Clinical Trial

. 2021 Nov;41(8):1878-1892.

doi: 10.1007/s10875-021-01090-8. Epub 2021 Sep 3.

Simple Measurement of IgA Predicts Immunity and Mortality in Ataxia-Telangiectasia

Stefan Zielen¹, Ruth Pia Duecker², Sandra Woelke¹, Helena Donath¹, Sharhzad Bakhtiar³, Aileen Buecker¹, Hermann Kreyenberg³, Sabine Huenecke³, Peter Bader³, Nizar Mahlaoui⁴, Stephan Ehl⁵, Sabine M El-Helou^{5

6

7}, Barbara Pietrucha⁸, Alessandro Plebani⁹, Michiel van der Flier¹⁰, Koen van Aerde¹¹, Sara S Kilic¹², Shereen M Reda¹³, Larysa Kostyuchenko¹⁴, Elizabeth McDermott¹⁵, Nermeen Galal¹⁶, Claudio Pignata¹⁷, Juan Luis Santos Pérez¹⁸, Hans-Juergen Laws¹⁹, Tim Niehues²⁰, Necil Kutukculer²¹, Markus G Seidel²², Laura Marques²³, Peter Ciznar²⁴, John David M Edgar²⁵, Pere Soler-Palacín²⁶, Horst von Bernuth^{27

28

29}, Renate Krueger²⁷, Isabelle Meyts³⁰, Ulrich Baumann³¹, Maria Kanariou³², Bodo Grimbacher^{5

6

33}, Fabian Hauck³⁴, Dagmar Graf³⁵, Luis Ignacio Gonzalez Granado³⁶, Seraina Prader³⁷, Ismail Reisli³⁸, Mary Slatter³⁹, Carlos Rodríguez-Gallego⁴⁰, Peter D Arkwright⁴¹, Claire Bethune⁴², Elena Deripapa⁴³, Svetlana O Sharapova⁴⁴, Kai Lehmberg⁴⁵, E Graham Davies⁴⁶, Catharina Schuetz⁴⁷, Gerhard Kindle^{5

