Skip to main content

The Immunobiology of Immunoglobulin G4 and Complement Activation Pathways in IgG4-Related Disease

  • Chapter
  • First Online:
IgG4-Related Disease

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 401))

Abstract

High serum immunoglobulin (Ig) G4 concentration and abundant IgG4-bearing plasma cell infiltration are characteristic features in autoimmune pancreatitis (AIP). AIP is also complicated with a variety of other organ involvements that commonly share marked IgG4-bearing plasma cell infiltration, suggesting the existence of a systemic disease associated with IgG4 currently recognized as IgG4-related disease (IgG4-RD). However, it is controversial whether IgG4 plays a role in the pathogenesis of AIP or IgG4-RD through such characteristic attributes as Fab-arm exchange and rheumatoid factor (RF)-like activity. Hypocomplementemia has been observed in AIP and several other IgG4-RDs. Muraki et al. reported that complements C3 and C4 were decreased in 36 % of patients with AIP, which implicated the complement activation system in disease pathogenesis. AIP patients with a high level of immune complexes showed serum elevation of IgG4-type immune complexes in an active disease stage, elevated serum IgG1 concentration, and decreased C3 and C4 values. This inferred that while IgG4 may have had little contribution to complement activation, IgG1 played a prominent role via the classical pathway. On the other hand, Sugimoto et al. observed that polyethylene glycol-precipitated immune complexes from patients with IgG4-RD and hypocomplementemia had the ability to activate the complement system through both the classical and the mannose-binding lectin pathways and that IgG4 might participate in the complement activation system. Thus, debate continues on which complement activation systems are working in AIP and IgG4-RD and whether they are associated with the pathogenesis of these conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aalberse R (2011) The role of IgG antibodies in allergy and immunotherapy. Allergy 66(Suppl 95):28–30. doi:10.1111/j.1398-9995.2011.02628.x

    Article  PubMed  Google Scholar 

  • Aalberse RC, Stapel SO, Schuurman J, Rispens T (2009) Immunoglobulin G4: an odd antibody. Clin Exp Allergy 39(4):469–477. doi:10.1111/j.1365-2222.2009.03207.x (CEA3207 [pii])

    Article  CAS  PubMed  Google Scholar 

  • Abraham SC, Cruz-Correa M, Argani P, Furth EE, Hruban RH, Boitnott JK (2003) Lymphoplasmacytic chronic cholecystitis and biliary tract disease in patients with lymphoplasmacytic sclerosing pancreatitis. Am J Surg Pathol 27(4):441–451

    Article  PubMed  Google Scholar 

  • Beck LH Jr, Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD et al (2009) M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 361(1):11–21. doi:10.1056/NEJMoa0810457 (361/1/11 [pii])

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ferrari S, Mudde GC, Rieger M, Veyradier A, Kremer Hovinga JA, Scheiflinger F (2009) IgG subclass distribution of anti-ADAMTS13 antibodies in patients with acquired thrombotic thrombocytopenic purpura. Journal of thrombosis and haemostasis: JTH. 7(10):1703–1710. doi:10.1111/j.1538-7836.2009.03568.x

    Google Scholar 

  • Hamano H, Kawa S, Horiuchi A, Unno H, Furuya N, Akamatsu T et al (2001) High serum IgG4 concentrations in patients with sclerosing pancreatitis. New Engl J Med 344(10):732–738

    Article  CAS  PubMed  Google Scholar 

  • Hamano H, Kawa S, Ochi Y, Unno H, Shiba N, Wajiki M et al (2002) Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis. Lancet 359(9315):1403–1404. doi:10.1016/S0140-6736(02)08359-9

    Article  PubMed  Google Scholar 

  • Hennig C, Rink L, Kirchner H (2000) Evidence for presence of IgG4 anti-immunoglobulin autoantibodies in all human beings. Lancet 355(9215):1617–1618. doi:10.1016/S0140-6736(00)02223-6

