Screening for Antibody Deficiencies in Adults by Serum Electrophoresis and Calculated Globin.

Antibody deficiency adults calculated globulin gamma globulin fraction immunoglobulin G protein electrophoresis

Journal

Journal of clinical immunology
ISSN: 1573-2592
Titre abrégé: J Clin Immunol
Pays: Netherlands
ID NLM: 8102137

Informations de publication

Date de publication:
11 2023
Historique:
received: 03 03 2023
accepted: 09 06 2023
medline: 21 11 2023
pubmed: 28 7 2023
entrez: 28 7 2023
Statut: ppublish

Résumé

This study aimed to investigate the correlation between calculated globulin (CG, total protein level minus albumin level) and the gamma globulin fraction (Gamma), obtained from serum protein electrophoresis with serum IgG levels in adults (≥ 18 years). Using linear regression models, analyses of CG and Gamma levels correlation with IgG levels in adults were performed. Receiver-operator curves were created to determine cutoff values and the respective sensitivity and specificity measures. A total of 886 samples were analyzed. CG and Gamma were positively and statistically correlated with IgG levels (r Both CG and Gamma levels determined by protein electrophoresis analysis may be used to screen for antibody deficiencies in adults, enabling earlier diagnosis of antibody deficiencies in a routine clinical setting.

Identifiants

pubmed: 37505322
doi: 10.1007/s10875-023-01536-1
pii: 10.1007/s10875-023-01536-1
doi:

Substances chimiques

Globins 9004-22-2
Immunoglobulin G 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1873-1880

