Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands.
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Front Immunol. 2022 Jun 2;13:868973. doi: 10.3389/fimmu.2022.868973. eCollection 2022.
Immunoglobulins (Igs) play a pivotal role in host defense and prevention of pneumonia. Aging influences serum Ig levels, but the association between Igs and pneumonia in community-dwelling older individuals remains unknown. We evaluated the association of serum IgA, IgG, and IgM with pneumonia and lung function in middle-aged and older individuals.
We performed Cox and negative binomial regression analyses for the association of Igs with incident pneumonia and pneumonia-related mortality, and recurrent pneumonia respectively. We performed logistic regression analyses for the association between Igs and lung function values. Associations were adjusted for age, sex, smoking, comorbidities, and serum C-reactive protein.
We included 8,766 participants (median age 62.2 years, 57% women, median follow-up 9.8 years). Higher IgA (hazard ratio [HR]: 1.15; 95% confidence interval [95% CI]: 1.00-1.32) and IgG (HR: 1.13; 95% CI: 1.06-1.19) were associated with an increased pneumonia risk. Higher IgG was associated with an increased risk of pneumonia-related mortality (HR: 1.08; 95% CI: 1.01-1.16) and recurrent pneumonia (incidence rate ratio: 1.04; 95% CI: 1.00-1.09). Higher IgA and IgG were also associated with lower forced expiratory volume in one second (FEV), lower forced vital capacity (FVC), and an increased odds of preserved ratio impaired spirometry (PRISm, i.e. FEV <80% and FEV/FVC ratio ≥70%). No association was seen with an obstructive spirometry pattern.
Higher serum IgA and IgG levels were associated with pneumonia, pneumonia-related mortality, and PRISm in middle-aged and older individuals from the general population. Future studies should validate our findings and elucidate underlying pathophysiology.
免疫球蛋白（Igs）在宿主防御和预防肺炎方面发挥着关键作用。衰老会影响血清 Ig 水平，但社区居住的老年人的 Ig 与肺炎之间的关系尚不清楚。我们评估了血清 IgA、IgG 和 IgM 与中年和老年人肺炎和肺功能的关系。
我们进行了 Cox 和负二项回归分析，以评估 Ig 与新发肺炎和肺炎相关死亡率以及复发性肺炎的关系。我们进行了逻辑回归分析，以评估 Ig 与肺功能值之间的关系。调整了年龄、性别、吸烟、合并症和血清 C 反应蛋白等因素。
我们纳入了 8766 名参与者（中位年龄 62.2 岁，57%为女性，中位随访时间为 9.8 年）。较高的 IgA（危险比 [HR]：1.15；95%置信区间 [95%CI]：1.00-1.32）和 IgG（HR：1.13；95%CI：1.06-1.19）与肺炎风险增加相关。较高的 IgG 与肺炎相关死亡率（HR：1.08；95%CI：1.01-1.16）和复发性肺炎（发生率比：1.04；95%CI：1.00-1.09）的风险增加相关。较高的 IgA 和 IgG 也与用力呼气量第一秒（FEV）降低、用力肺活量（FVC）降低以及保留比受损的肺量计（PRISm，即 FEV<80%和 FEV/FVC 比≥70%）的几率增加相关。与阻塞性肺量计模式无关。
在来自普通人群的中年和老年人中，较高的血清 IgA 和 IgG 水平与肺炎、肺炎相关死亡率和 PRISm 相关。未来的研究应验证我们的发现并阐明潜在的病理生理学。
