial IgA deficiency (PIgAD) was defined as IgA levels below lower limits of IgA normal range for age but higher than 7 mg/dL.Fifty-three patients (19 [35.8%] male and 34 [64.2%] female) with autoimmune polyendocrinopathy enrolled in the study. Parental consanguinity and positive family history of autoimmunity were reported in 38.0% and 52.9% of patients, respectively. Overall, IgA deficiency was observed in 5 (9.4%) patients including PIgAD in 3 (5.7%) and SIgAD in 2 (3.8%) patients. Among IgA deficient patients, the first autoimmune disorder was developed at earlier ages (The prevalence of IgA deficiency in patients with autoimmune polyendocrinopathy is higher than that in the general population. In these patients, immunologic workup may lead to early diagnosis of inborn error of immunity, which can positively impact the evolution of complications and even management of the autoimmune disorders.

Introduction. The search for possible prognostic criteria for the severity of COVID-19 is very relevant, as it can provide significant assistance in choosing a more effective and personalized therapy. The degree of severity of the infectious process is reflected by acute-phase proteins, in particular ferritin. The degree of informative assessment of its level as a predictive criterion is debatable, which determined the purpose of this study. Aim of the study – to reveal the clinical and immunological features of the course of COVID-19 in patients with a moderate variant of the course, depending on the level of ferritin. Material and methods. The study included patients with moderate COVID-19 (43 patients), who were subsequently divided into two groups: with high ferritin levels – 1744 mcg/l [985.75;2402.85] (22 patients) and with normal ferritin levels – 264.4 mcg/l [129.5;375.6] (21 patients). The group of comparison consisted of practically healthy donors (31 persons). Blood samples was taken for 2–3 days from the moment of admission for general clinical and biochemical analysis. CD3+-, CD4+-, CD8+-, CD16+- and CD19+-lymphocytes were evaluated by flow cytofluorimetry, as well as the level of serum IgA, IgM and IgG – by radial gel immunodiffusion by Mancini. A computer tomography of the chest organs was performed for all study participants. Results. Lymphopenia, increased levels of C-reactive protein, and active proliferation of CD19+-lymphocytes without increased antibody production were observed in the group of patients with high ferritin levels. Clinical manifestations in this group of patients are more severe than in the group with normal ferritin content. Conclusion. An increase of the blood ferritin level in patients with moderate COVID-19 is a predictor of a more severe course and is accompanied by a violation of the maturation of the T-cell part of adaptive immunity and increased proliferation of B-lymphocytes without an adequate increase of antibody formation processes. (English) [ FROM AUTHOR] Введение. Поиск возможных прогностических критериев тяжести течения COVID-19 весьма актуален, так как он может оказать существенную помощь в выборе более эффективной и персонифицированной терапии. Степень остроты инфекционного процесса отражают острофазные белки, в частности ферритин. Степень информативности оценки его уровня в качестве прогностического критерия дискуссионна, что и определило цель данного исследования. Цель – выявить клинико-иммунологические особенности течения COVID-19, формирующиеся при различных уровнях ферритина у пациентов со среднетяжелым вариантом течения. Материал и методы. В исследование включали пациентов со среднетяжелой формой COVID-19 (43 человека), которые впоследствии были разделены на две группы: лица с высоким уровнем ферритина – 1744 мкг/л [985,75;2402,85] (22 человека) и с его нормальным содержанием – 264,4 мкг/л [129,5;375,6] (21 человек). Группу сравнения составили практически здоровые доноры (31 человек). Забор крови для проведения общеклинического и биохимического анализа проводили на 2–3-и сутки с момента поступления пациента в лечебное учреждение. Содержание лимфоцитов, экспрессирующих популяционные рецепторы (CD3, CD4, CD8, CD16, CD19), оценивали методом проточной цитофлуориметрии, содержание сывороточных IgА, IgМ, IgG – методом радиальной иммунодиффузии в геле по Манчини. Всем участникам исследования проводили компьютерную томографию органов грудной клетки. Результаты. В группе пациентов с высоким уровнем ферритина отмечались лимфопения, повышение уровня С-реактивного белка и активная пролиферация СD19+лимфоцитов без усиления процессов антителогенеза. Клинические проявления у данной группы пациентов были тяжелее, чем в группе с нормальным содержанием ферритина. Заключение. Повышение уровня ферритина крови у пациентов со среднетяжелыми формами COVID-19 является предиктором более тяжелого течения и сопровождается нарушением процессов созревания Т-клеточного звена адаптивного иммунитета и усиленной пролиферацией В-лимфоцитов без адекватного усиления процессов антителогенеза. (Russian) [ FROM AUTHOR] Copyright of Immunologiya is the property of Publishing Group GEOTAR-Media and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Carbamazepine (CBZ) is one of the oldest antiepileptic drugs (AEDs) that is still used for the treatment of tonic-clonic seizures in children. Long-term use of AEDs induces potential toxic effects that may remain undetermined for a long time. Earlier studies have revealed a wide spectrum of hematological toxicities associated with CBZ. This study was conducted to unveil the toxic effects of carbamazepine as an antiepileptic monotherapy on hematological and immunological parameters in a group of Egyptian pediatric patients using it for different durations. Fifty pediatric epileptics of either sex were enrolled; 38 were taking CBZ as antiepileptic monotherapy for ≥ 6 months and 12 were newly diagnosed untreated patients. Hematological and immunological parameters studied were compared with their age and sex-matched 15 controls and among groups. CBZ was found more toxic for total leukocyte count, lymphocyte count, serum IgA and IgM levels (p

