IMMUNOGLOBULIN SERUM CONCENTRATIONS DO NOT CORRELATE WITH ACUTE APPENDICITIS
Abstract
Immunoglobulins are a central component of humoral immunity and their serum concentrations are routinely determined in clinical practice because they provide key information on the humoral immune status. In a single centre prospective design study, we evaluated IgA, IgE, IgG, and IgM serum concentrations in patients with histologically confirmed acute appendicitis (study group, N=54) and compared it to the control group (N=69), patients submitted to appendectomy, but with normal histological findings, patients submitted to day case surgery and healthy volunteers. The serum concentrations of immunoglobulins were normal in all cases, except for IgE, that were elevated in both the study (20%) and control (21 %) groups (p= 0.609). These values are in good agreement with the prevalence of allergies in the general population. Our study is the first to address specifically the acute appendicitis Immunoglobulins humoral immune response in the English literature. We showed that acute appendicitis does not elicit a specific humoral immune response.
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References
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15. Landry ML. Immunoglobulin M for Acute Infection: True or False? Clin Vaccine Immunol. 2016 Jul 5;23(7):540-5. doi: 10.1128/CVI.00211-16. PMID: 27193039; PMCID: PMC4933779.
16. Kumar Y, Lakshmi PVM, Minz RW, Chhabra S, Saikia B (2015) Evaluation of Serum Immunoglobulins IgG, IgA, IgM and Total IgE in Chronic Alcoholics: A Community-based Study. Immunochem Immunopathol 1: 102. doi: 10.4172/2469- 9756.1000102
17. Fuller JM, Keyser JW. Serum immunoglobulins after surgical operation. Clin Chem. 1975 May; 21(6):667-71. PMID: 1122610.
18 Khamis RY, Hughes AD, Caga-Anan M, Chang CL, Boyle JJ, Kojima C, Welsh P, Sattar N, Johns M, Sever P, Mayet J, Haskard DO. High Serum Immunoglobulin G and M Levels Predict Freedom From Adverse Cardiovascular Events in Hypertension: A Nested Case-Control Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial. EBioMedicine. 2016 Jul; 9:372-380. doi: 10.1016/j.ebiom.2016.06.012. Epub 2016 Jun 20. PMID: 27333022; PMCID: PMC4972545.
19. Lamps LW. Infectious Causes of Appendicitis. Infect Dis Clin North Am. 2010;24(4):995-1018. doi:10.1016/j.idc.2010.07.012
20. Aspasia Katragkou, Emmanuel Roilides, and Thomas J. Walsh. Role of Immunoglobulin Therapy to Prevent and Treat Infections. Management of Infections in the Immunocompromised Host, 2018. Jun 19: 339-358
21. Latiff AH, Kerr MA. The clinical significance of immunoglobulin A deficiency. Ann Clin Biochem. 2007 Mar;44(Pt 2):131-9. doi: 10.1258/000456307780117993. PMID: 17362578.
22. Woof JM, Kerr MA. The function of immunoglobulin A in immunity. J Pathol. 2006 Jan;208(2):270-82. doi: 10.1002/path.1877. PMID: 16362985
23. Vernersson, M., 2002. The rise and fall of IgE. Acta Universitatis Upsaliensis.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and
Technology. 742. 61 pp. Uppsala. ISBN 91-554-5388-0.
24. Pate MB, Smith JK, Chi DS, Krishnaswamy G. Regulation and dysregulation of immunoglobulin E: a molecular and clinical perspective. Clin Mol Allergy. 2010 Feb 23;8:3. doi: 10.1186/1476-7961-8-3. PMID: 20178634; PMCID: PMC2837605.
25. Carvalho N, Barros A, Coelho H, Cóias A, Botelho P, Cismasiu B, Moita L, Costa P. Increased IgE Deposition in Appendicular Tissue Specimens Is Compatible with a Type I Hypersensitivity Reaction in Acute Appendicitis. Mediators Inflamm. 2021 Oct 18;2021:4194859. doi: 10.1155/2021/4194859. PMID: 34707461; PMCID: PMC8545569.
26. Camilla Janefjord. Th1, Th2 and Treg associated factors in relation to allergy. Linköping University Medical Dissertations No. 947. ISBN: 91-85497-83-5
27. Dullaers M, De Bruyne R, Ramadani F, Gould HJ, Gevaert P, Lambrecht BN. The who, where, and when of IgE in allergic airway disease. J Allergy Clin Immunol. 2012 Mar;129(3):635-45. doi: 10.1016/j.jaci.2011.10.029. Epub 2011 Dec 9. PMID: 22168998.
28. Salö M, Gudjonsdottir J, Omling E, Hagander L, Stenström P. Association of IgE-Mediated Allergy With Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr. 2018 Oct 1;172(10):943-948. doi: 10.1001/jamapediatrics.2018.1634. PMID: 30083704; PMCID: PMC6233766.
