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Multireactive pattern of serum autoantibodies in asymptomatic individuals with immunoglobulin A deficiency.
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Selective
immunoglobulin
A
(
IgA
)
deficiency
(
sIgAD
)
is
associated
with
certain
autoimmune
states
.
Increased
production
of
autoantibodies
and
eventual
development
of
overt
autoimmune
disease
are
related
in
part
to
genetic
and
environmental
factors
as
well
as
to
the
immune
deficiency
.
We
surveyed
serum
specimens
from
60
healthy
subjects
with
sIgAD
for
the
presence
of
21
different
autoantibodies
by
enzyme-linked
immunosorbent
assays
.
The
frequencies
of
16
autoantibodies
were
higher
in
sIgAD
patients
than
in
normal
healthy
controls
.
Autoantibodies
to
Jo-
1
(
28
%
)
,
cardiolipin
(
21
%
)
,
phosphatidylserine
(
20
%
)
,
Sm
(
15
%
)
,
asialo-
GM
1
(
21
%
)
,
sulfatide
(
32
%
)
,
sulfoglucuronyl
paragloboside
(
11
%
)
,
and
collagen
type
I
(
10
%
)
were
detected
at
high
frequencies
in
comparison
to
those
of
normal
healthy
controls
.
Many
of
the
serum
samples
were
multireactive
(
i
.
e
.
,
exhibited
binding
to
more
than
two
autoantigens
)
.
Forty
percent
(
24
of
60
)
of
sIgAD
serum
samples
reacted
against
six
or
more
autoantigens
;
10
%
(
6
of
60
)
of
sIgAD
serum
samples
were
not
reactive
with
any
of
the
21
autoantigens
.
Three
percent
(
7
of
209
)
of
consecutive
serum
samples
submitted
for
autoimmune
antibody
analysis
that
were
positive
for
autoantibodies
were
from
patients
with
IgA
deficiency
.
Our
finding
of
an
increased
frequency
of
autoantibodies
in
sIgAD
patients
supports
the
notion
of
polyclonal
stimulation
by
repeated
environmental
stimuli
as
an
etiologic
mechanism
.
Alternatively
,
the
increased
frequency
may
be
caused
by
a
dysregulation
of
the
immune
response
in
such
individuals
.
The
mere
detection
of
autoantibodies
can
not
predict
whether
a
subject
with
sIgAD
will
develop
an
autoimmune
disease
or
determine
which
specific
disease
will
emerge
.