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

Ciljevi: Svrha ovog istraživanja bila je ispitati klinička obilježja IgA vaskulitisa kod pacijenata liječenih u Klinici za unutarnje bolesti KBC-a Split u petnaestogodišnjem razdoblju. Ispitanici i postupci: Istraživanje je obuhvatilo 36 bolesnika s dijagnosticiranim IgA vaskulitisom u razdoblju od 2007. do 2022. godine. Prikupljeni podaci dobiveni su iz stacionara i dnevne bolnice Zavoda za reumatologiju i imunologiju Klinike za unutarnje bolesti KBC-a Split. Podatci su tijekom prikupljanja unošeni u Microsoft Excel program dok je u statističkoj obradi korišten program MedCalc. Od testova su pritom korišteni χ2 test, Mann-Whitney test, Pearsonova korelacija i logistička regresija. Rezultati: Istraživanje je obuhvatilo 36 bolesnika s dijagnozom IgA vaskulitisa tijekom petnaestogodišnjeg razdoblja od kojih je bilo 29 muškaraca (80,6%) i 7 žena (19,4%). Medijan životne dobi iznosio je 62 godine (min-maks: 20-86 godina, Q1-Q3: 48-72 godine). Pokazala se statistički značajna razlika u razinama IgA u serumu između pacijenata starijih i mlađih od 60 godina kao i statistički značajna korelacija slabije snage između dobi i razina IgA u serumu. Od kliničkih očitovanja, najučestaliji simptom je bila purpura, zatim artritis i/ili artralgija, potom zahvaćenost bubrega te najrjeđe zahvaćenost gastrointestinalnog sustava. U konačnici se nije pokazala značajna razlika u kliničkom očitovanju kod pacijenata starijih i mlađih od 60 godina. U terapiji IgA vaskulitisa koristila se prvenstveno glukokortikoidna i imunosupresivna linija lijekova koja je u većini slučajeva dovela do poboljšanja stanja. Pritom se nije pokazala statistički značajna razlika u terapijskom izboru između definiranih dobnih skupina. Kod 10 pacijenata se određeni lijekovi mogu promatrati kao potencijalni okidači IgA vaskulitisa. Na kraju se pokazala statistički značajna razlika u broju pacijenata s poboljšanjem stanja kod uspoređivanih dobnih skupina. Zaključci: Istraživanje je pokazalo 2,4 dijagnosticirana IgA vaskulitisa godišnje i omjer muškaraca i žena od 4:1. Također, utvrđena je statistički značajna razlika u razinama IgA u serumu između mlađih i starijih pacijenata te značajna korelacija slabije snage između dobi i razine IgA u serumu. Utvrđeno je kako ne postoji značajna razlika u simptomatologiji između mlađih i starijih pacijenata, a da je pritom učestalost promatranih simptoma jednaka u oba spola. Simptomi od češćih prema rjeđima su purpura, artritis i/ili atralgija; zahvaćenost bubrega i gastrointestinalnog sustava. Najčešće primjenjivani lijekovi su kortikosteroidi i imunosupresivi koji su u većini slučajeva doveli do poboljšanja stanja, a penicilini i cefalosporini mogu biti okidači pojave IgA vaskulitisa., Objectives: The purpose of this study was to examine the clinical features of IgA vasculitis in patients treated in the Clinic for internal diseases at University Hospital of Split over a fifteen-year period. Subjects and methods: The research included 36 patients diagnosed with IgA vasculitis in the period 2007-2022. The collected data were obtained from Department of rheumatology and immunology in the Clinic for internal diseases at University Hospital of Split. Data were entered into the Microsoft Excel program during the collection, while the MedCalc program was used for statistical processing. Among the tests, the χ2 test, Mann-Whitney test, Pearson's correlation and logistic regression were used. Results: The research included 36 patients diagnosed with IgA vasculitis over a fifteen-year period, of whom there were 29 men (80.6%) and 7 women (19.4%). The median age was 62 years (min-max: 20-86 years, Q1-Q3: 48-72 years). A statistically significant difference in serum IgA levels between patients older and younger than 60 years was shown, as well as a statistically significant correlation of weaker strength between age and serum IgA levels. Of the clinical manifestations, the most common symptom was purpura, followed by arthritis and/or arthralgia, then kidney involvement, and the least frequent, involvement of the gastrointestinal system. In the end, no significant difference in clinical manifestations was shown in patients older than and younger than 60 years. In the therapy of IgA vasculitis, primarily glucocorticoid and immunosuppressive drugs were used, which in most cases led to improvement of the condition. There was no statistically significant difference in the choice of therapy between defined age groups. In 10 patients, certain drugs can be seen as potential triggers of IgA vasculitis. In the end, a statistically significant difference was shown in the number of patients with improved conditions in the compared age groups. Conclusions: The research showed 2.4 diagnosed IgA vasculitis per year and a male to female ratio of 4:1. Also, a statistically significant difference in serum IgA levels was found between younger and older patients, as well as a significant weaker correlation between age and serum IgA levels. It was found that there is no significant difference in symptomatology between younger and older patients, while the frequency of observed symptoms is the same in both sexes. Symptoms from more common to less common are purpura, arthritis and/or arthralgia; involvement of the kidneys and gastrointestinal system. The most used drugs are corticosteroids and immunosuppressants, which in most cases lead to an improvement in the condition, while penicillin and cephalosporins can be triggers for the appearance of IgA vasculitis.

