REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1672413
This article is part of the Research TopicSecondary Antibody DeficiencyView all articles
Secondary Antibody Deficiencies: What's around the corner?
Provisionally accepted
- 1Department of Translational Medical Sciences, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
- 2World Allergy Organization (WAO) Center of Excellence, Naples, Italy., Naples, Italy
- 3World Allergy Organization (WAO) Center of Excellence, Naples, Italy, Naples, Italy
- 4Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy, Naples, Italy
- 5Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy, Naples, Italy
- 6Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy, Naples,, Italy
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Secondary antibody deficiencies (SADs) are characterized by impaired humoral immunity, which can cause recurrent and severe infections. Several factors may contribute to SAD development, making it difficult to establish a clear etiological classification. This heterogeneity also leads to clinical variability, further complicating patient management and treatment strategies. Various diagnostic and therapeutic algorithms are often adapted from those used in primary antibody deficiencies, potentially resulting in under- or over-treatment. Key points include the decision to initiate Immunoglobulin Replacement Therapy (IgRT) and the duration of the treatment. Given the increasing prevalence of SADs and the limited availability of immunoglobulin products, it is important to clarify when IgRT should be started. In this review, we summarize and update the different etiologies of SADs and propose a diagnostic algorithm applicable regardless of the underlying cause. We also examine the possible treatment options and diagnostic tools that can assist in making the correct therapeutic choice.
Keywords: secondary, antibody, deficiency, immunology, hypogammaglobulinemia, Haematological abnormality, Algorithm decision
Received: 24 Jul 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Lagnese, Messuri, Varricchi, Poto and Spadaro. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Giuseppe Spadaro, spadaro@unina.it
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