Quantitative measurements of immunoglobulin production in common variable hypogammaglobulinemia and the effect of cimetidine on immunoglobulin production

Abstract

Common variable hypogammaglobulinemia (CVH) includes a variety of disorders. The pathogenetic mechanisms responsible for the impaired immunoglobulin production in CVH are diverse with abnormalities in both B cells and immunoregulatory T cells. In this report, 11 cases with CVH were analyzed regarding the function of immunoglobulin production by means of enzyme immunoassay (EIA). In all cases, very low dose immunoglobulins were detected in culture supernatant. The enhancement of Igs production was not revealed in pokeweed mitogen induced culture system. In 6 of 11 cases B cell functions were disturbed. The others (5) were demonstrated T cell dysfunction. Moreover, 3 cases of them were proved the hyperfunction of the suppressor activity.
Recent report shows that cimetidine, an antagonist to histamine H₂-receptors decreases excessive suppressor activity and allows endogeneous immunoglobulin production in some patients with CVH. So, the effect of cimetidine on immunoglobulin production was examined with two patients demonstrated hyperfunction of the suppressor activity. Two cases were given a one-month course of oral cimetidine. Serum immunoglobulin concentrations rose slithtly in one case and held the same level in another case. These effects were reversible after the drug was stopped. There was no difference in cell surface marker analysis, in vitro immunoglobulin production and suppressor activity while taking cimetidine.
These results suggest that cimetidine may allow endogeneous immunoglobulin production in some patients with CVH. But this mechanism of cimetidine efficasy is not clarified. Further investigation should be observed.