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. 2024 Jul 19;11:1388940. doi: 10.3389/fmed.2024.1388940

Table 1.

Studies reporting on associations between serum/mucosal IgG4 and IBD.

Author, year Study design Serum or mucosal IgG4 levels IBD pts (UC/CD) Control group Findings
Koutroumpakis et al. (42) Observational, monocentric study Serum IgG4 (Ref 9–89 mg/dL) N: 1193 (788 CD, 405 UC) /
  • High serum IgG4 levels in 61/1193 (5%); no difference between CD and UC

  • Association with PSC

  • No correlation with disease extent or severity

Faria et al. (43) Cross-sectional study Serum IgG4 > 140 mg/dL; Colon tissue ≥10 IgG4+ plasma cells per field N: 56 (26 CD, 30 UC) /
  • High serum IgG4 levels: 9 UC, 1 CD (p = 0,006); no association with disease activity

  • 3/26 increased number of colon tissue IgG4 plasma cells, no correlation with high IgG4 in serum

Wang et al. (44) Case–control study Serum IgG4 > 1.50 g/L; Mucosal >10 IgG4+ plasma cells/HPF N: 232 (28 CD, 104 UC) 45 healthy controls
  • Serum IgG4: no significant difference between groups (p > 0.05), elevated in 9.9% of IBD pts.

  • Higher mucosal IgG4 in UC and CD

  • In UC: correlation between high mucosal IgG4 and serum IgG4 levels, disease extension and severity

  • Mucosal IgG4 significantly decreased after treatment with glucocorticosteroids

Raina et al. (45) Retrospective Mucosal >10 IgG4+ plasma cells/HPF in rectal biopsies N: 54 (13 CD, 18 UC, 23 UC + PSC) 11 controls (aspecific diarrhea or microscopic colitis)
  • Significantly elevated in active UC and UC + PSC (p = 0.05). Not in CD, inactive UC, and controls

Şimşek et al. (46) Retrospective Mucosal >10 IgG4+ plasma cells/HPF N: 72 (17 CD, 55 UC) /
  • Significantly higher mucosal IgG4 in UC than CD (p = 0.01), correlation with disease activity in UC

Keyashian et al. (47) Retrospective Mucosal IgG4+ plasma cells/HPF in rectal biopsies N: 134 UC /
  • Significant association between IgG4-positive plasma cells and histological disease activity (p = 0.001)

  • No association between IgG4 counts and clinical outcome

Navaneethan et al. (48) Retrospective Serum IgG4 > 112 mg/dL N: 50 PSC pts. of which 42 had UC /
  • High IgG4 in 10 PSC pts. (20%); not significantly associated with UC (p = 0.067), significantly associated with younger age at PSC diagnosis, backwash ileitis, UC flares, and reduced colectomy-free survival

Tavaghi et al. (49) Retrospective Serum IgG4-levels N: 73 PSC pts. of which 51 had IBD /
  • No significant difference between IgG4 serum levels in PSC pts. with or without IBD

Navaneethan et al. (50) Prospective Serum IgG4 ≥ 112 mg/dL N: 124 UC pts. with symptomatic pouchitis /
  • 8% (10/124) high serum IgG4

  • No significant association with auto-immune disorders or PSC

  • Significantly more chronic antibiotic-refractory pouchitis in high serum IgG4 (p = 0.03)

Virk et al. (51) Retrospective Mucosal >10 IgG4+ plasma cells/HPF in pretreatment colonic biopsies N: 78 (50 UC, 38 CD) /
  • Significantly higher mucosal IgG4 in UC than CD (p = 0.0001)

  • Significant correlation with histological activity, but not with disease extent.

IBD, inflammatory bowel disease; CD, Crohn’s disease, UC, ulcerative colitis, pts, patients; PSC, primary sclerosing cholangitis; HPF, high power field.