Department of Tuberculosis and Respiratory Pathology, Military Hospital 175, Ho Chi Minh City, Vietnam.
Respiratory Center, Military Hospital 103, Medical Military University, Hanoi city, Vietnam.
BMC Pulm Med. 2024 Aug 2;24(1):381. doi: 10.1186/s12890-024-03185-5.
The study aimed to characterize serum immunoglobulin (Ig) concentrations and their relationship with clinical and paraclinical features in patients with COPD group E in the stable stage. Additionally, the study focused on evaluating the relationship between serum Ig levels and the risk of exacerbations over the next 12 months, thereby clarifying the role of serum Ig deficiency in affecting the future risk for these patients.
A prospective observational study assessed IgG, IgA, IgM, and IgE levels in 67 COPD patients and 30 healthy controls at Military Hospital 103 from October 2017 to August 2020. Primary outcomes included Ig isotype levels in COPD patients, with secondary outcomes exploring differences compared to controls and associations with clinical variables.
COPD patients showed significantly lower IgG concentrations and higher IgA levels than controls. IgM and IgE levels did not differ significantly. Subgroup analysis revealed notable decreases in IgG1 and IgG3 concentrations, with 10.4% of patients exhibiting reduced IgG levels and 0.3% diagnosed with common variable immunodeficiency. No significant associations were found between Ig levels and exacerbation risk or clinical variables.
Serum IgG and IgM concentrations were significantly reduced in COPD patients compared to normal individuals, with IgG1 and IgG3 concentrations notably low. Serum IgA levels were significantly higher in COPD patients compared with normal controls. However, no significant association was found between Ig concentrations, particularly serum IgG deficiency and its subclasses, with the frequency and risk of exacerbations during 12 months of longitudinal follow-up. Caution is warranted in the use of immunoglobulin therapy in the treatment of COPD patients.
An independent ethics committee approved the study (Ethics Committee of Military Hospital 103 (No. 57/2014/VMMU-IRB), which was performed in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice.
本研究旨在描述稳定期 E 组 COPD 患者的血清免疫球蛋白（Ig）浓度特征及其与临床和实验室特征的关系。此外，本研究还评估了血清 Ig 水平与未来 12 个月内加重风险的关系，以明确血清 Ig 缺乏对这些患者未来风险的影响。
一项前瞻性观察性研究于 2017 年 10 月至 2020 年 8 月在 103 军医院评估了 67 例 COPD 患者和 30 例健康对照者的 IgG、IgA、IgM 和 IgE 水平。主要结局包括 COPD 患者的 Ig 同种型水平，次要结局则探索了与对照组的差异以及与临床变量的关系。
与对照组相比，COPD 患者的 IgG 浓度显著降低，而 IgA 水平升高。IgM 和 IgE 水平无显著差异。亚组分析显示 IgG1 和 IgG3 浓度明显降低，10.4%的患者存在 IgG 水平降低，0.3%被诊断为普通可变免疫缺陷。Ig 水平与加重风险或临床变量之间无显著相关性。
与正常个体相比，COPD 患者的血清 IgG 和 IgM 浓度显著降低，特别是 IgG1 和 IgG3 浓度明显降低。与正常对照组相比，COPD 患者的血清 IgA 水平显著升高。然而，在为期 12 个月的纵向随访期间，Ig 浓度，尤其是血清 IgG 缺乏及其亚类与加重频率和风险之间未发现显著相关性。在 COPD 患者的治疗中，使用免疫球蛋白治疗需要谨慎。
本研究得到了独立伦理委员会的批准（103 军医院伦理委员会（编号：57/2014/VMMU-IRB），符合《赫尔辛基宣言》和《良好临床实践指南》。
