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Hypogammaglobulinemia in asthmatic patients
D L Hamilos1, R M Young, J B Peter
1National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado.
Annals of Allergy
|June 1, 1992
Summary
Asthmatic patients on systemic corticosteroids show higher rates of hypogammaglobulinemia. While most don't have increased infections, some exhibit impaired pneumococcal vaccine response, indicating a need for monitoring.
Area of Science:
- Immunology
- Pulmonology
- Clinical Medicine
Background:
- Asthma is a chronic respiratory disease often managed with systemic corticosteroids.
- Hypogammaglobulinemia, a deficiency in immunoglobulin levels, can increase infection risk.
- The relationship between corticosteroid use, hypogammaglobulinemia, and infection susceptibility in asthma is not fully understood.
Purpose of the Study:
- To investigate the prevalence of hypogammaglobulinemia in asthmatic patients.
- To determine the association between hypogammaglobulinemia and systemic corticosteroid use.
- To assess the impact of hypogammaglobulinemia on immune response to vaccination and infection rates.
Main Methods:
- Quantitative immunoglobulins (IgG, IgA, IgM, IgG subclasses) were measured in 101 asthmatic patients.
- Patients were categorized based on immunoglobulin levels and corticosteroid treatment.
- Immune response to tetanus and pneumococcal vaccines was assessed in different patient subgroups.
Main Results:
- Hypogammaglobulinemia was identified in 12% of asthmatic patients, significantly higher than the general population.
- Hypogammaglobulinemia was strongly associated with systemic corticosteroid use (P = .0001).
- Impaired pneumococcal vaccine response was observed in a small subgroup of hypogammaglobulinemic patients, but no significant increase in overall infectious episodes was noted.
Conclusions:
- Systemic corticosteroid use in asthma is linked to a higher prevalence of hypogammaglobulinemia.
- While not consistently associated with increased infections, a subset of asthmatic patients with hypogammaglobulinemia may have impaired specific antibody production.
- Pneumococcal vaccination response assessment is warranted in asthmatic patients with hypogammaglobulinemia to identify those at increased risk for bacterial infections.