恶化
血清型
医学
抗体
免疫学
慢性阻塞性肺病
低丙种球蛋白血症
免疫球蛋白G
免疫系统
内科学
作者
David C. LaFon,Han Woo,Neal S. Fedarko,Antoine Azar,Harry R. Hill,Anne E. Tebo,Thomas B. Martins,MeiLan K. Han,Jerry A. Krishnan,Victor E. Ortega,Igor Barjaktarević,Robert J. Kaner,Annette T. Hastie,Wanda K. O’Neal,David Couper,Prescott G. Woodruff,Jeffrey L. Curtis,Nadia N. Hansel,Moon H. Nahm,Mark T. Dransfield,Nirupama Putcha
标识
DOI:10.1016/j.clim.2023.109324
摘要
While hypogammaglobulinemia is associated with COPD exacerbations, it is unknown whether frequent exacerbators have specific defects in antibody production/function. We hypothesized that reduced quantity/function of serum pneumococcal antibodies correlate with exacerbation risk in the SPIROMICS cohort. We measured total pneumococcal IgG in n = 764 previously vaccinated participants with COPD. In a propensity-matched subset of n = 200 with vaccination within five years (n = 50 without exacerbations in the previous year; n = 75 with one, n = 75 with ≥2), we measured pneumococcal IgG for 23 individual serotypes, and pneumococcal antibody function for 4 serotypes. Higher total pneumococcal IgG, serotype-specific IgG (17/23 serotypes), and antibody function (3/4 serotypes) were independently associated with fewer prior exacerbations. Higher pneumococcal IgG (5/23 serotypes) predicted lower exacerbation risk in the following year. Pneumococcal antibodies are inversely associated with exacerbations, supporting the presence of immune defects in frequent exacerbators. With further study, pneumococcal antibodies may be useful biomarkers for immune dysfunction in COPD.
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