Increased interest in microbiota calls for the thorough analysis of antibody reactivity to different microorganisms. As salivary IgA represents the first line of defence against microorganisms contacting mucosal surfaces, we explored the binding and specificity of salivary IgA by testing the binding of purified, FITC-labelled salivary IgA to different microorganisms in flow cytometry and conclude that this kind of analysis enables the differentiation of species/strains with high IgA binding capacity, which should be corroborated on a larger sample size. Further we compare, with in-house ELISA, the binding of polyclonal salivary IgA with the binding of polyclonal serum IgA from the same individuals to whole microbial cells and to purified microbial components. High correlations were obtained in total salivary IgA binding to Lactobacillus rhamnosus and Escherichia coli, very distant bacterial species, as well as to isolated bacterial components (r = .70–.97). The binding of total salivary IgA resembled the binding of both salivary IgA1 and IgA2, with IgA2 predominating. For serum polyclonal IgA repertoire, substantially higher specificity was obtained. Serum IgA binding to E. coli correlated best with serum IgA binding to lipopolysaccharide (r = .86), and serum IgA against L. rhamnosus correlated best with the anti-peptidoglycan IgA levels (r = .88). We have also detected that total serum IgA response is governed by either IgA1 or IgA2 response, depending on the nature of the antigen/s. We conclude that steady state salivary IgA repertoire, unlike serum IgA repertoire, consists of polyreactive antibodies with innate specificity, questioning its capacity to select resident microbiota.

