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IgG subclasses of FVIII inhibitors in an argentine cohort of severe hemophilia A patients: Analysis by flow cytometry.

Abstract：

INTRODUCTION:FVIII inhibitors consist of a polyclonal population of antibodies. Previous studies have demonstrated different distribution of IgG subclasses. IgG4 was associated to high level of FVIII inhibitors and failure of immune tolerance induction (ITI) treatment. This study monitored the relative distribution of IgG subclasses of anti-FVIII in patients with severe hemophilia A (SHA). METHODS:Anti-FVIII antibodies were measured employing an immunomethod, developed in our laboratory, that combines flow cytometry (FC) with microspheres coupled (FVIII-m) or not (Control-m) to FVIII. Seventy-five patients with SHA were studied, 17 without inhibitors (Group I); 58 with inhibitor history, 13 low responders: (LR: Group II), and 45 high responders (HR: Group III). Eight patients undergoing ITI were also included. RESULTS:We found anti-FVIII antibodies in 11 of 27 patients (40%) without inhibitors and in 45 of 48 with inhibitors at the moment of the study. IgG4 was predominant only in the Group III: P=0.02 in patients with low level of inhibitors and P=0.0001 with high titer of inhibitors. Longitudinal analysis performed on patients undergoing ITI showed a gradual decrease of IgG4 values that was associated to improvement of clinical parameters during treatment. CONCLUSION:We suggest the use of the FC method to supplement functional traditional assays and to help to improve the management of patients with SHA.

journal_name

Int J Lab Hematol

journal_title

International journal of laboratory hematology

authors

Irigoyen MB,Primiani L,Felippo M,Candela M,de Bracco MME,Galassi NV

doi

10.1111/ijlh.12696

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

569-576

issue

6

eissn

1751-5521

issn

1751-553X

journal_volume

39

pub_type

杂志文章

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