48}, Ralf Schubert¹

Affiliations

¹ Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany.
² Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany. RuthPia.Duecker@kgu.de.
³ Division for Stem Cell Transplantation, Immunology and Intensive Care Unit, Department for Children and Adolescents, Goethe University, Frankfurt, Germany.
⁴ Pediatric Immunology-Hematology and Rheumatology Unit, French National Reference Center for Primary Immune Deficiencies (CEREDIH), Necker Children's University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
⁵ Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ RESIST - Cluster of Excellence 2155 To Hanover Medical School, Satellite Center Freiburg, Freiburg, Germany.
⁷ Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.
⁸ Department of Immunology, The Children's Memorial Health Institute, Av. Dzieci Polskich 20, 04-730, Warsaw, Poland.
⁹ Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, University of Brescia and ASST-Spedali Civili di Brescia, Brescia, Italy.
¹⁰ Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
¹¹ Department of Pediatrics, Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Department of Pediatric Immunology and Rheumatology, the School of Medicine, Uludag University, Bursa, Turkey.
¹³ Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
¹⁴ Center of Pediatric Immunology, Western Ukrainian Specialized Children's Medical Centre, Lviv, Ukraine.
¹⁵ Clinical Immunology and Allergy Unit, Nottingham University Hospitals, Nottingham, UK.
¹⁶ Department of Pediatrics, Cairo University Specialized Pediatric Hospital, Cairo, Egypt.
¹⁷ Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
¹⁸ Infectious Diseases and Immunodeficiencies Unit, Service of Pediatrics, Hospital Universitario Virgen de Las Nieves, Granada, Spain.
¹⁹ Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Center of Child and Adolescent Health, Heinrich-Heine University, Duesseldorf, Germany.
²⁰ Centre for Child and Adolescent Health, Helios Klinikum Krefeld, Krefeld, Germany.
²¹ Faculty of Medicine, Department of Pediatric Immunology, Ege University, Izmir, Turkey.
²² Research Unit for Pediatric Hematology and Immunology, Division of Pediatric Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.
²³ Pediatric Department, Infectious Diseases and Immunodeficiencies Unit, Porto Hospital Center, Porto, Portugal.
²⁴ Pediatric Department, Faculty of Medicine, Children University Hospital in Bratislava, Comenius University in Bratislava, Bratislava, Slovakia.
²⁵ The Royal Hospitals & Queen's University, Belfast, UK.
²⁶ Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
²⁷ Department of Pediatric Pneumology, Immunology and Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²⁸ Department of Immunology, Labor Berlin Charité - Vivantes GmbH, Berlin, Germany.
²⁹ Berlin Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany.
³⁰ Department of Pediatrics, University Hospitals Leuven, and the Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
³¹ Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany.
³² Department of Immunology and Histocompatibility, Centre for Primary Immunodeficiencies, "Aghia Sophia" Children's Hospital, Athens, Greece.
³³ DZIF-German Center for Infection Research, Satellite Center Freiburg, Freiburg, Germany; Centre for Integrative Biological Signalling Studies, Albert-Ludwigs University, Freiburg, Germany.
³⁴ Department of Pediatrics, Dr. Von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
³⁵ MVZ Dr. Reising-Ackermann Und Kollegen, Leipzig, Germany.
³⁶ Primary Immunodeficiencies Unit, Pediatrics, Hospital 12 Octubre, Complutense University School of Medicine, Madrid, Spain.
³⁷ Division of Immunology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
³⁸ Department of Pediatrics, Division of Pediatric Immunology and Allergy, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
³⁹ Primary Immunodeficiency Group, Paediatric Immunology and Haematopoietic Stem Cell Transplantation, Translational and Clinical Research Institute, Great North Childrens' Hospital, Newcastle University, Newcastle upon Tyne, UK.
⁴⁰ Department of Immunology, Dr. Negrin University Hospital of Gran Canaria, University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
⁴¹ Lydia Becker Institute of Immunology and Inflammation, University of Manchester and Royal Manchester Children's Hospital, Manchester, UK.
⁴² University Hospital Plymouth NHS Trust, Plymouth, UK.
⁴³ National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
⁴⁴ Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk region, Minsk, Belarus.
⁴⁵ Division for Pediatric Stem Cell Transplantation and Immunology, Clinic for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴⁶ Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, UK.
⁴⁷ Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
⁴⁸ FREEZE Biobank, Center for Biobanking, Medical Center and Faculty of Medicine, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany.

PMID: 34477998
PMCID: PMC8604875
DOI: 10.1007/s10875-021-01090-8

Clinical Trial

Simple Measurement of IgA Predicts Immunity and Mortality in Ataxia-Telangiectasia

Stefan Zielen et al. J Clin Immunol. 2021 Nov.

. 2021 Nov;41(8):1878-1892.

doi: 10.1007/s10875-021-01090-8. Epub 2021 Sep 3.

