IgA and IgM-enriched Immunoglobulins in Primary Immunodeficiencies: a Pilot Study.
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Collet Aurore, Coiffard Benjamin, Ledoult Emmanuel, Fieschi Claire, Cheminant Morgane, Serris Alexandra, Suarez Felipe, Sanges Sébastien, Neel Antoine, Nove-Josserand Raphaële, Stabler Sarah, El Husseini Kinan, Huault Alice, Cougoul Pierre, Mausservey Christelle, Cassir Nadim, Mirgot Floriane, Meresse Bertrand, Dendooven Arnaud, Poizot Sandrine, Le Scornet Tanguy, Bravard Anne-Sophie, Conrad Anne, Levêque Manon, Fadlallah Jehane, Melenotte Cléa, De La Roque Chloë Dumas, Tinevez Claire, Chahla Wadih Abou, Dubucquoi Sylvain, Labalette Myriam, Neven Bénédicte, Malphettes Marion, Schleinitz Nicolas, Galicier Lionel, Viallard Jean-François, Gorochov Guy, Lefèvre Guillaume
Аннотация
METHODS: A compassionate use program (CUP) in France enrolled 20 PID patients with undetectable IgA/IgM levels, receiving IgGAM IV infusions every 7-14 days. Tolerance, infection frequency, hospitalizations, and biological markers (Ig levels, complement activation, salivary IgA) were analyzed prospectively.
RESULTS: Twenty patients were included in the CUP at the time of analysis. No severe adverse event was reported. Half of the patients experienced mild to moderate hypersensitivity symptoms. Mean antibiotic courses dropped from 5.4 to 2.3/year (p = 0.0009) and mean number of hospitalizations decreased from 2.6 to 1.2/year (p = 0.01). Median serum IgA and IgM levels increased three months after IgGAM start. IgM and low levels of IgA were detected in saliva samples, suggesting at least a transient transfer of IgA/IgM from IgGAM into mucosal fluids.
CONCLUSION: In patients with severe PID and undetectable IgA/IgM, IgGAM was associated with reduced infections and hospitalizations. Controlled studies are needed to confirm the benefit of IgA/M enriched immunoglobulin preparations in PID patients with persistent and/or recurrent respiratory or digestive infections.