REVIEW PAPER
Paediatric immunoglobulin A deficiency revisited
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1
2nd year medical student's Research Group, Poznan University of Medical Sciences, Poznan, Poland
2
Department of Paediatric Pneumonology, Allergology, and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
Submission date: 2019-07-04
Final revision date: 2019-10-04
Acceptance date: 2019-10-05
Publication date: 2019-10-31
Pediatr Pol 2019;94(5):311-318
KEYWORDS
TOPICS
ABSTRACT
Immunoglobulin A (IgA) is the most abundant antibody isotype on mucosal surfaces, with predominantly neutralising non-activating functions, and which plays multifaceted roles in the immune system. IgA protects the host from pathogen invasion in the gastrointestinal and respiratory tracts, enhances diversification of microbiota, and maintains the intestinal homeostasis, exerting its twofold proinflammatory and anti-inflammatory functions by different immune cells and receptors. Therefore, IgA deficiency in children encompasses a broad spectrum of clinical phenotypes including infectious, allergic, autoimmune, and inflammatory conditions. In this review we also provide new insight into the genetic background and immunopathology of IgA deficiency in children.
REFERENCES (60)
1.
Moschese V, Chini L, Graziani S, et al. Follow-up and outcome of symptomatic partial or absolute IgA deficiency in children. Eur J Pediatr 2019; 178: 51-60.
2.
Seidel MG, Kindle G, Gathmann B, 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: 1763-1770.
3.
Fagarasan S, Honjo T. Intestinal IgA synthesis: regulation of frontline body defenses. Nat Rev Immunol 2003; 3: 63-72.
4.
Corthésy B. Multi-Faceted Functions of Secretory IgA at Mucosal Surfaces. Front Immunol 2013; 4: 185.
5.
Leong KW, Ding JL. The Unexplored Roles of Human Serum IgA. DNA Cell Biol 2014; 33: 823-829.
6.
Johansen FE, Braathen R, Brandtzaeg P. Role of J chain in secretory immunoglobulin formation. Scand J Immunol 2000; 52: 240-248.
7.
Suzuki K, Kawamoto S, Maruya M, et al. GALT: organization and dynamics leading to IgA synthesis. Adv Immunol 2010; 107: 153-185.
8.
Tsuji M, Suzuki K, Kitamura H, et al. Requirement for lymphoid tissue-inducer cells in isolated follicle formation and T cell-independent immunoglobulin A generation in the gut. Immunity 2008; 29: 261-271.
9.
Tsuji M, Komatsu N, Kawamoto S, et al. Preferential generation of follicular B helper T cells from Foxp3+ T cells in gut Peyer’s patches. Science 2009; 323: 1488-1492.
10.
Ferreira RC, Pan-Hammarström Q, Graham RR, et al. High-density SNP mapping of the HLA region identifies multiple independent susceptibility loci associated with selective IgA deficiency. PLoS Genetics 2012; 8: e1002476.
11.
Kralovicova J, Hammarström L, Plebani A, et al. Fine-scale mapping at IGAD1 and genome-wide genetic linkage analysis implicate HLA-DQ/DR as a major susceptibility locus in selective IgA deficiency and common variable immunodeficiency. J Immunol 2003; 170: 2765-2775.
12.
Bronson P, Chang D, Bhangale T, et al. Common variants at PVT1, ATG13-AMBRA1, AHI1 and CLEC16A are associated with selective IgA deficiency. Nat Amer 2016; 48: 1425-1429.
13.
Karaca NE, Severcan EU, Guven B, et al. TNFRSF13B/TACI Alterations in Turkish Patients with Common Variable Immunodeficiency and IgA Deficiency. Avicenna J Med Biotechnol 2018; 10: 192-195.
14.
Karaca NE, Severcan EU, Bilgin BG, et al. Familial inheritance and screening of first-degree relatives in common variable immunodeficiency and immunoglobulin A deficiency patients. Int J Immunopathol Pharmacol 2018; 32: 2058738418779458.
15.
Woof JM, Kerr MA. Immunoglobulin A: Molecular Mechanisms of Function and Role in Immune Defence. J Pathol 2013; 208: 270-282.
16.
Woof JM, Kerr MA. The function of immunoglobulin A in immunity. J Pathol 2006; 208: 270-282.
17.
Ganal-Vonarburg S, Macpherson AJ. IgA-about the unexpected. J Exp Med 2018; 215: 1965-1966.