29. Das NM, Thomas S, Aravindan KP. Morphology and serum IgE levels in recurrent acute appendicitis. Int. J. Adv. Res. 2016, 4(10), 855-859. DOI: 10.21474/IJAR01/1869
30. Gudjonsdottir J, Roth B, Lovén G, Ohlsson B, Hagander L and Salö M (2022) An Evaluation of Serum IgE and Th2-Associated Interleukins in Children With Uncomplicated and Complicated Appendicitis. Front. Pediatr. 10:884138. doi: 10.3389/fped.2022.884138
2. Carvalho N, Borges F, Costa B, Costa P. A etiologia da apendicite aguda. Será a alergia o elo perdido? Uma revisão narrativa. The aetiology of acute appendicitis. Is allergy the missing link? A narrative review. Revista Portuguesa de Cirurgia, [S.l.], n. 52, p. 1-10, mar. 2022. ISSN 2183-1165
3. Watson Ng WS, Hampartzoumian T, Lloyd AR, Grimm MC. A murine model of appendicitis and the impact of inflammation on appendiceal lymphocyte constituents. Clin Exp Immunol. 2007 Oct; 150(1):169-78. doi: 10.1111/j.1365-2249.2007.03463.x. Epub 2007 Aug 3. PMID: 17680826; PMCID: PMC2219294.
4. van den Boom AL, de Wijkerslooth EML, Mauff KAL, Dawson I, van Rossem CC, Toorenvliet BR, Wijnhoven BPL. Interobserver variability in the classification of appendicitis during laparoscopy. Br J Surg. 2018 Jul; 105(8):1014-1019. doi: 10.1002/bjs.10837. Epub 2018 Apr 16. PMID: 29663311; PMCID: PMC6033013.
5. Andreu-Ballester JC, Pérez-Griera J, Ballester F, Colomer-Rubio E, Ortiz-Tarín I, Peñarroja Otero C. Secretory immunoglobulin A (sIgA) deficiency in serum of patients with GALTectomy (appendectomy and tonsillectomy). Clin Immunol. 2007 Jun;123(3):289-97. doi: 10.1016/j.clim.2007.02.004. Epub 2007 Apr 20. PMID: 17449327
6. Abu-Raya B, Michalski C, Sadarangani M, Lavoie PM. Maternal Immunological Adaptation During Normal Pregnancy. Front Immunol. 2020 Oct 7;11:575197. doi: 10.3389/fimmu.2020.575197. PMID: 33133091; PMCID: PMC7579415.
7. Rolf Pieper, Lars Kager, Per Nasman, Lamps LW. Beyond acute inflammation a review of appendicitis and infections of the appendix. Diagnostic Histopathology 14:2, 2008
8. Cooley Butler, Surgical Pathology of Acute Appendicitis. Human Pathology -Vol 12, Nº 10 October 1981. 870-878
9. Rubér M, Berg A, Ekerfelt C, Olaison G, Andersson RE. Different cytokine profiles in patients with a history of gangrenous or phlegmonous appendicitis. Clin Exp Immunol. 2006 Jan;143(1):117-24. doi: 10.1111/j.1365-2249.2005.02957.x. PMID: 16367942; PMCID: PMC1809572.
10. Rubér M, Andersson M, Petersson BF, Olaison G, Andersson RE, Ekerfelt C. Systemic Th17-like cytokine pattern in gangrenous appendicitis but not in phlegmonous appendicitis. Surgery. 2010 Mar;147(3):366-72. doi: 10.1016/j.surg.2009.09.039. Epub 2009 Nov 5. PMID: 19892382.
11. Guo X, Meng G, Liu F, Zhang Q, Liu L, Wu H, Du H, Shi H, Xia Y, Liu X, Li C, Bao X, Su Q, Gu Y, Fang L, Yu F, Yang H, Yu B, Sun S, Wang X, Zhou M, Jia Q, Chen X, Huang G, Song K, Niu K. Serum levels of immunoglobulins in an adult population and their relationship with type 2 diabetes. Diabetes Res Clin Pract. 2016 May; 115:76-82. doi: 10.1016/j.diabres.2016.03.007. Epub 2016 Mar 12. PMID: 27242126.
12. Salminen P. Acute Appendicitis Incidence-Predisposing Factors, From Microbiota to Socioeconomic Status? JAMA Surg. 2020 Apr 1;155(4):338-339. doi: 10.1001/jamasurg.2019.6031. PMID: 32129802.
13. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015 Sep 26; 386(10000):1278-1287. doi: 10.1016/S0140-6736(15)00275-5. Erratum in: Lancet. 2017 Oct 14; 390(10104):1736. PMID: 26460662
14. Carvalho N, Barros A, Coelho HO, Moita CF, Neves-Costa A, Pedroso D, Borges FC, Moita LF, Costa PM. A Th2 Cytokine Profile in Appendicular Lavage Fluid Suggests Allergy as a Possible Etiology for Acute Appendicitis. Mediators Inflamm. 2019 Oct 28; 2019:8146257. doi: 10.1155/2019/8146257. PMID: 31772507; PMCID: PMC6854935.
