Serum Immunoglobulin Levels and Natural Antibodies to Haemophilus influenzae in Hemodialysis Patients: Evidence for IgG Subclass Imbalances

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Abstract
Humoral immune parameters were studied in 13 patients with end-stage renal failure on maintenance hemodialysis. Serum IgA, IgM and IgG concentrations were comparable to control values from 14 healthy blood donors. IgG subclass analysis revealed significantly increased IgGl levels in the patients when compared to controls (p < 0.01). In 3 patients, IgG2 deficiency was found, in one case associated with low IgG3 level. Concentrations and subclass composition of naturally occurring antibodies to Haemophilus influenzae type b (Hib) polysaccharide (PS) were measured using an indirect ELISA. In patients IgM and IgG, including IgGl and IgG2 antibodies to Hib, presented no difference from controls. Subclass analysis of Hib specific IgG antibodies revealed that IgG2 accounted for a substantial amount of the anti-Hib PS antibody response in controls as well as in patients. We conclude that patients on maintenance hemodialysis present imbalances of immunoglobulin levels. However, the antibody response to certain PS antigens could remain unaffected by renal failure.