18.
Mantis J, Rol N, Corthésy B. Secretory IgA’s Complex Roles in Immunity and Mucosal Homeostasis in the Gut. Mucosal Immunol 2011; 4: 603-611.
19.
Bakema JE, van Egmond M. The human immunoglobulin A Fc receptor FcαRI: a multifaceted regulator of mucosal immunity. Mucosal Immunol 2011; 4: 612-624.
20.
Hansen IS, Baeten D, Dunnen J. The inflammatory function of human IgA. Cell Mol Life Sci 2019; 76: 1041-1055.
21.
Berrón-Ruiz L, López-Herrera G, Vargas-Hernández A, et al. Lymphocytes and B-cell abnormalities in patients with common variable immunodeficiency (CVID). Allergol Immunopathol 2014; 42: 35-43.
22.
Litzman J, Vlková M, Pikulová Z, et al. T and B lymphocyte subpopulations and activation/differentiation markers in patients with selective IgA deficiency. Clin Exp Immunol 2006; 147: 249-254.
23.
Yel L. Selective IgA deficiency. J Clin Immunol 2010; 30: 10-16.
24.
Warnatz K, Denz A, Drager R, et al. Severe deficiency of switched memory B cells (CD27(+)IgM(–) IgD(–)) in subgroups of patients with common variable immunodeficiency: a new approach to classify a heterogeneous disease. Blood 2002; 99: 1544-1551.
25.
Nechvatalova J, Pavlik T, Litzman J, et al. Terminally differentiated memory T cells are increased in patients with common variable immunodeficiency and selective IgA deficiency. Centr Eur J Immunol 2017; 42: 244-251.
26.
Castigli E, Wilson SA, Garibyan L, et al. TACI is mutant in common variable immunodeficiency and IgA deficiency. Nat Genet 2005; 37: 829-834.
27.
Lemarquis AL, Einarsdottir HK, Kristjansdottir RN, et al. Transitional B Cells and TLR9 Responses Are Defective in Selective IgA Deficiency. Front Immunol 2018; 9: 909.
28.
Asano T, Kaneko H, Terada T, et al. Molecular analysis of B-cell differentiation in selective or partial IgA deficiency. Clin Exp Immunol 2004; 136: 284-290.
29.
Yazdani R, Fatholahi M, Ganjalikhani-Hakemi M, et al. Role of apoptosis in common variable immunodeficiency and selective immunoglobulin A deficiency. Mol Immunol 2016; 71: 1-9.
30.
Bateman EA, Ayers L, Sadler R, et al. T cell phenotypes in patients with common variable immunodeficiency disorders: associations with clinical phenotypes in comparison with other groups with recurrent infections. Clin Exp Immunol 2012; 170: 202-211.
31.
Rothblum-Oviatt C, Wright J, Lefton-Greif MA, et al. Ataxia telangiectasia: a review. Orphanet J Rare Dis 2016; 11: 159.
32.
Derfalvi B, Maurer K, McDonald McGinn DM, et al. B cell development in chromosome 22q11.2 deletion syndrome. Clin Immunol 2016; 163: 1-9.
33.
Macpherson AJ, Geuking MB, McCoy KD. Immunoglobulin A: a bridge between innate and adaptive immunity. Curr Opin Gastroenterol 2011; 27: 529-533.
34.
Gutzeit C, Magri G, Cerutti A. Intestinal IgA production and its role in host-microbiome interaction. Immunol Rev 2014; 260: 76-85.
35.
Macpherson AJ, Köller Y, McCoy KD. The bilateral responsiveness between intestinal microbes and IgA. Trends Immunol 2015; 36: 460-470.
36.
Donaldson GP, Ladinsky MS, Yu KB, et al. Gut microbiota utilize immunoglobulin A for mucosal colonization. Science 2018; 360: 795-800.
37.
Fadlallah J, El Kafsi H, Sterlin D, et al. Microbial ecology perturbation in human IgA deficiency. Sci Transl Med 2018; 10: pii: eaan1217.
38.
Palm NW, de Zoete MR, Cullen TW, et al. Immunoglobulin A coating identifies colitogenic bacteria In inflammatory bowel disease. Cell 2014; 158: 1000-1010.
39.
Bienvenu F, Anghel SI, Duvanel CB, et al. Early diagnosis of celiac disease in IgA deficient children: contribution of a point-of-care test. BMC Gastroenterol 2014; 14: 186.
