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dc.contributor.authorFilho, F.S.L.
dc.contributor.authorRa, S.W.
dc.contributor.authorMattman, A.
dc.date.accessioned2019-06-21T18:46:26Z
dc.date.available2019-06-21T18:46:26Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85042095858&doi=10.1186%2fs12931-018-0733-z&partnerID=40&md5=67cdf75ba3ab7bae5f6dfeafaac6adb4
dc.identifier.urihttp://hdl.handle.net/10713/9689
dc.description.abstractBackground: The literature is scarce regarding the prevalence and clinical impact of IgG subclass deficiency in COPD. We investigated the prevalence of IgG subclass deficiencies and their association with exacerbations and hospitalizations using subjects from two COPD cohorts. Methods: We measured IgG subclass levels using immunonephelometry in serum samples from participants enrolled in two previous COPD trials: Macrolide Azithromycin for Prevention of Exacerbations of COPD (MACRO; n = 976) and Simvastatin for the Prevention of Exacerbations in Moderate-to-Severe COPD (STATCOPE; n = 653). All samples were collected from clinically stable participants upon entry into both studies. IgG subclass deficiency was diagnosed when IgG subclass levels were below their respective lower limit of normal: IgG1 < 2.8 g/L; IgG2 < 1.15 g/L; IgG3 < 0.24 g/L; and IgG4 < 0.052 g/L. To investigate the impact of IgG subclass levels on time to first exacerbation or hospitalization, we log-transformed IgG levels and performed Cox regression models, with adjustments for confounders. Results: One or more IgG subclass deficiencies were found in 173 (17.7%) and 133 (20.4%) participants in MACRO and STATCOPE, respectively. Lower IgG1 or IgG2 levels resulted in increased risk of exacerbations with adjusted hazard ratios (HR) of 1.30 (95% CI, 1.10-1.54, p < 0.01) and 1.19 (95% CI, 1.05-1.35, p < 0.01), respectively in the MACRO study, with STATCOPE yielding similar results. Reduced IgG1 or IgG2 levels were also associated with increased risk of hospitalizations: the adjusted HR for IgG1 and IgG2 was 1.52 (95% CI: 1.15-2.02, p < 0.01) and 1.33 (95% CI, 1.08-1.64, p < 0.01), respectively for the MACRO study; in STATCOPE, only IgG2 was an independent predictor of hospitalization. In our multivariate Cox models, IgG3 and IgG4 levels did not result in significant associations for both outcomes in either MACRO or STATCOPE cohorts. Conclusions: Approximately 1 in 5 COPD patients had one or more IgG subclass deficiencies. Reduced IgG subclass levels were independent risk factors for both COPD exacerbations (IgG1 and IgG2) and hospitalizations (IgG2) in two COPD cohorts. Copyright 2018 The Author(s).en_US
dc.description.urihttps://dx.doi.org/10.1186/s12931-018-0733-zen_US
dc.language.isoen-USen_US
dc.publisherBioMed Central Ltd.en_US
dc.relation.ispartofRespiratory Research
dc.subjectCOPDen_US
dc.subjectExacerbationen_US
dc.subjectHospitalizationen_US
dc.subjectIgGen_US
dc.subjectIgG subclass deficiencyen_US
dc.titleSerum IgG subclass levels and risk of exacerbations and hospitalizations in patients with COPDen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s12931-018-0733-z
dc.identifier.pmid29444682


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