A systematic research on immunomodulation in autoimmune pulumonary alveolar proteinpsis.

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High avidity GM-CSF autoantibodies (GMAb) with IgG isotype are now considered to be the etiology for autoimmune pulmonary alveolar proteinsosis (aPAP). We detected low concentrations of IgM-GMAb in more than 80% of 71 aPAP patients and 22% of 23 healthy subjects. The frequencies and concentrations of IgM type in culture supernatants were even between aPAP and controls. In contrast, the frequency of IgG-GMAb producing B cells was higher in aPAP than those in controls. The present results suggest that the isotype switch from IgM to IgG is accelerated in patients with aPAP.