Immunoglobulin levels from the newborn period to adulthood and in immunoglobulin deficiency states.

Beta-2A globulin and the 7S and 19S gamma globulins are the major proteins of the serum derived from the immune system. Collectively they have been termed the immunoglobulins. The 19S gamma globulin, also known as the gamma-1 macroglobulin, the 82 macroglobulin or 82M, has been the subject of intensive study in recent years. The rheumatoid factor as well as a variety of anti-bodies fall into this protein group, and abnormally high levels are found in Waldenstroem's macro-globulinemia. Less is known about 82A globulin (gamma 1-A). It is like gamma globulin in that it has a sedimentation constant of 7S, but contains more carbohydrate (1). Recent observations imply that it is the carrier of the reaginic activity of the serum (2). All of immunoglobulins are easily detectable in normal adult serum by im-munoelectrophoretic analysis. 82A and 82M are absent in cord serum, and in agammaglobulinemia all three immunoglobulins are absent or in greatly reduced concentrations. Other antibody deficiency states have been described in which only one or two immunoglobulins are in low concentration (3-6). The present paper reports the levels of the im-munoglobulins in cord serum and in the serum of infants, children, and adults as determined by a method based on a combination of immunoelectro-phoretic analysis and the quantitative precipitin reaction (7). The data reveal a variable rate of maturation of the synthetic mechanisms for these proteins that is not apparent from semi-quantitative estimates based on simple immunoelectro-phoretic analysis of serum. Also reported are the serum levels of the immunoglobulins in various immunoglobulin and antibody deficiency states, including agammaglobulinemia, hypogammaglobu-linemia, agammaglobulinemia with 82 macroglobu-linemia, isolated P2A deficiency, various transient hypoimmunoglobulinemias, and the Aldrich syndrome. The data bring out a number of points concerning interrelationships among the immunoglobulins. In all the deficiency states, the most frequently affected immunoglobulin is 82A. This protein was usually low or absent in conditions in which #2M and gamma globulin were low. Beta-2A does not appear, however, to have antibody activity of clinical importance, since isolated P82A deficiency seen in a number of subjects is not associated with an antibody deficiency syndrome. Isolated P2m deficiency was not seen. In certain of the deficiency states the immunoglobulin patterns correspond closely to those that would obtain with arrest of development at various stages in the immuno-globin maturation sequence. An unexpected observation was an unusually high level of /2A in Aldrich's syndrome (8), a hereditary disease characterized by absence …