Introduction

In modern era, serum immunoglobulin assay takes a major role in diagnosis of various diseases and in ascertain their types, mode, depth and age of the infections, allergic as well as autoimmune disorders. The study of these immunoglobins or immunoglobulins is therefore necessary for Homoeopaths too in deciding the chronicity and prognosis of a case. The repeated immunoassay is a good and reliable meter to see the progress of the case and to guide the physician in directing the correct line of treatment.

DEFINITION OF IMMUNOGLOBULINS

Abbr. - Ig

Immunoglobulins are glycoprotein molecules that are produced by plasma cells in response to an immunogen and which function as antibodies (Psora).

FUNCTIONS OF IMMUNOGLOBULINS

1. Antigen binding - Immunoglobulins bind specifically to one or a few closely related antigens (Psora).

2. Effector Functions – The biological effects are due to secondary "effector functions" of antibodies (Psora). The ability to carry out a particular effector function requires that the antibody bind to its antigen. Effector functions include-

1. Fixation of complement - This results in lysis of cells (Syphilis) and release of biologically active molecules (Psora).
2. Binding to various cell types - Phagocytes, lymphocytes, platelets, mast cells, and basophils have receptors that bind immunoglobulins. This binding can activate the cells to perform their functions (Psora). Some immunoglobulins also bind to receptors on placental trophoblasts, which results in transfer of the immunoglobulin across the placenta. As a result, the transferred maternal antibodies provide immunity to the fetus and infant.

TYPES AND MODALITIES OF IMMUNOGLOBULINS

The immunoglobulins are divided into five different classes, based on differences in the amino acid sequences in the constant region of the heavy chains.

1. IgG - Gamma heavy chains- 1^st to circulate; indicates infection; too large to cross placenta.

Increases in:

1. All types of Infections
2. Chronic granulomatous infections
3. Disease associated with hypersensitivity granulomas, dermatologic disorders, and IgG myeloma
4. Dysproteinemia
5. Hyperimmunization
6. Liver disease
7. Rheumatoid arthritis
8. Severe Malnutrition

IgG should be raised in remedies having symptomatology of above mentioned conditions - Rhus t, Calc, Colch, Spig, Ant t, Ars a , Bell, Bry, Cham, Chin, Cocc, Dig, Graph, Hep, Lyc, Merc, Mez, Nux v, Psor, Puls, Sep, Staph, Sulph, Acon, Ant c, Apis, Aur m, Borax, Cact, Caust, Clem etc.

Decreases in:

1. Agammaglobulinemia
2. Bence Jones proteinemia
3. Chronic lymphoblastic leukemia
4. IgA myeloma
5. Lymphoid aplasia
6. Selective IgG, IgA deficiency

IgG should be lowered in remedies having symptomatology of above mentioned conditions - Acet ac, ars i, Ars a, Bar I, Bry, Calc p, Calc, Carb v, Carb s, Carc, Con, Crot h, Ferr pic, Helleb, Kali p, Med, Merc, Nat m, Nat s, Nit ac, Op, Phos, Pic ac, Scir, Sulph, Symph, Thuja, X ray, Acon, Aran, Bar m, Benz, Benzoic ac etc.

2. IgM - Mu heavy chains- 1^st to circulate; indicates infection; too large to cross placenta.

Increases (in adults) in:

1. Actinomycosis
2. Carrión's disease (bartonellosis)
3. Incertain cases Dysgammaglobulinemia
4. Infectious mononucleosis
5. Lupus erythematosus
6. Malaria
7. Rheumatoid arthritis
8. Trypanosomiasis
9. Waldenström's macroglobulinemia

In newborn, a level of IgM above 20 ng./dl is an indication of in utero stimulation of the immune system and stimulation by the rubella virus, the cytomegalovirus, syphilis, or toxoplasmosis.

IgM should be raised in remedies having symptomatology of above mentioned conditions - Phos, Ars a, Sulph, Rhus t, Bell, Lach, Phos ac, Sil, Arn, Iod, Merc s, Nit ac, Sulph ac, Carbo v, China, Nat m, Nux v, Sec, Bry, Crot h, Chin s, Cal c, Con, Merc c, Apis, Ars I, Sep, Lyc, Fer ars, Acon, Ham, Nat s, Tub etc.

