RESUMEN
Immunoglobulin A deficiency (IgAD) is the most common primary immunodeficiency, with suggested association with various types of autoimmunity, including Graves' disease. This study investigated the association of IgAD with elevated thyrotropin-receptor autoantibodies (TRAb). IgA was measured in TRAb-seropositive individuals from both Iceland (N = 299] and Sweden (N = 841]. In addition, TRAb levels were evaluated in 43 Icelandic and 50 Swedish IgAD individuals using Medizym TRA immunoassay, and positive samples were re-evaluated using BRAHMS TRAK human RIA. The IgAD individuals were HLA-genotyped to determine the HLA-B, DR, and DQ alleles. None of the 299 Icelandic TRAb-seropositive individuals had IgAD, whereas, a high prevalence of IgAD (14/841 (1:60)) was observed in the Swedish cohort (p = 0.027). The prevalence of TRAb-seropositivity in IgAD individuals was, however, increased in both cohorts. The HLA-DQ6 allele was associated with TRAb-seronegativity within the Icelandic IgAD cohort (p = 0.037). The prevalence of IgAD in TRAb-seropositive individuals in Sweden is 10 times higher than expected in the general population. Furthermore, TRAb seropositivity is common among IgAD individuals, both in Iceland and Sweden, suggesting a predisposition toward Graves' disease. These findings underline the significant association of IgAD with autoimmunity and its possible association with certain HLA-DQ alleles.
Asunto(s)
Autoanticuerpos/inmunología , Estudios de Asociación Genética , Enfermedad de Graves/inmunología , Deficiencia de IgA/inmunología , Receptores de Tirotropina/inmunología , Adulto , Alelos , Autoanticuerpos/genética , Autoinmunidad/genética , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Enfermedad de Graves/epidemiología , Enfermedad de Graves/genética , Antígenos HLA-B/genética , Antígenos HLA-B/inmunología , Antígenos HLA-DQ/genética , Antígenos HLA-DQ/inmunología , Antígenos HLA-DR/genética , Antígenos HLA-DR/inmunología , Humanos , Islandia , Deficiencia de IgA/genética , Inmunoglobulina A/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Radioinmunoensayo , Receptores de Tirotropina/genética , SueciaRESUMEN
INTRODUCTION: The prevelance of allery and asthma has increased rapidly over the last 3 decades and is now estimated that 25-30% of population in Western industrialized countries show symptoms of allergy or asthma. The aim of this study was to reveal the success of allergen immunotherapy (AIT) in Landspitali from 1977-2006. MATERIAL AND METHODS: During the study period a total number of 289 individuals underwent immunotherapy in outpatient clinic of allergy and asthma in Landspítali. A total number of 169 individuals were contacted, of whom 128 (76%) accepted to participate in the study. The evaluation was based on medical records, standardized questionnaire and skin-prick tests. RESULTS: Patients were evaluated on the average of 20 years after finishing treatment. 118 (92%) patients were desensitized to grass pollen, to birch pollen (30%), cat dander (30%) and dust mite (28%). At the time of the study 67% reported to be asymptomatic or with greatly improved allergy symptoms. Males had better response to AIT than women (p=0.04). Participants with positive family history of allergy and/or asthma in first degree relatives also reported better response to AIT (p=0.02). Furthermore, AIT to grass pollen and dust mite seemed to be more effective than AIT to cat dander and birch (p=0.04). AIT was also shown to reduce asthma. CONCLUSION: AIT for 3-5 years provides significant beneficial effect of allergy and asthma symptoms in patients who undergo such therapy. Finally, it s findings support the notion that AIT may reduce the risk of new allergic manifestations.
Asunto(s)
Asma/terapia , Desensibilización Inmunológica , Hipersensibilidad/terapia , Inmunoterapia , Adolescente , Adulto , Asma/diagnóstico , Asma/inmunología , Niño , Preescolar , Femenino , Humanos , Hipersensibilidad/diagnóstico , Hipersensibilidad/inmunología , Islandia , Lactante , Recién Nacido , Pruebas Intradérmicas , Masculino , Persona de Mediana Edad , Servicio Ambulatorio en Hospital , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Immunoglobulin A (IgA) is important for mucosal health. Selective IgA deficiency (IgAD) is the most common primary immunodeficiency but its effect on oral health is unclear. The aim of this study was to investigate dental, periodontal and oral mucosal health in IgAD individuals. MATERIAL AND METHODS: In total, 32 adult IgAD subjects were compared with 63 randomly selected individuals. Participants answered questionnaires regarding general and oral health and underwent oral examination, including examination using the periodontal screening and recording (PSR) system and dental examination using the DMF system. RESULTS: The IgAD individuals had significantly more often undergone tonsillectomy (44%versus 24%, p=0.046) and adenoidectomy (31%versus 8%, p=0.003) compared with the controls. Furthermore, the IgAD subjects reported having pharyngitis, stomatitis and herpes labialis significantly more often. There was no significant difference in periodontal health (mean PSR index; 1.87 versus 1.77) or dental health (mean DMFS; 51.3 versus 53.7) between the two cohorts. A positive correlation between Helicobacter pylori infection and severity of periodontitis was found (p=0.036). CONCLUSION: IgAD predisposes to oral mucosal infections but does not influence periodontal or dental health. This is the first controlled study to include detailed clinical history and investigations, together with full oral and dental examination, in adults with IgAD.
Asunto(s)
Deficiencia de IgA/complicaciones , Enfermedades de la Boca/complicaciones , Enfermedades Periodontales/complicaciones , Enfermedades Dentales/complicaciones , Adenoidectomía , Adulto , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Índice CPO , Femenino , Reflujo Gastroesofágico/complicaciones , Gingivitis/complicaciones , Estado de Salud , Helicobacter/aislamiento & purificación , Infecciones por Helicobacter/complicaciones , Herpes Labial/complicaciones , Humanos , Deficiencia de IgA/sangre , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Salud Bucal , Índice Periodontal , Periodontitis/complicaciones , Faringitis/complicaciones , Estomatitis/complicaciones , Tonsilectomía , Xerostomía/complicacionesRESUMEN
BACKGROUND: The prevalence of autoimmunity is thought to be increased among IgA deficient (IgAD) individuals. However, it is currently unclear if the two conditions coincide within families. OBJECTIVE: To evaluate the prevalence of autoimmunity among IgAD individuals and their 1 degrees relatives. MATERIAL AND METHODS: A total of 43 IgAD individuals (32 adults and 11 children) and all available 1 degrees relatives were evaluated by a physician. A family history of autoimmunity was obtained, together with physical examination and a structured questionnaire that focused on symptoms and signs suggestive of autoimmunity. RESULTS: Eight of the 32 (25%) adult IgAD, were found to have definite autoimmunity, with organ specific- and systemic autoimmune diseases equally distributed. None of the IgAD children had autoimmunity. Among the 1 degrees relatives, 27/269 (10%) had autoimmunity, compared to an estimate of 5% in the general population (p<0.05). CONCLUSION: Autoimmune diseases are highly prevalent in individuals with IgAD and more common in their 1 degrees relatives than expected, thus, suggesting a possible common genetic component.