Authors

Affiliations

¹ Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany.
² Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany. RuthPia.Duecker@kgu.de.
³ Division for Stem Cell Transplantation, Immunology and Intensive Care Unit, Department for Children and Adolescents, Goethe University, Frankfurt, Germany.
⁴ Pediatric Immunology-Hematology and Rheumatology Unit, French National Reference Center for Primary Immune Deficiencies (CEREDIH), Necker Children's University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
⁵ Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ RESIST - Cluster of Excellence 2155 To Hanover Medical School, Satellite Center Freiburg, Freiburg, Germany.
⁷ Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.
⁸ Department of Immunology, The Children's Memorial Health Institute, Av. Dzieci Polskich 20, 04-730, Warsaw, Poland.
⁹ Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, University of Brescia and ASST-Spedali Civili di Brescia, Brescia, Italy.
¹⁰ Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
¹¹ Department of Pediatrics, Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Department of Pediatric Immunology and Rheumatology, the School of Medicine, Uludag University, Bursa, Turkey.
¹³ Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
¹⁴ Center of Pediatric Immunology, Western Ukrainian Specialized Children's Medical Centre, Lviv, Ukraine.
¹⁵ Clinical Immunology and Allergy Unit, Nottingham University Hospitals, Nottingham, UK.
¹⁶ Department of Pediatrics, Cairo University Specialized Pediatric Hospital, Cairo, Egypt.
¹⁷ Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
¹⁸ Infectious Diseases and Immunodeficiencies Unit, Service of Pediatrics, Hospital Universitario Virgen de Las Nieves, Granada, Spain.
¹⁹ Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Center of Child and Adolescent Health, Heinrich-Heine University, Duesseldorf, Germany.
²⁰ Centre for Child and Adolescent Health, Helios Klinikum Krefeld, Krefeld, Germany.
²¹ Faculty of Medicine, Department of Pediatric Immunology, Ege University, Izmir, Turkey.
²² Research Unit for Pediatric Hematology and Immunology, Division of Pediatric Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.
²³ Pediatric Department, Infectious Diseases and Immunodeficiencies Unit, Porto Hospital Center, Porto, Portugal.
²⁴ Pediatric Department, Faculty of Medicine, Children University Hospital in Bratislava, Comenius University in Bratislava, Bratislava, Slovakia.
²⁵ The Royal Hospitals & Queen's University, Belfast, UK.
²⁶ Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall D'Hebron Research Institute, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
²⁷ Department of Pediatric Pneumology, Immunology and Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²⁸ Department of Immunology, Labor Berlin Charité - Vivantes GmbH, Berlin, Germany.
²⁹ Berlin Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany.
³⁰ Department of Pediatrics, University Hospitals Leuven, and the Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
³¹ Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany.
³² Department of Immunology and Histocompatibility, Centre for Primary Immunodeficiencies, "Aghia Sophia" Children's Hospital, Athens, Greece.
³³ DZIF-German Center for Infection Research, Satellite Center Freiburg, Freiburg, Germany; Centre for Integrative Biological Signalling Studies, Albert-Ludwigs University, Freiburg, Germany.
³⁴ Department of Pediatrics, Dr. Von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
³⁵ MVZ Dr. Reising-Ackermann Und Kollegen, Leipzig, Germany.
³⁶ Primary Immunodeficiencies Unit, Pediatrics, Hospital 12 Octubre, Complutense University School of Medicine, Madrid, Spain.
³⁷ Division of Immunology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
³⁸ Department of Pediatrics, Division of Pediatric Immunology and Allergy, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
³⁹ Primary Immunodeficiency Group, Paediatric Immunology and Haematopoietic Stem Cell Transplantation, Translational and Clinical Research Institute, Great North Childrens' Hospital, Newcastle University, Newcastle upon Tyne, UK.
⁴⁰ Department of Immunology, Dr. Negrin University Hospital of Gran Canaria, University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
⁴¹ Lydia Becker Institute of Immunology and Inflammation, University of Manchester and Royal Manchester Children's Hospital, Manchester, UK.
⁴² University Hospital Plymouth NHS Trust, Plymouth, UK.
⁴³ National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
⁴⁴ Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk region, Minsk, Belarus.
⁴⁵ Division for Pediatric Stem Cell Transplantation and Immunology, Clinic for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴⁶ Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, UK.
⁴⁷ Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
⁴⁸ FREEZE Biobank, Center for Biobanking, Medical Center and Faculty of Medicine, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany.