Both the innate and adaptive immune responses are deregulated in individuals with obesity and are key drivers of its associated metabolic alterations. Although the anti-inflammatory growth differentiation factor 15 (GDF-15) is a candidate protein against obesity, its mechanisms regulating the immune responses are not fully cleared. We examined whether GDF-15 was related to serum immunoglobulins in a children's cohort assessed longitudinally during childhood. Results showed that circulating GDF-15 positively associated with IgA (p

BACKGROUND Dental caries is one of the most common microbial infectious diseases. The important method for as-sessment of oral health status is DMFT (Decayed, Missing, and Filled Teeth). Recent studies have shown conflicting results regarding the relationship of antibodies with dental caries. This study aimed to investigate the salivary and serum IgA and IgG levels in adult caries. METHODS This cross-sectional study was conducted on 96 patients with dental caries who were referred to the specialized dental clinic in Yasuj. Based on the DMFT index, patients were divided into three groups. DMFT index in group 1, 2, and 3 were 0, 1 - 3, and more than 3, respectively. Salivary and serum levels of IgA and IgG were measured by nephelometric method. Data were analyzed using SPSS software, chisquared, and paired t-test. RESULTS The mean salivary IgA level in group 1, 2, and 3 were 0.259 ± 0.118, 0.264 ± 0.175, and 0.169 ± 0.106 mg%, respectively (p = 0.001). Also, the mean salivary IgG level in group 1, 2, and 3 were 1.360 ± 316, 1.320 ± 0.350 and 1.320 ± 0.370 mg% (p = 0.929). The mean serum IgA level were 1.443 ± 0.433, 1.805 ± 0.518 and 1.790 ± 0.700 gr% in group 1, 2 and 3, respectively (p = 0.363). Also, the mean serum IgG level in group 1, 2, and 3 were 9.275 ± 1.899, 10.257 ± 1.658 and 10.589 ± 3.113 gr% (p = 0.451). CONCLUSIONS This study showed that by decreasing the level of salivary IgA, the rate of dental caries and DMFT index increase and this indicates the protection mechanism against dental caries by IgA.

Immunoglobulins are the primary protective products in human milk and are responsible for transferring maternal pathogen memory to the infant, providing protection by binding to recognized pathogens and inhibiting virulence. To better understand potentially protective/anti-infective compounds in human milk, the establishment of human milk–tailored analytical approaches is crucial, as most contemporary analytical methods have been optimized for plasma or serum. One of the most prominent immunoglobulins in human milk is secretory immunoglobulin A (sIgA), which may be relevant for the protection of breastfed infants from harmful pathogens. Advanced sIgA detection methods can help monitor the immune status and development of the mother-infant dyad. We therefore developed an enzyme-linked immunosorbent assay (ELISA) sIgA method for the quantitative analysis of IgA plus secretory component (SC), validated with sIgA standards and substantiated by mass spectrometry (MS)–based proteomics. A very strong correlation was observed between the MS-detected IgA1 and the human milk–specific sIgA ELISA (r = 0.82). Overall, the MS data indicate that the developed human milk sIgA ELISA does not differentiate between sIgA1 and sIgA2 and is, therefore, a reflection of total sIgA. Furthermore, our MS data and the human milk–derived sIgA ELISA data are better correlated than data derived from a standard serum IgA ELISA kit (relative to MS IgA1 r = 0.82 and r = 0.42, respectively). We therefore propose our human milk–specific sIgA ELISA as an ideal quantitative indicator of total sIgA with advantages over current serum IgA ELISA kits. Supplementary Information The online version contains supplementary material available at 10.1007/s00216-021-03468-4.

Background Smokeless tobacco (SLT) remains a threat amongst a large population across the globe and particularly in India. Among the 28 known carcinogens in SLT, tobacco-specific nitrosamines are considered to be the most potent and it has been shown to cause immunomodulatory effects making the individual susceptible to various diseases. Immunoglobulins (Ig) form the defense against pathogens at the mucosal surfaces and SLT might interfere with its production and function. Therefore, the present study was undertaken to estimate the level of IgG and IgA in SLT patients and establish a correlation between them. Materials and methods A total of 60 subjects (34 khaini users and 26 gutkha users) were selected for the study. Complete demographic data and history was taken and clinical examination done to evaluate any oral mucosal changes. Venous blood samples were taken to analyze the serum immunoglobulin parameters. Results Significant changes were observed in the serum IgA and IgG level in SLT users. Serum IgG level had a positive correlation whereas serum IgA had a negative correlation with the form of SLT and were statistically insignificant. Conclusion The present study might serve as an early diagnostic tool and helpful in creating awareness on the hazards of using SLT among the Indian population as a despicable substitute to smoking tobacco. It also confers an imperative role into SLT mediated effects on immunoglobulins levels.