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Durandy A, Kracker S, Fischer A. Primary antibody deficiencies. Nat Rev Immunol. 2013;13(7):519–33.
pubmed: 23765059
Patel S, Carbone J, Jolles S. The expanding field of secondary antibody deficiency: causes, diagnosis, and management. Front Immunol. 2019;10:33.
pubmed: 30800120 pmcid: 6376447
Bousfiha A, Moundir A, Tangye SG, Picard C, Jeddane L, Al-Herz, et al. The 2022 Update of IUIS phenotypical classification for human inborn errors of immunity. J Clin Immunol. 2022;42(7):1508–20.
pubmed: 36198931
Quinn J, Modell V, Orange JS, Modell F. Growth in diagnosis and treatment of primary immunodeficiency within the global Jeffrey Modell Centers Network. Allergy Asthma Clin Immunol. 2022;18(1):19.
pubmed: 35246253 pmcid: 8896271
Jolles S. The variable in common variable immunodeficiency: a disease of complex phenotypes. J Allergy Clin Immunol Pract. 2013;1(6):545–56 (quiz 557).
pubmed: 24565700
Bonilla FA, Barlan I, Chapel H, Costa-Carvalho BT, Cunningham-Rundles C, Morena MT, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. J Allergy Clin Immunol Pract. 2016;4(1):38–59.
pubmed: 26563668
Ameratunga R, Allan C, Woon S-T. Defining common variable immunodeficiency disorders in 2020. Immunol Allergy Clin N Am. 2020;40:403–20.
Latin American Society of Immunodeficiencies PID Registry homepage. Available at: https://www.lasidregistryorg/view/statistics . Accessed January 10, 2023.
Seidel GM, Kindle G, Gathmann B, Quinti I, Buckland M, Montfrans J, et al. ESID Registry Working Party and collaborators The European Society for Immunodeficiencies (ESID) Registry Working Definitions for the clinical Diagnosis of Inborn Errors of Immunity. J Allergy Clin Immunol Pract. 2019;7(6):1763–70.
pubmed: 30776527
Cunninghan-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clin Immunol. 1999;92:34–48.
Chapel H, Lucas M, Lee M, Bjorkander J, Webster D, Grimbacher B, et al. Common variable immunodeficiency disorders: division into distinct clinical phenotypes. Blood. 2008;112:277–86.
pubmed: 18319398
Thalhammer J, Kindle G, Nieters A, Rusch S, Seppänen MRJ, Fischer A, et al. Initial presenting manifestations in 16,486 patients with inborn errors of immunity include infections and noninfectious manifestations. J Allergy Clin Immunol. 2021;148(5):1332–41.
pubmed: 33895260
Agarwal S, Cunningham-Rundles C. Autoimmunity in common variable immunodeficiency. Ann Allergy Asthma Immunol. 2019;123(5):454–60.
pubmed: 31349011
Kiace F, Azizi G, Rafiemanesh H, Zainaldain H, Sadaat RF, Alizadeh M, et al. Malignancy in common variable immunodeficiency: a systematic review and meta-analysis. Expert Rev Clin Immunol. 2019;15(10):1105–13.
Resnick ES, Moshier EL, Godbold JH, Cunningham-Rundles C. Morbidity and mortality in common variable immune deficiency over 4 decades. Blood. 2012;119:1650–7.
pubmed: 22180439 pmcid: 3286343
Hovermale E, Scalchunes C, Boyle M. Comparative effectiveness research in the United States and primary immunodeficiency disease. Pharmaceutical policy Law. 2011;13:183–91.
Otani IM, Lehman HK, Jongco AM, Tsao LR, Azar AE, Tarrant TK, et al. Practical guidance for the diagnosis and management of secondary hypogammaglobulinemia: a work group report of the AAAAI Primary Immunodeficiency and Altered Immune Response Committees. J Allergy Clin Immunol. 2022;149:1525–60.
pubmed: 35176351
Dhalla F, Misbah SA. Secondary antibody deficiencies. Curr Opin Allergy Clin Immunol. 2015;15(6):505–13.
pubmed: 26406183
Chinen J, Sharer WT. Secondary immunodeficiencies, including HIV infection. J Allergy Clin Immunol. 2010;125(2 suppl):S195-203.
pubmed: 20042227
Tallantyre EC, Robertson NP, Jolles S. Secondary antibody deficiency in neurology. Curr Opin Allergy Clin Immunol. 2018;18(6):481–8.
pubmed: 30299398
Jolles S, Giralt S, Kerre T, Hillard LM, Mustafa SS, Ris R, Vinh DC. Agents contributing to secondary immunodeficiency development in patients with multiple myeloma, chronic lymphocytic leukemia and non-hodgkin lymphoma: a systematic literature review. Systematic Review Front Oncol.  Hematologic Malignancies. In press22
Dhalla F, Lucas M, Schuh A, Bhole M, Jain R, Pate SY, et al. Antibody deficiency secondary to chronic lymphocyte leukemia: should patients be treated with prophylactic replacement immunoglobulin? J Clin Immunol. 2014;34(3):277–82.
