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Change in IgG and evolution of lung function in children with cystic fibrosis

M Proesmans1, C Els, F Vermeulen

  • 1Dept. Pediatrics, Pediatric Pulmonology University Hospital of Leuven, Belgium. Marijke.proesmans@uz.kuleuven.be

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|January 12, 2011
PubMed

Insights

In cystic fibrosis (CF) patients, rising immunoglobulin G (IgG) levels correlate with worsening lung function (FEV1). This study monitored IgG in pediatric CF patients over four years, finding increased IgG levels linked to declining lung capacity.

Area of Science:

  • Pediatric Pulmonology
  • Immunology
  • Chronic Disease Management

Background:

  • Previous studies linked high immunoglobulin G (IgG) levels in cystic fibrosis (CF) patients with severe lung disease and poor prognosis.
  • Current standards of care for CF aim to mitigate disease progression, necessitating updated outcome parameters.

Purpose of the Study:

  • To investigate immunoglobulin G (IgG) levels as a potential outcome measure for lung disease severity in pediatric cystic fibrosis (CF) patients.
  • To assess the relationship between IgG levels and lung function (FEV1) in a cohort of children with CF.

Main Methods:

  • A 4-year longitudinal study of 73 pediatric CF patients (aged 5-15 years at baseline) treated under current standards of care.
  • Data collected included spirometry (FEV1), height, weight, sputum cultures, and total IgG levels.
  • Statistical analysis focused on IgG z-scores and their correlation with FEV1% predicted, both cross-sectionally and longitudinally.

Main Results:

  • The prevalence of patients with IgG z-scores >2 SD increased from 16% in 2004 to 25% in 2008.
  • IgG z-scores showed a significant inverse correlation with FEV1% predicted (r=-0.323 in 2004; p<.001).
  • Longitudinal analysis revealed that changes in IgG z-score were inversely correlated with changes in FEV1% predicted (r=-0.498; p<.001).

Conclusions:

  • Even in pediatric CF patients receiving current standards of care, IgG z-scores tend to increase with age.
  • Elevated IgG levels are associated with a decline in lung function (FEV1) in pediatric CF patients.
  • IgG z-score may serve as a valuable indicator of lung disease progression in pediatric CF.

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