PMID: 34477998
PMCID: PMC8604875
DOI: 10.1007/s10875-021-01090-8

Abstract

Patients with ataxia-telangiectasia (A-T) suffer from progressive cerebellar ataxia, immunodeficiency, respiratory failure, and cancer susceptibility. From a clinical point of view, A-T patients with IgA deficiency show more symptoms and may have a poorer prognosis. In this study, we analyzed mortality and immunity data of 659 A-T patients with regard to IgA deficiency collected from the European Society for Immunodeficiencies (ESID) registry and from 66 patients with classical A-T who attended at the Frankfurt Goethe-University between 2012 and 2018. We studied peripheral B- and T-cell subsets and T-cell repertoire of the Frankfurt cohort and survival rates of all A-T patients in the ESID registry. Patients with A-T have significant alterations in their lymphocyte phenotypes. All subsets (CD3, CD4, CD8, CD19, CD4/CD45RA, and CD8/CD45RA) were significantly diminished compared to standard values. Patients with IgA deficiency (n = 35) had significantly lower lymphocyte counts compared to A-T patients without IgA deficiency (n = 31) due to a further decrease of naïve CD4 T-cells, central memory CD4 cells, and regulatory T-cells. Although both patient groups showed affected TCR-ß repertoires compared to controls, no differences could be detected between patients with and without IgA deficiency. Overall survival of patients with IgA deficiency was significantly diminished. For the first time, our data show that patients with IgA deficiency have significantly lower lymphocyte counts and subsets, which are accompanied with reduced survival, compared to A-T patients without IgA deficiency. IgA, a simple surrogate marker, is indicating the poorest prognosis for classical A-T patients. Both non-interventional clinical trials were registered at clinicaltrials.gov 2012 (Susceptibility to infections in ataxia-telangiectasia; NCT02345135) and 2017 (Susceptibility to Infections, tumor risk and liver disease in patients with ataxia-telangiectasia; NCT03357978).

Keywords: Ataxia-telangiectasia; IgA deficiency; Immunodeficiency; Immunoglobulins; Lymphopenia; Mortality.

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Conflict of interest statement

The authors have the following conflicts to declare:

Dr. Zielen reports honoraria from CSL-Behring, AstraZeneca; Sanofi-Aventis GmbH; Boehringer Ingelheim; Stallergenes Greer; Allergy Therapeutics, bene-Arzneimittel GmbH; Vifor Pharma GmbH; Novartis AG; GlaxoSmithKline GmbH; ALK-Abelló Arzneimittel GmbH; Lofarma GmbH, IMS Health GmbH & Co; and Biotest Pharma GmbH, outside the submitted work.

Dr. Ehl reports grants from UCB, during the conduct of the study.

Dr. Sabine M. El-Helou was funded by the Federal Ministry of Education and Research (BMBF), by the European Society for Immunodeficiencies (ESID), by the Care-for-Rare Foundation, by PROimmun e.V., and by a restricted grant from LFB, CSL Behring, and Grifols. For GAIN and RESIST, she was funded by the BMBF.

Dr. Kindle reports grants from ESID (European Society for Immunodeficiencies) and grants from BMBF (German Federal Ministry of Education and Research), during the conduct of the study.

Dr. van Aerde reports grants from Baxter, during the conduct of the study.

Dr. Laws reports personal fees from Shire; Roche; Novonordisk; Pfizer; Csl Behring, outside the submitted work.

Dr. Niehues reports honoraria from uptodate.com; travelling costs from PENTA and JIR cohorts (Padua, Italy; Lausanne Switzerland), up to 2017 from PPTA (plasma protein therapeutics association).

Dr. Seidel reports personal fees from Shire [Hypogammaglobulinemia (Subcutaneous IgG, hyaluronic acid, immune globulin (human))], outside the submitted work.

Dr. Meyts reports grants from CSL Behring, outside the submitted work. IM is a senior clinical investigator at FWO Vlaanderen (supported by CSL Behring Chair of Primary Immunodeficiencies, by a KU Leuven C1 Grant C16/18/007, by a VIB GC PID Grant, by a FWO Grants G0C8517N; and G0E8420N and by the Jeffrey Modell Foundation. IM is a recipient of a ERC-StG MORE2ADA2. This work is supported by ERN-RITA.

Dr. Grimbacher reports grants from DZIF, DFG, BMBF, Fritz Thyssen Stiftung, Shire/Baxalta, Merck, BMS, Novartis, CSL Behring, personal fees from Janssen Cilag, Novartis, during the conduct of the study, outside the submitted work.