BACKGROUNDTo identify an IgA deficiency, the availability of reliable IgA lower reference limits is essential, especially in pediatrics. In this study, we reported the results of an intercomparison study aimed to verify the status of standardization of IgA measurements using 11 commercially available measuring systems (MSs).METHODSAfter confirming its commutability, the ERM-DA470k/IFCC reference material was used for the trueness evaluation of IgA MSs. Furthermore, the interassay agreement was verified using 18 patient pools. By combining the bias, if any, between the obtained mean of ERM-DA470k/IFCC and its target value and the mean imprecision of MSs with the uncertainty of respective calibrators, we also estimated the mean uncertainty (U) of IgA measurements on clinical samples.RESULTSAlthough the majority of IgA MSs were sufficiently aligned with each other, the bias against the ERM-DA470k/IFCC target value was unacceptable in 55% of cases. This bias resulted in an excessive U of IgA measurement on clinical samples. Importantly, when the analysis focused on the lower IgA concentrations—typical of children—the situation worsened, with only 4 MSs showing good equivalence.CONCLUSIONSAlthough the harmonization among most commercially available IgA MSs is good, the implementation of traceability to higher order references is inadequate, especially at concentrations ≤0.7 g/L. This analytical background information needs to be considered carefully when defining traceable reference intervals in the pediatric population.

The human body is daily exposed to possible pathogens such as bacteria, viruses, fungi and parasites, as well as to essential non-body food components. The immune system ensures that there is a good balance between tolerating important elements such as the nutrients in our diet on the one hand, and preventing and fighting infections on the other hand. The immune system does this efficiently together with the organs, tissues and cells in the body. Antibodies are important immunological mediators and are produced by our body in different forms called IgA, IgG, IgE, IgD and IgM. IgA is the most predominant antibody at mucosal surfaces and plays an important role in maintaining homeostasis. In the intestinal tract IgA regulates a healthy microbiota composition and it plays an important role in preventing infection and disease. In the unlikely event that pathogens do enter, IgA can form a layer around the pathogen thereby forming a complex. FcαRI-expressing immune cells are activated with IgA complexes and produce more pro-inflammatory compounds compared to activation with IgG complexes. This potent stimulation by IgA is beneficial in elimination of the pathogen. Unfortunately, it can also happen that IgA is not directed against a pathogen, but against the body's own molecules. This so-called auto-IgA can result in tissue damage such as occurs in various autoimmune diseases. Auto-IgA can activate immune cells that have FcαRI on their cell surface and cause a deteriorated condition of the patient. Blocking interactions between IgA and FcαRI is a promising new therapy for IgA-mediated diseases. To maintain the health of the human body, it is therefore important that IgA and the interaction between IgA and FcαRI remain in balance.

Previous studies have shown that polyreactive antibodies play an important role in the frontline defense against the dissemination of pathogens in the pre-immune host. Interestingly, antigen-binding polyreactivity can not only be inherent, but also acquired post-translationally. The ability of individual monoclonal IgG and IgE antibodies to acquire polyreactivity following contact with various agents that destabilize protein structure (urea, low pH) or have pro-oxidative potential (heme, ferrous ions) has been studied in detail. However, to the best of our knowledge this property of human IgA has previously been described only cursorily. In the present study pooled human serum IgA and two human monoclonal IgA antibodies were exposed to buffers with acidic pH, to free heme or to ferrous ions, and the antigen-binding behavior of the native and modified IgA to viral and bacterial antigens were compared using immunoblot and ELISA. We observed a dose-dependent increase in reactivity to several bacterial extracts and to pure viral antigens. This newly described property of IgA may have therapeutic potential as has already been shown for pooled IgG with induced polyreactivity.

