Serum immunoglobulins in the infected and convalescent phases in community-acquired pneumonia

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• 作者：Mari C. de la Torre ; Ignasi Bol铆bar ; Montse Vendrell ; Javier de Gracia ; Ester Vendrell ; M. Jos茅 Rodrigo ; Xavier Boquet ; Pablo Torrebadella ; Joan-Carles Y茅benes ; Mateu Serra-Prat ; Jordi Rello ; Antoni Torres ; Jordi Almirall
• 关键词：Community-acquired pneumonia ; IgG ; IgG subclasses ; Immunoglobulins ; Prognosis
• 刊名：Respiratory Medicine
• 出版年：December, 2013
• 年：2013
• 卷：107
• 期：12
• 页码：2038-2045
• 全文大小：572 K

文摘

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Summary

Background

A population-based case-control study was designed to assess changes of serum levels of immunoglobulins and IgG subclasses between infected and convalescent phase in community-acquired pneumonia (CAP).

Methods

Over a 2-year period, all subjects who were >14 years of age living in the Maresme region (Barcelona, Spain) diagnosed of CAP were registered. Controls were healthy subjects selected from the municipal census. Prognostic factors were assessed and serum levels of total IgG, IgA, IgM, and IgG subclasses were measured at diagnosis and 1 month later (cases).

Results

We studied 171 patients with CAP and 90 controls. All immunoglobulins were significantly lower in cases than in controls. At diagnosis, 42.7% of cases showed low levels of some immunologic parameter, mainly total IgG and IgG2. Low immunoglobulin levels at diagnosis were more frequent in patients requiring in-patient care and in those with pneumonia of other etiology than Streptococcus pneumoniae. In the convalescent phase, 26 (23.6%) patients normalized immunological levels. In 27 (24.5%) cases, some parameter with low levels persisted especially in patients with etiology of CAP other than S. pneumoniae.

Conclusions

Low serum levels of immunoglobulins particularly total IgG and IgG2 were a common finding in patients with CAP compared to healthy controls. Low immunoglobulin levels may be related to CAP prognosis and persisted in the convalescent phase in one-fourth of cases.