Dr. Schubert reports grants from A-T Children’s Project, DFG, SPARKS–Action for A-T, Starke Lunge Foundation, personal fees from Biotest Pharma GmbH and Vifor Pharma Deutschland GmbH, outside the submitted work.

The other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Fig. 1**
IgA deficiency influences survival in A-T. a Flow chart of the analyzed patients from the ESID registry. b Survival of patients with deficient IgA and patients with no deficient IgA. IgA < 0.07 g/L was defined as IgA deficient, and IgA ≥ 0.07 g/L was defined as no deficient IgA values below the age-appropriate normal range were defined as partial. ^† number of deceased patients

**Fig. 2**
Effect of IgA deficiency on survival of A-T patients with IgG₂ deficiency. a Flow charts of the analyzed patient cohorts. b Survival of patients with deficient IgG₂ and patients with no deficient IgG₂. c Survival of patients with deficient IgG₂ only and patients with deficient IgG₂ and deficient IgA. IgA < 0.07 g/L, and IgG₂ < 0.3 were defined as deficient. ^† number of deceased patients

**Fig. 3**
Effect of IgA deficiency on survival of A-T patients with lymphopenia. a Flow charts of the analyzed patient cohorts. b Survival of patients with lymphopenia and patients with normal lymphocytes. c Survival of patients with lymphopenia only and patients with lymphopenia and deficient IgA. IgA < 0.07 g/L was defined as deficient. Lymphopenia was defined as ≤ 1,500 cells/µL. ^† number of deceased patients

**Fig. 4**
Lymphocytes in A-T patients with deficient IgA (IgA-D) and no deficient IgA (noDef). Blood samples of A-T patients were analyzed for total numbers of a CD3⁺ T-cells, b CD19⁺ B-cells, c CD3-CD56⁺ NK-cells, d CD3⁺CD4⁺ helper T-cells, e CD3⁺CD8⁺ cytotoxic T-cells and f CD4⁺CD25^brightCD127^dim regulatory T-cells. IgA-D. * p < 0.05, ** p < 0.01

**Fig. 5**
T-cell subpopulations in A-T patients with deficient IgA (IgA-D) and no deficient IgA (noDef). Blood samples of A-T patients were analyzed for total numbers of a CD4⁺CD45RA⁺CD62L⁺ naïve T-cells, b CD4⁺CD45RO⁺CD62L⁺ central memory (CM) T-cells c CD4⁺CD45RO⁺CD62L⁻ effector memory (EM) T-cells, d CD4⁺CD45RA⁺CD62L⁻ effector memory RA (EMRA) T-cells, e CD8⁺CD45RA⁺CD62L⁺ naïve T-cells, f CD8⁺CD45RO⁺CD62L⁺ central memory (CM) T-cells g CD8⁺CD45RO⁺CD62L⁻ effector memory (EM) T-cells, h CD8⁺CD45RA⁺CD62L⁻ effector memory RA (EMRA) T-cells. * p < 0.05, ** p < 0.01

**Fig. 6**
T-cell rearrangement in A-T patients with deficient IgA (IgA-D), no deficient IgA (noDef) and controls. a CDR3 length distribution of the TCR-ß repertoire given as relative frequency (total = 1) for control, noDef, and IgA-D samples. b Calculated diversity index of controls and both patient groups. c Productive clonality score of controls and both patient groups. The clonality score is derived from the Shannon entropy, which is calculated from the frequencies of all productive sequences divided by the logarithm of the total number of unique productive sequences. This normalized entropy value is then inverted (1 — normalized entropy) to produce the clonality metric. Entropy was calculated by summing the frequency of each clone times the log (base 2) of the same frequency over all productive reads in a sample

See this image and copyright information in PMC

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Simple Measurement of IgA Predicts Immunity and Mortality in Ataxia-Telangiectasia

Affiliations

Simple Measurement of IgA Predicts Immunity and Mortality in Ataxia-Telangiectasia

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

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Medical

Research Materials

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