BACKGROUND: Celiac disease is a common gastrointestinal autoimmune disorder. Studies have shown that the prevalence of tooth decay is high in patients with celiac disease. This study was performed to evaluate the serology of celiac disease in children with dental caries. METHODS: Children aged 3 to 12 years who referred to the dental clinic with enamel caries were included in the study. Celiac disease was assessed by measuring serum IgA levels and anti-TTG (Anti TTG (IgA)) antibodies. Then, by analyzing the collected data, the prevalence of celiac disease in children with dental caries and its relationship with various variables were investigated. RESULTS: 120 children, 56 girls (46.7%) and 64 boys (53.3%) with dental caries were involved in this study. The positive celiac serology rate of studied population was 14 (11.6%). Based on the results of this study, a significant relationship was obtained between maternal education, sex and place of residence and celiac disease (p< 0.05). There were no significant relationships between celiac positive serology in children with dental caries, the number of decayed teeth, and breastfeeding (p> 0.05). CONCLUSION: The present study showed that dental caries, might be a red flag indicating possible celiac disease and prevent its complications. On the other hand, pediatricians and dentists should be aware of the oral symptoms of celiac disease. Further studies are needed to plan screening for children with celiac disease.

The current case report describes a 13-year-old young boy who presented with purpuric rashes following a completely asymptomatic COVID-19 infection and biopsy-confirmed leucocytoclastic vasculitis, mild haematuria and mild elevation of serum IgA. This case highlights one of the dermatological manifestations of COVID-19 infection which has not been reported so far. Paediatricians should explore the history of this infection when evaluating any child presenting with a vasculitic rash.

Objectives While physicians are often confronted with immunoglobulin A (IgA) deficiency in children with recurrent infections, the clinical relevance of this finding is unclear. Large‐scale studies examining the significance of IgA deficiency in children are hampered by differences in techniques for measuring IgA and the physiological increase of IgA with age. Both result in a variety of reference values used for diagnosing IgA deficiency. We propose a new laboratory‐independent method to accurately compare IgA measurements in children of varying ages. Methods We present a method to standardise IgA values for age and laboratory differences. We applied this method to a multicentre case–control study of children under the age of seven suffering from recurrent respiratory tract infections (rRTI, cases) and children who had IgA measured as part of coeliac disease screening (controls). We defined IgA deficiency as serum IgA measurements, With our method to standardize IgA values for laboratory and age differences, we show that IgA deficiency is more prevalent in children less than 7 years of age with recurrent respiratory infections compared with controls, implicating the clinical relevance.

In the conditions of steadily increasing urbanization and emerging negative microclimates, there is increase the morbidity of children in megacities. The damaging effect of environmental factors causes the development of “minimal persistent inflammation” of mucosa. We had studied 55 children in age 1–8 years suffering from recurrent ARVI associated with different chronic HVI (HSV I/II, EBV, CMV, HHV VI) and chronic recurrent bacterial diseases. The comparison group was 40 conditionally healthy children, comparable by sex and age. Clinical and immunological methods: ELISA, PCR, cytofluorimetry were used. We studied 2 groups of children: 1 group – 1–4 years old (early children) and 2 group – 5–8 years old, suffering from recurrent ARVI of a high rate of frequency. Clinical and anamnestic data showed that the incidence of ARVI was in 1 group – 7–15 and in 2 groups – 7–24 or more episodes per year, and the duration of these episodes was: 7.5 and 15.8 days, respectively. In all children, repeated ARI in combination with chronic respiratory diseases with frequent exacerbations were associated with recurrent and/or mono- and mixed HVI. Comparative analysis showed that in the children from group 1 demonstrate deficient in IFN-α, serum IgA and various NG disorders. However more severe disorders in IFN-α, NK-cells, NG system were detected in group 2, which is associated with a greater age of infectious history. Our study revealed the urgency to create new approaches for targeted immunoprophylaxis for immunocompromised children living in the megapolis.

