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Low levels of IgG2 and pneumococcal antibodies as predictors of benefit from IgG replacement in IgG subclass deficiency

Wågström, Per ; Nyström, Katarina ; Björkander, Janne ; Nilsson, Mats ; Dahle, Charlotte ; Nilsdotter-Augustinsson, Åsa ; Skattum, Lillemor LU and Nyström, Sofia (2026) In Journal of human immunity 2(3).
Abstract

Immunoglobulin G subclass deficiencies (IgGSD) are associated with recurrent respiratory tract infections. Tools to identify patients with IgGSD who benefit from immunoglobulin G replacement therapy (IgGRT) are lacking. This crossover study evaluated the number of antibiotic-demanding infections on and after up to 18 mo off IgGRT in 28 patients with IgGSD. Pneumococcal antibodies against 21 serotypes were assessed using a multiplex assay. After 12 mo on IgGRT, the frequency of infections was reduced during the following 6 mo compared with the last 6 mo without IgGRT, indicating a delayed therapeutic effect. Low levels of pneumococcal serotype-specific antibodies and lower IgG2 levels were associated with the need to restart IgGRT. In... (More)

Immunoglobulin G subclass deficiencies (IgGSD) are associated with recurrent respiratory tract infections. Tools to identify patients with IgGSD who benefit from immunoglobulin G replacement therapy (IgGRT) are lacking. This crossover study evaluated the number of antibiotic-demanding infections on and after up to 18 mo off IgGRT in 28 patients with IgGSD. Pneumococcal antibodies against 21 serotypes were assessed using a multiplex assay. After 12 mo on IgGRT, the frequency of infections was reduced during the following 6 mo compared with the last 6 mo without IgGRT, indicating a delayed therapeutic effect. Low levels of pneumococcal serotype-specific antibodies and lower IgG2 levels were associated with the need to restart IgGRT. In conclusion, IgGRT effectively reduces bacterial infections in IgGSD, but the benefits may take at least a year to manifest. Pneumococcal antibody profiling and IgG2 levels may help identify patients needing long-term IgGRT.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of human immunity
volume
2
issue
3
article number
e20250188
external identifiers
  • scopus:105039263257
  • pmid:42170001
ISSN
3065-8993
DOI
10.70962/jhi.20250188
language
English
LU publication?
yes
additional info
© 2026 Wågström et al.
id
45213942-4ff2-4dc8-9a91-6538c296a8d5
date added to LUP
2026-05-25 09:24:03
date last changed
2026-05-26 04:02:25
@article{45213942-4ff2-4dc8-9a91-6538c296a8d5,
  abstract     = {{<p>Immunoglobulin G subclass deficiencies (IgGSD) are associated with recurrent respiratory tract infections. Tools to identify patients with IgGSD who benefit from immunoglobulin G replacement therapy (IgGRT) are lacking. This crossover study evaluated the number of antibiotic-demanding infections on and after up to 18 mo off IgGRT in 28 patients with IgGSD. Pneumococcal antibodies against 21 serotypes were assessed using a multiplex assay. After 12 mo on IgGRT, the frequency of infections was reduced during the following 6 mo compared with the last 6 mo without IgGRT, indicating a delayed therapeutic effect. Low levels of pneumococcal serotype-specific antibodies and lower IgG2 levels were associated with the need to restart IgGRT. In conclusion, IgGRT effectively reduces bacterial infections in IgGSD, but the benefits may take at least a year to manifest. Pneumococcal antibody profiling and IgG2 levels may help identify patients needing long-term IgGRT.</p>}},
  author       = {{Wågström, Per and Nyström, Katarina and Björkander, Janne and Nilsson, Mats and Dahle, Charlotte and Nilsdotter-Augustinsson, Åsa and Skattum, Lillemor and Nyström, Sofia}},
  issn         = {{3065-8993}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{3}},
  series       = {{Journal of human immunity}},
  title        = {{Low levels of IgG2 and pneumococcal antibodies as predictors of benefit from IgG replacement in IgG subclass deficiency}},
  url          = {{http://dx.doi.org/10.70962/jhi.20250188}},
  doi          = {{10.70962/jhi.20250188}},
  volume       = {{2}},
  year         = {{2026}},
}