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Increased serum IgA and decreased IgG3 strongly correlate with increased serum TGF‐β1 levels in patients with nonimmune chronic idiopathic neutropenia of adults

Abstract: Objective: To study the changes in serum immunoglobulins and some closely related pro‐inflammatory cytokines in patients with nonimmune chronic idiopathic neutropenia of adults (NI‐CINA). Methods: Serum levels of gamma‐globulins, IgG, IgA, IgM, IgG subclasses, interleukin‐4 (IL‐4), interferon‐gamma (IFN‐γ) and transforming growth factor‐beta1 (TGF‐β1) were evaluated in 83 NI‐CINA patients and 65 normal controls using the respective conventional methods. Results: We found that serum gamma‐globulin, IgG and IgG1 levels were all significantly increased in the entire group of patients studied, compared to controls (p<0.001, p<0.01 and p<0.01, respectively), while the levels of IgG3 were significantly reduced (p<0.001). Serum IgA were increased in patients with severe neutropenia (p<0.001). No significant changes were noted in serum IgM, IgG2 and IgG4 levels. The infrequent occurrence of detectable amounts of IL‐4 and IFN‐γ in the serum was similar in both, patients and control subjects. Serum levels of TGF‐β1 were increased in all groups of patients studied and they correlated inversely with the levels of IgG3 (p<0.001) and positively with the levels of IgA (p<0.001), suggesting the possible involvement of the cytokine in immunoglobulin class switching. Conclusion: Patients with NI‐CINA have significant changes in serum immunoglobulins and some inflammation‐related cytokines. These findings provide additional evidence for the existence of an unrecognized low‐grade chronic inflammatory process in NI‐CINA patients and coroborate our previously reported suggestion for the possible involvement of this inflammation in the pathogenesis of neutropenia in the affected subjects.