Introduction

When a foreign substance or organism enters the body, the immune system identifies the attack and produces special proteins called immunoglobulins. These are made and released by plasma cells. Having fewer immunoglobulins in the body makes one susceptible to infections. Too many immunoglobulins in the body could indicate allergies or an overactive immune system.

The body produces different types of immunoglobulins:

Immunoglobulin A (IgA).

Immunoglobulin G (IgG).

Immunoglobulin M (IgM).

Immunoglobulin D (IgD).

Immunoglobulin E (IgE).

Immunoglobulin G is the most common type of antibody, representing almost 75 % of the total serum antibodies. It is the main antibody in the blood and extracellular fluid and protects the body from infections by binding to bacteria, viruses, and fungi. Immunoglobulin G is the only immunoglobulin that can cross the placenta in mothers and is responsible for protecting the newborn during the first months of life. These are often used in immunological research and clinical diagnostics because of their relative abundance. IgG has four subclasses: IgG1, IgG2, IgG3, and IgG4, named in order of their abundance in the serum.

Immunoglobulin G antibodies are the smallest but the most abundant in the body. They help in providing secondary immune responses in the body. Functions of IgG include:

IgG binds to the pathogen and causes their immobilization.

IgG coating on the pathogen surface helps the phagocytic cells recognize and ingest them.

IgG activates a pathway for a cascade of immune protein production that helps in pathogen elimination.

IgG helps neutralize toxins.

IgG is the only antibody that passes through the human placenta and helps protect the fetus in utero.

IgG is secreted in the breast milk, and the IgG that passes through the placenta helps provide the infant with humoral immunity before the immune system develops.

IgG deficiency refers to a condition in which the body does not produce enough IgG (immunoglobulin G) antibodies. IgG protects the body against infections by binding to microorganisms, immobilizing and eliminating them. Hence, IgG deficiency makes the body more susceptible to infections, as the immune response against microorganisms like bacteria, viruses, and fungi gets impaired. The most common deficiency of IgG subclasses in early childhood is IgG2 deficiency, whereas, in adults, IgG1 and IgG3 deficiencies are more common. In addition, the development of IgG2 and IgG4 is slower in children compared to IgG1 and IgG3 levels. However, in some children, the complete development of the whole range of IgG subclasses can be delayed until the teenage years.

The cause of primary immunoglobulin G deficiency is not apparent, but genetics may play a role.

IgG deficiency can be caused by:

Malnutrition.

Chemotherapy.

Long-term corticosteroids.

HIV (human immunodeficiency virus).

Aging.

IgG deficiency affects both children and adults. Infections that can affect people with the condition include:

Gastrointestinal infections.

Ear infections.

Pneumonia.

Sinus infections.

Respiratory problems.

Sore throat.

Bronchitis.

Severe and life-threatening infections.

The level of immunoglobulins in the body is diagnosed through a blood test. An immunoglobulin test helps measure the levels of different types of immunoglobulins in the body. An individual may have an optimum total IgG level; hence it is crucial to test the concentration of the subclasses of IgG as well. Children lower than 24 months of age cannot make IgG2 antibodies; therefore, measuring levels of IgG2 before this age is not recommended.

It is a test that measures the level of different types of antibodies or immunoglobulin in the blood. The body produces antibodies to protect against bacteria, viruses, and allergens. The immunoglobulin produced for each type of infection is different; for example, the antibodies against measles are not the same as the antibodies for mononucleosis. Hence diagnosing the antibody produced helps identify an infection in the body. Sometimes the body may produce antibodies against its cells and organs, which is an autoimmune disorder.

The treatment for IgG deficiency depends upon the time of onset of symptoms and their severity. Symptoms that appear later in life are harder to manage, and the person will also be susceptible to further infections. The primary objective of treatment includes the appropriate use of antibiotics to treat and prevent infections. The type of antibiotic used and the duration of treatment would depend on the type and severity of the infection. Intravenous administration of 300 - 600 mg/kg of IgG once every three to four weeks, or 100 - 200 mg/kg/wk subcutaneously, is the currently recommended therapy. In patients with chronic sinopulmonary infections, higher doses are more effective. Although IgG replacement therapy has shown to be effective in appropriate patients, intravenous IgG may have infusion-related adverse effects. For example, three to 12 % of the treated patients developed myalgia, headache, fever, chills, and mild nausea. However, subcutaneous IgG replacement therapy was associated with local infusion site reactions and free from systemic reactions. Patients with persistent IgG deficiencies and frequent infections with optimum anti-polysaccharide antibodies must also be treated using adequate prevention, vaccine, and antibiotic therapy.

Conclusion

IgG is the smallest and the most abundant antibody in the serum and constitutes 75 % of the total serum. It helps in protecting the body from infections by binding to the microorganism, immobilizing, and eliminating the pathogen. It also helps neutralize toxins. Immunoglobulin G is the only antibody that can pass through the placenta; hence they play an essential role in the humoral immunity of the fetus in utero and during the first few months after birth. The deficiency of IgG antibodies makes a person more susceptible to infections, and an abundance than required of IgG develops allergies and an overactive immune response. IgG deficiency can be treated with IgG replacement therapy. If one is diagnosed with IgG deficiency, consult the healthcare provider whenever there is a sign of infection, including a minor cold.