Although, the association between celiac disease (CD) and selective immunoglobulin A deficiency (SIgAD) has been known for more than fifty years, the procedures for diagnosing and monitoring patients with both conditions are still far from definitive. When serological markers were introduced as pre-bioptic investigations, it was immediately clear that searching for specific IgA antibodies without checking total serum IgA could lead to a failure in diagnosing IgA-deficient CD patients, while specific IgG antibodies could be useful as additional tests, because they are frequently found in the serum of affected patients. Nonetheless, until recently the diagnosis of CD in IgA-deficient patients was based on the few, fragmentary and often contradictory data available in literature. The introduction of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines in 2012 provided the current criteria for diagnosing CD in IgA-deficient patients, although some issues remained open, such as the selection of patients who should undergo specific IgG antibody testing and the choice of the most reliable IgG-based test for both diagnosis and follow-up. A real-life study recently assessed the impact of the 2012 ESPGHAN guidelines in diagnosing and monitoring CD in SIgAD patients, highlighting several pitfalls that can lead to operational uncertainties and difficulties in patient management. In the present report, the evolution of diagnostic tools and criteria for CD in SIgAD patients has been critically assessed, both strengths and open issues have been highlighted, and future perspectives for improving the current diagnostic protocols have been suggested.

Highlights • Saliva is an eligible matrix for SARS-CoV-2 molecular detection and IgA measurement. • Saliva collection offers several advantages: safe, non-invasive and self-collection. • Positive molecular testing results were associated with disease duration. • The presence of salivary IgA was associated with pneumonia and CRP values., Aim This study aims to verify whether standardized saliva collection is suitable for SARS-CoV-2 molecular detection and IgA measurement. Methods 43 COVID-19 inpatients and 326 screening subjects underwent naso-pharyngeal (NP)-swab and saliva collection (Salivette). Inpatients also underwent repeated blood collections to evaluate inflammation and organs involvement. In all patients and subjects, SARS-CoV-2 (gene E) rRT-PCR was undertaken in saliva and NP-swabs. Salivary IgA and serum IgA, IgG, IgM were measured on inpatients’ samples. Results NP-swabs and saliva were both SARS-CoV-2 positive in 7 (16%) or both negative in 35 (82%) out of 43 patients successfully included in the study. NP-swabs and saliva results did not perfectly match in one patient (saliva positive, NP-swab negative). Positive molecular results were significantly associated with disease duration (p = 0.0049). 326/326 screening subjects were SARS-CoV-2 negative on both NP-swabs and saliva. Among the 27 saliva samples tested for IgA, 18 were IgA positive. Salivary IgA positivity was associated with pneumonia (p = 0.002) and CRP values (p = 0.0183), not with other clinical and molecular data, or with serum immunoglubulins. Conclusions A standardized saliva collection can be adopted to detect SARS-CoV-2 infection in alternative to NP-swabs. Preliminary data on salivary IgA support the use of saliva also for patient monitoring.

International audience; IgA antibodies are key immune effectors against invading pathogens but also possess essential immunoregulatory functions. Detecting and quantifying human IgA+ B-cell subsets and secreted IgA molecules is needed for investigating the protective, modulatory and pathophysiologic roles of IgAs. Here, we produced a recombinant tagged trimeric form of the streptococcal IgA-binding peptide (SAP) by transient transfection-based eukaryotic expression system. The trimeric SAP (tSAP) probe had a higher production yield and apparent binding affinity to human IgA1 and IgA2 immunoglobulins when compared to the dimeric SAP molecule classically used to purify IgAs. tSAP bound both monomeric and dimeric IgAs, and allowed immunoblot detection and ELISA quantification of serum IgA antibodies in humans and non-human primates. Fluorescently labeled tSAP also permitted an accurate quantification of circulating human blood IgA-expressing memory B cells by flow-cytometric analyses. Thus, the easy-to-produce high affinity recombinant tSAP probe we developed is a versatile and valuable tool to quantify secreted and membrane-bound human but also primate IgA immunoglobulins.

Unlike IgG monoclonal proteins (MCPs), IgA MCP quantification is unreliable due to beta-migration of IgA MCPs on serum protein electrophoresis (SPEP). The utility of nephelometric quantitative IgA (qIgA) to monitor IgA multiple myeloma (MM) is unclear. We retrospectively studied disease response kinetics using qIgA versus MCPs by SPEP, and developed and validated novel qIgA disease assessment criteria in 491 IgA MM patients. The SPEP MCP nadir occurred a median of 41 (IQR 0–102) days before the qIgA. The median time to achieve a partial response (PR) was shorter using standard IMWG versus qIgA response criteria (32 vs 58 days, p