    Article  CAS  PubMed  Google Scholar 

  • Ito T, Kitahara K, Umemura T, Ota M, Shimozuru Y, Kawa S et al (2010) A novel heterophilic antibody interaction involves IgG4. Scand J Immunol 71(2):109–114. doi:10.1111/j.1365-3083.2009.02353.x (SJI2353 [pii])

    Article  CAS  PubMed  Google Scholar 

  • Kamisawa T, Funata N, Hayashi Y (2004) Lymphoplasmacytic sclerosing pancreatitis is a pancreatic lesion of IgG4-related systemic disease. Am J Surg Pathol. 28(8):1114. doi:00000478-200408000-00023 [pii]

    Google Scholar 

  • Kawa S, Hamano H (2007) Clinical features of autoimmune pancreatitis. J Gastroenterol 42(Suppl 18):9–14. doi:10.1007/s00535-007-2044-x

    Article  PubMed  Google Scholar 

  • Kawa S, Kitahara K, Hamano H, Ozaki Y, Arakura N, Yoshizawa K et al (2008) A novel immunoglobulin-immunoglobulin interaction in autoimmunity. PLoS ONE 3(2):e1637. doi:10.1371/journal.pone.0001637

    Article  PubMed  PubMed Central  Google Scholar 

  • Kawaguchi K, Koike M, Tsuruta K, Okamoto A, Tabata I, Fujita N (1991) Lymphoplasmacytic sclerosing pancreatitis with cholangitis: a variant of primary sclerosing cholangitis extensively involving pancreas. Hum Pathol 22(4):387–395

    Article  CAS  PubMed  Google Scholar 

  • Masaki Y, Dong L, Kurose N, Kitagawa K, Morikawa Y, Yamamoto M et al (2008) Proposal for a new clinical entity, IgG4-positive multi-organ lymphoproliferative syndrome: analysis of 64 cases of IgG4-related disorders. Ann Rheum Dis 68:1310–1315. doi:10.1136/ard.2008.089169 (ard.2008.089169 [pii])

    Article  PubMed  Google Scholar 

  • Medzhitov R, Janeway C Jr (2000) Innate immunity. N Engl J Med 343(5):338–344. doi:10.1056/NEJM200008033430506

    Article  CAS  PubMed  Google Scholar 

  • Mukai M, Shinata R, Sugisaki T (2004) Circulating IgG4 anti-IgG4 antibodies in patients with idiopathic membranous nephropathy. Showa Univ J Med Sci 16:289–299

    Article  CAS  Google Scholar 

  • Muraki T, Hamano H, Ochi Y, Komatsu K, Komiyama Y, Arakura N et al (2006) Autoimmune pancreatitis and complement activation system. Pancreas. 32(1):16–21. doi:00006676-200601000-00003 [pii]

    Google Scholar 

  • Plomp JJ, Huijbers MG, van der Maarel SM, Verschuuren JJ (2012) Pathogenic IgG4 subclass autoantibodies in MuSK myasthenia gravis. Ann NY Acad Sci 1275:114–122. doi:10.1111/j.1749-6632.2012.06808.x

    Article  CAS  PubMed  Google Scholar 

  • Rispens T, Ooievaar-De Heer P, Vermeulen E, Schuurman J, van der Neut Kolfschoten M, Aalberse RC (2009) Human IgG4 binds to IgG4 and conformationally altered IgG1 via Fc-Fc interactions. J Immunol. 182(7):4275–4281. doi:10.4049/jimmunol.0804338 (182/7/4275 [pii])

  • Rispens T, Ooijevaar-de Heer P, Bende O, Aalberse RC (2011) Mechanism of immunoglobulin G4 Fab-arm exchange. J Am Chem Soc. 133(26):10302–10311. doi:10.1021/ja203638y

    Google Scholar 

  • Rock B, Martins CR, Theofilopoulos AN, Balderas RS, Anhalt GJ, Labib RS et al (1989) The pathogenic effect of IgG4 autoantibodies in endemic pemphigus foliaceus (fogo selvagem). N Engl J Med 320(22):1463–1469

