Unique properties of IgG4 antibody and its clinical application in autoimmune pancreatitis

Abstract

Background: Autoimmune pancreatitis (AIP) is defined as a unique form of chronic pancreatitis characterized by clinical presentation with obstructive jaundice, a dense lymphoplasmacytic infiltrate and fibrosis histologically, and a dramatic response to steroids therapeutically. The possible role of IgG4 in driving the pathology of AIP is a controversial subject that has not been addressed satisfactorily. 

Objective: The purpose of this review is to discuss the unique biology of IgG4 that are important for its role and the clinical applications for serologic detection.

Methods: Review of current literature about IgG4 antibody in the clinical application in AIP.

Results: High serum levels of IgG4 are an important biomarker and broadly used for diagnosis, differentiation from diseases especially pancreatic cancer, and as a parameter to indicate disease activity, extra-pancreatic lesions, and treatment monitoring. However, some controversial studies show it has a limited specificity and sensitivity in these conditions. 

Conclusion: Although increasing studies have promoted our understanding of the structure and function of IgG4, there is still dilemma between the beneficial and the adverse aspect of IgG4 in the pathogenesis of AIP. 

Keywords:

• Autoimmune pancreatitis
• IgG4
• IgG4-related disease
• pancreatic cancer
• disease activity

Disclosure statement

The authors do not have any possible conflicts of interest and the study complies with current ethical consideration.