40.
Pallav K, Xu H, Leffler DA, et al. Immunoglobulin A deficiency in Celiac Disease in the United States. J Gastroenterol Hepatol 2016; 31: 133-137.
41.
Cinetto F, Scarpa R, Rattazzi M, et al. The broad spectrum of lung diseases in primary antibody deficiencies. Eur Respir Rev 2018; 27: pii: 180019.
42.
Jesenak M, Banovcin P, Jesenakova B, et al. Pulmonary manifestations of primary immunodeficiency disorders in children. Front Pediatr 2014; 2: 77.
43.
Pasternak G, Lewandowicz-Uszyńska A, Pentoś K. Disorders of Humoral Immunity in Children with IgG Subclass Deficiency and Recurrent Respiratory Infections. Adv Exp Med Biol 2018; 1108: 99-106.
44.
Aghamohammadi A, Cheraghi T, Gharagozlou M, et al. IgA deficiency: correlation between clinical and immunological phenotypes. J Clin Immunol 2009; 29: 130-136.
45.
De Oliveira-Serra FA, Mosca T, Santos de Menezes MD, et al. Clinical symptoms in IgA deficiency. Rev Alerg Mex 2017; 64: 34-39.
46.
Hodkinson J, Bangs C, Wartenberg-Demand A, et al. Low IgA and IgM Is Associated with a Higher Prevalence of Bronchiectasis in Primary Antibody Deficiency. J Clin Immunol 2017; 37: 329.
47.
Schussler E, Beasley MB, Maglione PJ. Lung disease in primary antibody deficiencies. J Allergy Clin Immunol Pract 2016; 4: 1039-1042.
48.
Erkoçoğlu M, Civelek E, Kocabaş CN. Unusual presentation: Concurrent IgA deficiency and idiopathic pulmonary hemosiderosis. Pediatr Pulmonol 2016; 51: E34-E36.
49.
Özcan C, Metin A, Erkoçoğlu M, et al. Bronchial hyperreactivity in children with antibody deficiencies. Allergol Immunopathol (Madr) 2015; 43: 57-61.
50.
Özcan C, Metin A, Erkoçoğlu M, et al. Allergic diseases in children with primary immunodeficiencies. Turk J Pediatr 2014; 56: 41-47.
51.
Urm SH, Yun HD, Fenta YA, et al. Asthma and risk of selective IgA deficiency or common variable immunodeficiency: a population-based case-control study. Mayo Clin Proc 2013; 88: 813-821.
52.
Szczawińska-Popłonyk A, Komasińska P, Bręborowicz A. IgA deficiency: a risk factor for food allergy-related atopic dermatitis in infants and young children. Adv Dermatol Allergol 2016; XXXIII: 369-374.
53.
van de Ven AAJM, Janssen WJM, Schulz LS, et al. Increased Prevalence of Gastrointestinal Viruses and Diminished Secretory Immunoglobulin a Levels in Antibody Deficiencies. J Clin Immunol 2014; 34: 962-970.
54.
Aarason GJ, Jorgensen GH, Ludviksson BR. Primary immunodeficiency and autoimmunity: lessons from human diseases. Scand J Immunol 2010; 71: 317-328.
55.
Jacob CM, Pastorino AC, Fahl K, et al. Autoimmunity in IgA deficiency: revisiting the role of IgA as a silent housekeeper. J Clin Immunol 2008; 28: 56-61.
56.
Sparchez M, Lupan I, Delean D, et al. Primary complement and antibody deficiencies in autoimmune rheumatologic diseases with juvenile onset: a prospective study at two centers. Pediatr Rheumatol 2015; 13: 51.
57.
Carneiro-Sampaio M, Coutinho A. Early-onset autoimmune disease as a manifestation of primary immunodeficiency. Front Immunol 2015; 6: 185.
58.
Asada Y, Isomoto H, Shikuwa S, et al. Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency. World J Gastroenterol 2006; 12: 5240-5243.
59.
Mirpuri J, Raetz M, Sturge CR, et al. Proteobacteria-specific IgA regulates maturation of the intestinal microbiota. Gut Microbes 2014; 5: 28-39.
60.
Soheili H, Abolhassani H, Arandi N, et al. Evaluation of natural regulatory T cells in subjests with selective IgA deficiency: from senior idea to novel opportunities. Int Arch Allergy Immunol 2013; 160: 208-214.