pubmed: 24557494
Bonilla FA, Khan DA, Ballas ZK, Chinen J, Frank MM, Hsu JT, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol. 2015;136(5):1186–205.
pubmed: 26371839
Ilkjær FV, Rasmussen LD, Martin-Iguacel R, Westh L, Katzenstein TL, Hansen A-BE, et al. How to identify common variable immunodeficiency patients earlier: general practice patterns. J Clin Immunol. 2019;39(7):641–52.
pubmed: 31372799
Slade CA, Bosco JJ, Binh Giang T, Kruse E, Stirling RG, Cameron PU, et al. Delayed diagnosis and complications of predominantly antibody deficiencies in a cohort of Australian adults. Front Immunol. 2018;9:694.
pubmed: 29867917 pmcid: 5960671
Bazregari S, Azizi G, Tavakol M, Asgardoon MH, Kiaee F, Tavakolinia N, et al. Evaluation of infectious and non-infectious complications in patients with primary immunodeficiency. Cent Eur J Immunol. 2017;42(4):336–41.
pubmed: 29479289 pmcid: 5820987
Shehata N, Palda V, Bowen T, Haddad E, Issekutz TB, Mazer B, et al. The use of immunoglobulin therapy for patients with primary immune deficiency: an evidence-based practice guideline. Transfus Med Rev. 2010;24:S28-50.
pubmed: 19962579
Perez EE, Orange JS, Bonilla F, Chinen J, Chinn IK, Dorsey M, et al. Update on the use of immunoglobulin in human disease: a review of evidence. J Allergy Clin Immunol. 2017;139(3, Supplement):S1-46.
pubmed: 28041678
Elsink K, van Montfrans JM, van Gijn ME, Blom M, van Hagen PM, Kuijpers TW, et al. Cost and impact of early diagnosis in primary immunodeficiency disease: a literature review. Clin Immunol. 2020;213:108359.
pubmed: 32035178
Cunningham-Rundles C, Bodian C. Common variable immunodeficiency: clinical and immunological features of 248 patients. Clin Immunol. 1999;92:34–48.
pubmed: 10413651
Gathmann B, Goldacker S, Klima M, et al. The German national registry for primary immunodeficiencies (PID). Clin Exp Immunol. 2013;173:372–80.
pubmed: 23607573 pmcid: 3722937
Edgar JD, Buckland M, Guzman D, et al. The United Kingdom Primary Immune Deficiency (UKPID) Registry: report of the first 4 years’ activity. Clin Exp Immunol. 2014;175:68–78.
pubmed: 23841717
Blore J, Haeney MR. Primary antibody deficiency and diagnostic delay. BMJ. 1989;298:516–7.
pubmed: 2495090 pmcid: 1835789
Ameratunga R, Ahn Y, Jordan A, Lehnert K, Brothers S, Woon S-T. Keeping it in family: the case for considering late-onset combined immunodeficiency a subset of common variable immunodeficiency disorders. Expert Rev Clin Immunol. 2018;14(7):549–56.
pubmed: 29806948
Jolles S, Smith DB, Vihn DC, Mallick R, Espinoza G, DeKoven M, Divino V. Risk factors for severe infections in secondary immunodeficiency: a retrospective US administrative claims study in patients with haematological malignancies. Leuk Lymphoma. 2021;63(1):64–73.
pubmed: 34702119
Pickett D, Modell V, Leighton I, Modell F. Impact of a physician education and patient awareness campaign on the diagnosis and management of primary immunodeficiencies. Immunol Res. 2008;40:93–4.
pubmed: 18058072
Arkwright PD, Gennery AR. Ten warning signs of primary immunodeficiency: a new paradigm is needed for the 21
pubmed: 22129048
Kwan A, Abraham RS, Currier R, et al. Newborn screening for severe combined immunodeficiency in 11 screening programs in the United States. JAMA. 2014;312:729–38.
pubmed: 25138334 pmcid: 4492158
Holding S, Jolles S. Current screening approaches for antibody deficiency. Curr Opin Allergy Clin Immunol. 2015;15(6):547–55.
pubmed: 26513714
de Vries E. Patient-centered screening for primary immunodeficiency, a multi-stage diagnostic protocol designed for non-immunologists: 2011 update. Clin Exp Immunol. 2012;167:108–19.
pubmed: 22132890 pmcid: 3248092
Jolles S, Borrell R, Zouwail S, Heaps A, Sharp H, Moody M, et al. Calculated globulin (CG) as a screening test for antibody deficiency. Clin Exp Immunol. 2014;177(3):671–8.
pubmed: 24784320 pmcid: 4137851
Arnold DF, Wiggins J, Cunningham-Rundles C, et al. Granulomatous disease: distinguishing primary antibody disease from sarcoidosis. Clin Immunol. 2008;128:18–22.
pubmed: 18486555 pmcid: 2692233
