How is wAIHA treated?
Today, the old standard therapy using controlled steroid administration, with or without azathioprine or cyclophosphamide, is, when complemented with erythropoiesis-stimulating agents, still the most effective therapy in wAIHA.
What causes Waiha?
Warm autoimmune hemolytic anemia (wAIHA) is caused by increased erythrocyte destruction by immunoglobulin G (IgG) autoantibodies, with or without complement activation. Antibody-dependent cell-mediated cytotoxicity by macrophages/activated lymphocytes occurs in the lymphoid organs and spleen (extravascular hemolysis).
What is Waiha?
Warm autoimmune hemolytic anemia (WAIHA) is one of four clinical types of autoimmune hemolytic anemia (AIHA), with the characteristics of autoantibodies maximally active at body temperature. It produces a variable anemia—sometimes mild and sometimes severe.
Who gets autoimmune hemolytic anemia?
When acquired autoimmune hemolytic anemia occurs from unknown causes, it affects twice as many women as men, specifically women under 50 years old. Cold antibody hemolytic anemia most commonly affects elderly persons, and warm antibody hemolytic anemia can affect anyone at any age.
What causes a warm autoantibody?
Autoimmune hemolytic anemia (AIHA) is caused by autoantibodies that react with self red blood cells (RBCs) and cause them to be destroyed. Warm AIHA, due to antibodies that are active at body temperature, is the most common type of AIHA.
What does it mean when you have warm antibodies in your blood?
Warm antibody hemolytic anemia is the most common form of autoimmune hemolytic anemia. It is defined by the presence of autoantibodies that attach to and destroy red blood cells at temperatures equal to or greater than normal body temperature.
Do human IgG2 antibodies trigger antibody-dependent cellular cytotoxicity?
Human IgG2 antibodies against epidermal growth factor receptor effectively trigger antibody-dependent cellular cytotoxicity but, in contrast to IgG1, only by cells of myeloid lineage Ab-dependent cellular cytotoxicity (ADCC) is usually considered an important mechanism of action for immunotherapy with human IgG1 but not IgG2 Abs.
What is the difference between IgG1 and IgG2?
The hinge exon of IgG1 encompasses 15 amino acids and is very flexible. IgG2 has a shorter hinge than IgG1, with 12 amino acid residues. The lower hinge region of IgG2 (actually encoded by the CH2 region) also has a one amino acid deletion (lacking one of the double Glycines found at position 235-6),…
Which antigens induce IgG1 and IgG3?
Antibody responses to soluble protein antigens and membrane proteins primarily induce IgG1, but are accompanied with lower levels of the other subclasses, mostly IgG3 IgG4 (9).
Is the IgG2 disulfide isoform useful for receptor engagement of allosteric agonist antibodies?
The IgG2 disulfide isoform present has implications for IgG2 function with the compact IgG2B form thought to offer advantages in receptor engagement of allosteric agonist antibodies ( White et al., 2015 ).