Trough concentrations of specific antibodies in primary immunodeficiency patients receiving intravenous immunoglobulin replacement therapy

Ori Hassin, Yahya Abu Freih, Ran Hazan, Atar Lev, Keren S. Zrihen, Raz Somech, Arnon Broides, Amit Nahum*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Immunoglobulin replacement therapy is a mainstay therapy for patients with primary immunodeficiency (PID). The content of these preparations was studied extensively. Nevertheless, data regarding the effective specific antibodies content (especially in the nadir period), and, in different groups of PID patients is limited. We studied trough IgG concentrations as well as anti-Pneu-mococcus, anti-Haemophilus influenzae b, anti-Tetanus, and anti-Measles antibody concentrations in 17 PID patients receiving intravenous immunoglobulin (IVIg) compared with healthy controls matched for age and ethnicity. We also analyzed these results according to the specific PID diagno-sis: X-linked agammaglobulinemia (XLA), combined immunodeficiency (CID), and ataxia telangi-ectasia (AT). We recorded a higher concentration of anti-pneumococcal polysaccharide antibodies in healthy controls compared to the entire group of PID patients. We also found significantly higher anti-tetanus toxoid antibody concentrations in the XLA patients, compared to CID patients. Anti-Haemophilus Influenzae b antibody titers were overall similar between all the groups. Interestingly, there were overall low titers of anti-Measles antibodies below protective cutoff antibody concentrations in most patients as well as in healthy controls. We conclude that relying on total IgG trough levels is not necessarily a reflection of effective specific antibodies in the patient’s serum. This is especially relevant to CID patients who may have production of nonspecific antibodies. In such patients, a higher target trough IgG concentration should be considered. Another aspect worth considering is that the use of plasma from adult donors with a waning immunity for certain pathogens probably affects the concentrations of specific antibodies in IVIg preparations.

Original languageEnglish
Article number592
Pages (from-to)1-9
Number of pages9
JournalJournal of Clinical Medicine
Issue number4
StatePublished - 2 Feb 2021


  • Immunodefi-ciency
  • Intravenous immunoglobulin
  • Specific antibody
  • Trough concentration


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