Pecoraro A, Jolles S, Crescenzi L, Varricchi G, Marone G, Savoia M, et al. Validation of calculated globulin (CG) as a screening test for antibody deficiency in an Italian university hospital. Curr Pharm Biotechnol. 2018;19(9):728–33.
pubmed: 30091407
Hool T, Lim EM, John M, D’Orsogna L, McLean-Tooke A. Calculated globulin as a screening tool for hypogammaglobulinaemia or paraproteins in hospitalized patients. Ann of Clin Biochem. 2021;58(3):236–43.
Holding S, Khan S, Sewell WAC, Jolles S, Dore PC. Using calculated globulin fraction to reduce diagnostic delay in primary and secondary hypogammaglobulinaemias: results of a demonstration project. Ann Clin Biochem. 2015;52(Pt 3):319–26.
pubmed: 25024432
Lee AYS, Cassar PM, Johnston AM, Adelstein S. Clinical use and interpretation of serum protein electrophoresis and adjunt assays. Br J H Med (Lond). 2017;78(2):C18-20.
Vavricka SR, Burri E, Beglinger C, Degen L, Manz M. Serum protein electrophoresis: an underused but very useful test. Digestion. 2009;79(4):203–10.
pubmed: 19365122
Inmetro - Acreditação de Laboratórios de Análises Clínicas [Internet]. [accessed on December 03, 2022].Available from: http://inmetro.gov.br/Credenciamento/acre_lab_ac.asp
SBPC/ML | Programas da Qualidade (Categoria) PALC [Internet]. [accessed on December 03, 2022]. Available from : http://www.sbpc.org.br/programa-da-qualidade/palc/
Cole TJ. Applied logistic regression. D. W. Hosmer and S. Lemeshow, Wiley, New York, 1989. Statistics in Medicine1991;10(7):1162–3
Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3(1):32–5.
pubmed: 15405679
Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J. 2005;47(4):458–72.
pubmed: 16161804
Jolles S, Chapel H, Litzman J. When to initiate immunoglobulin replacement therapy (IGRT) in antibody deficiency: a practical approach. Clin Exp Immunol. 2017;188:333–41.
pubmed: 28000208 pmcid: 5422851
Friman V, Winqvist O, Blimark C, Langerbeins P, Chapel H, Dhalla F. Secondary immunodeficiency in lymphoproliferative malignancies. Hematol Oncol. 2016;34:121–32.
pubmed: 27402426
Byrd JC, O’Brien S, James DF. Ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med. 2013;369:1278–9.
pubmed: 24066758
Casulo C, Maragulia J, Zelenetz AD. Incidence of hypogammaglobulinemia in patients receiving rituximab and the use of intravenous immunoglobulin for recurrent infections. Clin Lymphoma Myeloma Leuk. 2013;13:106–11.
pubmed: 23276889
Pac M, Casanova JL, Reisli I, Marodi L. Advances in primary immunodeficiency in Central-Eastern Europe. Front Immunol. 2021;12:667727.
pubmed: 34084169 pmcid: 8168433
Franco-Jarava C, Colobran R, Mestre-Torres J, Vargas V, Pujol-Borrell R, Hernández-González M. Clinical laboratory standard capillary protein electrophoresis alerted of a low C3 state and lead to the identification of a Factor I deficiency due to a novel homozygous mutation. Immunol Lett. 2016;174:19–22. https://doi.org/10.1016/j.imlet.2016.04.011 .
de Piza CFST, Aranda CS, Solé D, Jolles S. Condino-Neto A 2021 Serum protein electrophoresis may be used as a screening tool for antibody deficiency in children and adolescents. Front Immunol. 2021;12:3332.
Gonzalez-Quintela A, Alende R, Gude F, Campos J, Rey J, Meijide LM, et al. Serum levels of immunoglobulins (IgG, IgA, IgM) in a general adult population and their relationship with alcohol consumption, smoking and common metabolic abnormalities. Clin Exp Immunol. 2008;151(1):42–50.
pubmed: 18005364 pmcid: 2276914
J.M.G. Wilson, G. Jungner. Principles and practice of screening for disease. Public Health Papers, WHO Public Health Papers. 34
Dobrow MJ, Hagens V, Chafe R, Sullivan T, Rabeneck L. Consolidated principles for screening based on a systematic review and consensus process. CMAJ. 2018;190(14):E422–9.
pubmed: 29632037 pmcid: 5893317

Auteurs

Cristina Frias Sartorelli de Toledo Piza (CFS)

Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.

Carolina Sanchez Aranda (CS)

Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.

Dirceu Solé (D)

Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil.

Stephen Jolles (S)

Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, Wales, UK.

Antonio Condino-Neto (A)

Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil. antoniocondino@gmail.com.

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