Increased serum IgA and decreased IgG(3) strongly correlate with increasedserum TGF-beta(1) levels in patients with nonimmune chronic idiopathic neutropenia of adults

Objective: To study the changes in serum immunoglobulins and some closely r elated pro-inflammatory cytokines in patients with nonimmune chronic idiopa thic neutropenia of adults (NI-CINA). Methods. Serum levels of gamma-globul ins, IgG, IgA, IgM, IgG subclasses, interleukin-4 (IL-4), interferon-gamma (IFN-gamma) and transforming growth factor-beta(1) (TGF-beta(1)) were evalu ated in 83 NI-CINA patients and 65 normal controls using the respective con ventional methods. Results: We found that serum gamma-globulin, IgG and IgG (1) 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, respective ly), while the levels of IgG, were significantly reduced (p<0.001). Serum I gA were increased in patients with severe neutropenia (p< 0.001). No signif icant changes were noted in serum IgM, IgG(2) and IgG(4) levels. The infreq uent occurrence of detectable amounts of IL-4 and IFN-gamma in the serum wa s similar in both, patients and control subjects. Serum levels of TGF-beta( 1) were increased in all groups of patients studied and they correlated inv ersely with the levels of IgG, (p<0.001) and positively with the levels of IgA (p<0.001), suggesting the possible involvement of the cytokine in immun oglobulin class switching. Conclusion. Patients with NI-CINA have significa nt changes in serum immunoglobulins and some inflammation-related cytokines . These findings provide additional evidence for the existence of an unreco gnized low-grade chronic inflammatory process in NI-CINA patients and corob orate our previously reported suggestion for the possible involvement of th is inflammation in the pathogenesis of neutropenia in the affected subjects .