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Meðfæddur IgA skortur

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Authors
Guðmundur H. Jörgensen
Björn Rúnar Lúðvíksson
Issue Date
2001-11-01

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Other Titles
The current concept of primary IgA deficiency and its prevalence in Iceland
Citation
Læknablaðið 2001, 87(11):873-79
Abstract
IgA deficiency is among the most common primary immune deficiency known. Its prevalence, ranging from 1/324-1/1850, depends upon the study group geographic location and its ethnicity. IgA deficiency is commonly associated with other immune defects such as IgG2, and IgG4 deficiency. In addition, ataxia telangiectasia has been associated with IgA deficiency as well. The clinical significans of IgA deficiency is presently unclear. However, increased susceptibility to atopy, autoimmunity, infections and cancer has been reported. Furthermore, majority of these diseases are bound to the mucosal surfaces; the organ where IgA is thought to have its most protective role. Recent studies focusing on the genealogy of primary IgA deficiency have found linkages to chromosome 6, 14, 18 and 22. In addition, a link to certain HLA haplotypes has been reported. Thus, further studies into the immunogenetics of IgA deficiency are needed, particularly focusing upon the question why some individuals with IgA deficiency are prone to diseases whereas others are not. In this article some of these questions are addressed, and the current literature on the topic reviewed.
IgA skortur er einn algengasti meðfæddi ónæmisgallinn og ræðst algengi hans meðal annars af kynþætti og þjóðerni. Hjá þjóðum N-Evrópu er algengið á bilinu 1/400-1/700. Einnig er þekkt að aðrir ónæmisgallar eins og IgG2 skortur og Louis-Bar heilkenni (ataxia telangiectasia) finnist hjá einstaklingum með IgA skort. IgA finnst í hvað mestum mæli á yfirborði slímhúðarinnar. Því er athyglivert að IgA skortur eykur líkur einstaklinga á að fá sjúkdóma er herja einna helst á slímhúðina og má þar nefna endurteknar sýkingar, ofnæmi og sjálfsofnæmissjúkdóma. Auk þess virðist þessum einstaklingum hættara við að fá krabbamein. Komið hefur í ljós að í sumum tilvikum hefur IgA skortur legið í ættum. Ættfræðilegar rannsóknir hafa þannig leitt í ljós tengsl við genasvæði á litningum 6, 14, 18 og 22. Auk þess virðast ákveðnar HLA samsætur hafa sterk tengsl við sjúkdóminn. Þrátt fyrir ítarlegar rannsóknir á orsökum og afleiðingum IgA skorts er mörgum lykilspurningum enn ósvarað og þá sérstaklega hvaða aðrir hugsanlegir virkir áhættuþættir leiða til ofangreindra sjúkdóma.
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Icelandic Journal Articles (Peer Reviewed)

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