Decreases in:

1. Agammaglobulinemia
2. Chronic lymphoblastic leukemia
3. Dysgammaglobulinemia
4. IgG and IgA myeloma
5. In certain cases Lymphoproliferative disorders
6. Lymphoid aplasia

IgM should be lowered in remedies having symptomatology of above mentioned conditions - Hekla, Chin, Merc s, Nit ac, Phos, Symph, Ars I, Bry, Calc c, Carbo v, Carcin, Nat m, Pic ac, Sulph, Acon, Anthracin, Arnica, Ars a, Bar m, Calc I, Calc s, Calend, Chin s, Con, Crot h, Hep, Lach, Med, Nat ars, Nat s, Nux v, Sil, Thuja etc.

3. IgA - Alpha heavy chains- 1^st to circulate; indicates infection; too large to cross placenta.

Increases in:

1. Certain stages of collagen and other autoimmune disorders such as rheumatoid arthritis and lupus erythematosus
2. Chronic infections not based on immunologic deficiencies
3. IgA myeloma
4. In most cases of liver Cirrhosis
5. Wiskott-Aldrich syndrome

IgA should be raised in remedies having symptomatology of above mentioned conditions - Phos, Lach, Arn, Chin, Nux v, Iod, Merc s, Sulph, Fer p, Ham, Hep, Bell, Ferr m, Kali bi, Puls, Acon, Ars a, Bry, Rhus t, Crot h, Dulc, Kali I, Kreos, Ruta, Amm c, Ars I, Aur, Calc c, Caust, Form, Hydr, Lyc, Mill, Nit ac, Plb etc.

Decreases in:

1. Acute lymphoblastic leukemia
2. Chronic lymphoblastic leukemia
3. Hereditary ataxia telangiectasia
4. IgG myeloma
5. Immunologic deficiency states (e.g., dysgammaglobulinemia, congenital and acquired agammaglobulinemia, and hypogammaglobulinemia)
6. Lymphoid aplasia
7. Malabsorption syndromes

IgA should be lowered in remedies having symptomatology of above mentioned conditions – Arg n, Phos, Ars a, Nux v, Sulph, Bell. Calc c, Pic ac, Cann s, Ars I, Carbo v, Con, Sil, Alum, Fer pic, Plb, Agar, Bar m, Lach, Nat s, Nux m, Onos, Nit ac, Sec, Caust, Cean, Fl ac, Gel, Hell, Merc s, Nat m, Stram, Thuja, Zinc etc.

4. IgD - Delta heavy chains- 1^st to circulate; indicates infection; too large to cross placenta.

Increases in:

1. Chronic infections
2. IgD myelomas

IgD should be raised in remedies having symptomatology of above mentioned conditions - Sulph, Lyc, Nit ac, Iod, Ars a, Hep, Puls, Sil, Thuja, Nux v, Calc c, Kali c, Sep, Con, Merc s, Phos, Bar c, Carcin, China, Kali I, Merc c, Psor, Apis, Nat m, Phyt, Alum, Calc p, Graph, Hydr, Lach, Sang, Calc f, Dig etc.

5. IgE - Epsilon heavy chains- 1^st to circulate; indicates infection; too large to cross placenta

Increases in:

1. Anaphylactic shock
2. Asthma
3. Atopic skin diseases such as eczema
4. Hay fever
5. IgE-myeloma

IgE should be raised in remedies having symptomatology of above mentioned conditions - Ars, Nat mur, Puls, Ars iod, Dulc, Lyc, Psor, Sulph, All c, Iod, Kali I, Naja, Sabad, Sang, Sin n, Tub, Am c, Arum t, Hep, Kali s, Med, Nat c, Nat s, Nux v, Phos, Stict, Sul ac, Thuj, Carc, Fuma ac, Galph, Kali bi, Nat ar, Nat p, Nux m etc.

Decreases in:

1. Congenital agammaglobulinemia
2. Hypogammaglobulinemia due to faulty metabolism or synthesis of immunoglobulins

IgE should be lowered in remedies having symptomatology of above mentioned conditions –  Sil, Arn, Hep, Echi, Sulph, Ars a, Calc c, Lach, Phos, Anthracin, Bell, Cal s, Merc s, Rhus t, Canth, Pyrog, Apis, Bell p, Bry, Cham, Chin, Sec, Acon, Puls, Staph, Syph, Ant c, Calc f, Crot h, Kali bi, Kali c, Kali I, Kali s, Med, Nat sil, Nux v etc.

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