What's the Significance of Reduced Serum Immunoglobulin G Concentrations in Multiple Sclerosis?

Celiac.com 01/08/2020 - Researchers currently don't have much good information on the frequency of hypogammaglobulinemia (Ig deficiency) in people with multiple sclerosis. A team of researchers recently set out to assess the frequency of reduced immunoglobulin (Ig) concentrations and its association with immunotherapy and disease course in two independent multiple sclerosis study groups.

The research team included Greta Zoehner, Andrei Miclea, Anke Salmen, Nicole Kamber, Lara Diem, Christoph Friedli, Maud Bagnoud, Farhad Ahmadi, Myriam Briner, Nazanin Sédille-Mostafaie, Constantinos Kilidireas, Leonidas Stefanis, Andrew Chan, Robert Hoepner, and Maria Eleftheria Evangelopoulos.

The lower limits of normal (LLN) for serum Ig concentration were IgG < 700 mg/dl, IgM < 40 mg/dl, and IgA < 70 mg/dl. The team analyzed the results using the Mann–Whitney U test, analysis of variance test, and multiple linear regression.

The study shows that multiple sclerosis patients have high rates of reduced serum IgG concentrations, both with and without disease-modifying treatments.  Interestingly, in patients with other autoimmune diseases, Ig deficiency is also more prevalent, and 1.7% of patients with celiac disease and 5.2% of patients with systemic lupus erythematosus also have IgA deficiency.

Given that infections or interference with antibody production usually happen at much lower IgG levels, around 400 mg/dl, and below, the importance of lower IgG concentrations at the levels noted remains unknown.

The team suggests using the information to monitor IgG levels, particularly with anti-B-cell therapies, and considering IgG substitution at levels below 400 mg/dl.

Read more in Therapeutic Advances in Neurological Disorders

The researchers are variously affiliated with the Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; the University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; the Center of Laboratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; the Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and the Department of Neurology, Eginition University Hospital at the National and Kapodistrian University of Athens, Athens, Greece.