15. Landry ML. Immunoglobulin M for Acute Infection: True or False? Clin Vaccine Immunol. 2016 Jul 5;23(7):540-5. doi: 10.1128/CVI.00211-16. PMID: 27193039; PMCID: PMC4933779.
16. Kumar Y, Lakshmi PVM, Minz RW, Chhabra S, Saikia B (2015) Evaluation of Serum Immunoglobulins IgG, IgA, IgM and Total IgE in Chronic Alcoholics: A Community-based Study. Immunochem Immunopathol 1: 102. doi: 10.4172/2469- 9756.1000102
17. Fuller JM, Keyser JW. Serum immunoglobulins after surgical operation. Clin Chem. 1975 May; 21(6):667-71. PMID: 1122610.
18 Khamis RY, Hughes AD, Caga-Anan M, Chang CL, Boyle JJ, Kojima C, Welsh P, Sattar N, Johns M, Sever P, Mayet J, Haskard DO. High Serum Immunoglobulin G and M Levels Predict Freedom From Adverse Cardiovascular Events in Hypertension: A Nested Case-Control Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial. EBioMedicine. 2016 Jul; 9:372-380. doi: 10.1016/j.ebiom.2016.06.012. Epub 2016 Jun 20. PMID: 27333022; PMCID: PMC4972545.
19. Lamps LW. Infectious Causes of Appendicitis. Infect Dis Clin North Am. 2010;24(4):995-1018. doi:10.1016/j.idc.2010.07.012
20. Aspasia Katragkou, Emmanuel Roilides, and Thomas J. Walsh. Role of Immunoglobulin Therapy to Prevent and Treat Infections. Management of Infections in the Immunocompromised Host, 2018. Jun 19: 339-358
21. Latiff AH, Kerr MA. The clinical significance of immunoglobulin A deficiency. Ann Clin Biochem. 2007 Mar;44(Pt 2):131-9. doi: 10.1258/000456307780117993. PMID: 17362578.
22. Woof JM, Kerr MA. The function of immunoglobulin A in immunity. J Pathol. 2006 Jan;208(2):270-82. doi: 10.1002/path.1877. PMID: 16362985
23. Vernersson, M., 2002. The rise and fall of IgE. Acta Universitatis Upsaliensis.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and
Technology. 742. 61 pp. Uppsala. ISBN 91-554-5388-0.
24. Pate MB, Smith JK, Chi DS, Krishnaswamy G. Regulation and dysregulation of immunoglobulin E: a molecular and clinical perspective. Clin Mol Allergy. 2010 Feb 23;8:3. doi: 10.1186/1476-7961-8-3. PMID: 20178634; PMCID: PMC2837605.
25. Carvalho N, Barros A, Coelho H, Cóias A, Botelho P, Cismasiu B, Moita L, Costa P. Increased IgE Deposition in Appendicular Tissue Specimens Is Compatible with a Type I Hypersensitivity Reaction in Acute Appendicitis. Mediators Inflamm. 2021 Oct 18;2021:4194859. doi: 10.1155/2021/4194859. PMID: 34707461; PMCID: PMC8545569.
26. Camilla Janefjord. Th1, Th2 and Treg associated factors in relation to allergy. Linköping University Medical Dissertations No. 947. ISBN: 91-85497-83-5
27. Dullaers M, De Bruyne R, Ramadani F, Gould HJ, Gevaert P, Lambrecht BN. The who, where, and when of IgE in allergic airway disease. J Allergy Clin Immunol. 2012 Mar;129(3):635-45. doi: 10.1016/j.jaci.2011.10.029. Epub 2011 Dec 9. PMID: 22168998.
28. Salö M, Gudjonsdottir J, Omling E, Hagander L, Stenström P. Association of IgE-Mediated Allergy With Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr. 2018 Oct 1;172(10):943-948. doi: 10.1001/jamapediatrics.2018.1634. PMID: 30083704; PMCID: PMC6233766.
29. Das NM, Thomas S, Aravindan KP. Morphology and serum IgE levels in recurrent acute appendicitis. Int. J. Adv. Res. 2016, 4(10), 855-859. DOI: 10.21474/IJAR01/1869
30. Gudjonsdottir J, Roth B, Lovén G, Ohlsson B, Hagander L and Salö M (2022) An Evaluation of Serum IgE and Th2-Associated Interleukins in Children With Uncomplicated and Complicated Appendicitis. Front. Pediatr. 10:884138. doi: 10.3389/fped.2022.884138
Published
2022-12-09
How to Cite
CARVALHO, Nuno et al.
IMMUNOGLOBULIN SERUM CONCENTRATIONS DO NOT CORRELATE WITH ACUTE APPENDICITIS.
Revista Portuguesa de Cirurgia, [S.l.], n. 53, p. 37-45, dec. 2022.
ISSN 2183-1165.
Available at: <https://revista.spcir.com/index.php/spcir/article/view/970>. Date accessed: 03 oct. 2023.
doi: https://doi.org/10.34635/rpc.970.
Section
Original Papers