    Article  CAS  PubMed  Google Scholar 

  • Saeki T, Ito T, Yamazaki H, Imai N, Nishi S (2009) Hypocomplementemia of unknown etiology: an opportunity to find cases of IgG4-positive multi-organ lymphoproliferative syndrome. Rheumatol Int. doi:10.1007/s00296-009-0925-4

    PubMed  Google Scholar 

  • Saeki T, Nishi S, Imai N, Ito T, Yamazaki H, Kawano M et al (2010) Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis. Kidney Int 78(10):1016–1023. doi:10.1038/ki.2010.271 (ki2010271 [pii])

    Article  CAS  PubMed  Google Scholar 

  • Shiokawa M, Kodama Y, Kuriyama K, Yoshimura K, Tomono T, Morita T et al (2016) Pathogenicity of IgG in patients with IgG4-related disease. Gut. doi:10.1136/gutjnl-2015-310336

    PubMed  Google Scholar 

  • Shirakata Y, Shiraishi S, Sayama K, Miki Y (1990) Subclass characteristics of IgG autoantibodies in bullous pemphigoid and pemphigus. J Dermatol 17(11):661–666

    Article  CAS  PubMed  Google Scholar 

  • Stone JH, Zen Y, Deshpande V (2012) IgG4-related disease. N Engl J Med 366(6):539–551. doi:10.1056/NEJMra1104650

    Article  CAS  PubMed  Google Scholar 

  • Sugimoto M, Watanabe H, Asano T, Sato S, Takagi T, Kobayashi H et al (2016) Possible participation of IgG4 in the activation of complement in IgG4-related disease with hypocomplementemia. Mod Rheumatol 26(2):251–258. doi:10.3109/14397595.2015.1076924

    Article  CAS  PubMed  Google Scholar 

  • Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T et al (2011) A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details. Mod Rheumatol. doi:10.1007/s10165-011-0508-6

    PubMed  PubMed Central  Google Scholar 

  • van der Neut Kolfschoten M, Schuurman J, Losen M, Bleeker WK, Martinez-Martinez P, Vermeulen E et al (2007) Anti-inflammatory activity of human IgG4 antibodies by dynamic Fab arm exchange. Science 317(5844):1554–1557. doi:10.1126/science.1144603 (317/5844/1554 [pii])

    Article  Google Scholar 

  • van der Zee JS, van Swieten P, Aalberse RC (1986) Serologic aspects of IgG4 antibodies. II. IgG4 antibodies form small, nonprecipitating immune complexes due to functional monovalency. J Immunol. 137(11):3566–3571

    Google Scholar 

  • Wucherpfennig KW, Yu B, Bhol K, Monos DS, Argyris E, Karr RW et al (1995) Structural basis for major histocompatibility complex (MHC)-linked susceptibility to autoimmunity: charged residues of a single MHC binding pocket confer selective presentation of self-peptides in pemphigus vulgaris. Proc Natl Acad Sci USA. 92(25):11935–11939

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yamamoto M, Takahashi H, Ohara M, Suzuki C, Naishiro Y, Yamamoto H et al (2006) A new conceptualization for Mikulicz’s disease as an IgG4-related plasmacytic disease. Mod Rheumatol 16(6):335–340. doi:10.1007/s10165-006-0518-Y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yang Y, Wang C, Jin L, He F, Li C, Gao Q et al (2016) IgG4 anti-phospholipase A2 receptor might activate lectin and alternative complement pathway meanwhile in idiopathic membranous nephropathy: an inspiration from a cross-sectional study. Immunol Res. doi:10.1007/s12026-016-8790-1

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shigeyuki Kawa .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kawa, S. (2016). The Immunobiology of Immunoglobulin G4 and Complement Activation Pathways in IgG4-Related Disease. In: Okazaki, K. (eds) IgG4-Related Disease. Current Topics in Microbiology and Immunology, vol 401. Springer, Cham. https://doi.org/10.1007/82_2016_39

Download citation

Publish with us

Policies and ethics