IMMUNE-COMPLEXES IN COCCIDIOIDOMYCOSIS - CORRELATION WITH DISEASE INVOLVEMENT

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Abstract
Circulating immune complexes were quantitated by C[complement component]1q-binding assays of serum from 73 patients with active coccidioidomycosis, 5 patients with inactive disease and 34 healthy subjects. Immune complexes were detected in sera of 8 (44%) of 18 patients with active pulmonary disease and 22 (40%) of 55 patients with active disseminated disease. Results in none of 5 patients with inactive disease and in only 2 (9%) of 34 healthy subjects were positive by the C1q-binding assay. Immune complex levels did not differ in patients with pulmonary disease vs. those with disseminated disease but did correlate with disease involvement. Of 57 patients with coccidioidomycosis involving a single organ system (pulmonary or extrapulmonary), 19 (33%) had immune complexes compared with 6 (67%) of 9 patients with disease involving 2 organ systems and 5 (71%) of 7 patients with disease of .gtoreq. 3 organ systems. Immune complex levels correlated with serum IgG but did not correlate with serum complement-fixing antibody titers to coccidioidin. The correlation curve between immune complexes and complement-fixing antibody titers yielded a bell-shaped distribution. This distribution pattern suggests that changes in antibody concentration affect the size and lattice of immune complexes, resulting in altered detection and/or clearance from the bloodstream.