Background Bird antigens are some of the most relevant antigens in hypersensitivity pneumonitis (HP). Possible sources of bird antigens are bird breeding, feather products and fertilizer with fowl droppings. For the screening and diagnosis of HP, the measurement of bird-specific antibodies should be standardized. The aim of this study was to clarify the utility of serum IgG (sIgG) and IgA (sIgA) antibodies to bird antigens in screening and diagnosing acute/chronic bird-related HP with ImmunoCAP® in multi-centre clinical research. Methods We executed a clinical performance test by conducting a multi-institutional study to measure the levels of sIgG/sIgA against pigeon, parrot and budgerigar antigens by the ImmunoCAP® system in 29 acute and 46 chronic bird-related HP patients. Results The levels of sIgG/sIgA against the bird antigens of the three species were significantly higher in subjects with acute bird-related HP and chronic bird-related HP with acute episodes (recurrent type) than in the control subjects. For sIgG, the optimal cutoff values by receiver operating characteristic (ROC) analysis were 24.6 mgA/L for pigeon, 14.0 mgA/L for parrot, and 8.7 mgA/L for budgerigar. By measuring multiple bird antigens and combining sIgG values of two species, the sensitivity and specificity for acute and recurrent-type chronic bird-related HP patients were 85–91% and 73–80%, respectively. For recurrent and insidious types of chronic bird-related HP, the sensitivity and specificity were 48–61% and 73–80%, respectively. Conclusions Measurement of the levels of sIgG/sIgA against pigeon, budgerigar and parrot antigens by ImmunoCAP® was useful for screening and diagnosis in bird-related HP.

IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis, and disease recurrence often occurs after transplantation. On the other hands, Asymptomatic IgA deposition (IgAD) is occasionally observed in donated kidney. It is recognized that IgAD does not progress to IgAN, but the mechanism has not demonstrated yet. In IgAN, aberrant IgA1 O-glycan structure in the hinge region (HR) of serum IgA is suggested as one of the most convincing key mediators. However, little is known about IgA1 O-glycan structure in IgAD patients. Herein, we investigated the prevalence of IgAD in living renal transplant donors in our cohort. IgAD was observed in 21(13.0%) among 161 renal transplant donors and have statistically significant blood relationship with IgAN recipients (28.6% in relatives vs. 9.8% in non-relatives, respectively; p = 0.0073). Next, we evaluated the IgA1 O-glycan structure of serum IgA from IgAN recipients (n = 26), IgAD donors (n = 17), and non-IgAD helthy donors (n = 27) using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI–TOF MS). The numbers of GalNAc and Gal and the Gal/GalNAc ratio in the HR of the IgAN recipients had significantly lower comparing to the IgAD and non-IgAD healthy donors. The decreased Gal/GalNAc ratio in IgAN recipients means the increased ratio of galactose-deficient IgA1. To the best of our knowledge, this is the first report to compare the O-glycan structures in IgAN recipients and IgAD donors using MALDI–TOF MS. We concluded that IgAD was more common in IgAN related donors. Overall, decreased GalNAc and Gal contents in HR could play a material pathogenic role in IgAN.

Background Selective immunoglobulin M deficiency (SIgMD) is a rare primary immunodeficiency that is frequently reported in Western countries. However, large epidemiological and clinical studies of SIgMD in China are still lacking. Herein, we describe a cohort of SIgMD subjects in a large tertiary university hospital in China. Methods A cross‐sectional study included 139 668 participants at First Affiliated Hospital of Wenzhou Medical University from January 2014 to October 2018 was conducted. Individuals with a serum IgM level less than 0.3 g/L with normal levels of serum IgA and IgG were defined as having SIgMD. Result A total of 63 subjects met the criteria for SIgMD(63/139668, 0.045%), with a male‐to‐female ratio of 0.85, aged from 19 to 99 years. The most common clinical manifestation was autoimmune disorders (38/63, 60.32%), while the second most common manifestation was infections (21/63, 33.33%). Neither allergies nor tumors were found among these 63 SIgMD subjects. Most importantly, there were 30 patients with systemic lupus erythematosus among these 63 SIgMD subjects, accounting for 47.62% of all SIgMD subjects. Conclusion To our knowledge, we describe here the first large single‐center cohort of adult patients affected by SIgMD in China. The most common clinical manifestation was autoimmune disorders, specifically systemic lupus erythematosus.