Journal article
Serum Immunoglobulin G Levels Are Associated with Risk for Exacerbations: An Analysis of SPIROMICS
American journal of respiratory and critical care medicine, Vol.211(2), pp.215-221
02/2025
DOI: 10.1164/rccm.202311-2184OC
PMCID: PMC11812537
PMID: 39441116
Abstract
Serum Immunoglobulin G (IgG) deficiency is associated with morbidity in chronic obstructive pulmonary disease (COPD) but it is unclear whether concentrations in the lower end of the normal range still confer risk.
To determine if levels above traditional cutoffs for serum IgG deficiency are associated with exacerbations among current and former smokers with or at risk for COPD.
Former and current smokers in SPIROMICS (n=1,497) were studied, n=1,026 with and n=471 at risk for COPD. In a subset (n=1,031), IgG subclasses were measured. Associations between total IgG or subclasses and prospective exacerbations were evaluated with multivariable models adjusting for demographics, current smoking, smoking history, FEV
% predicted, inhaled corticosteroids, and serum IgA.
The 35th percentile (1225 mg/dL in this cohort) of IgG was the best cutoff by Akaike Information Criterion (AIC). Below this, there was increased exacerbation risk (IRR 1.28, 95% CI 1.08-1.51). Among subclasses, IgG1 and IgG2 below 35
percentile (354 and 105 mg/dL, respectively) were both associated with increased risk of severe exacerbation (IgG1: IRR 1.39, 95% CI 1.06-1.84; IgG2: IRR 1.50, 95% CI 1.14-1.1.97). These associations remained significant when additionally adjusting for history of exacerbations.
Lower serum IgG is prospectively associated with exacerbations in individuals with or at risk for COPD. Among subclasses, lower IgG1 and IgG2 are prospectively associated with severe exacerbations. The optimal IgG cutoff was substantially higher than traditional cutoffs for deficiency, suggesting subtle impairment of humoral immunity may be associated with exacerbations.
Details
- Title: Subtitle
- Serum Immunoglobulin G Levels Are Associated with Risk for Exacerbations: An Analysis of SPIROMICS
- Creators
- Aparna Balasubramanian - Johns Hopkins MedicineNeal Fedarko - Johns Hopkins UniversityChristopher B Cooper - Harbor–UCLA Medical CenterRussell P Bowler - National Jewish HealthAlejandro Comellas - University of IowaJerry A Krishnan - University of Illinois ChicagoMeiLan K Han - University of MichiganDavid Couper - University of North Carolina at Chapel HillStephen P Peters - Wake Forest UniversityM Bradley Drummond - University of North Carolina at Chapel HillWanda O'Neal - University of North Carolina at Chapel HillRobert Paine - University of UtahMichael Burnim - Johns Hopkins MedicineNirupama Putcha - Johns Hopkins UniversityGerard Criner - Temple UniversityFernando J Martinez - Cornell UniversityDavid LaFon - University of Alabama at BirminghamHan Woo - Johns Hopkins UniversityJeffrey L Curtis - Michigan MedicineAntoine Azar - Johns Hopkins UniversityGraham Barr - Columbia UniversityLars Groenke - Boehringer Ingelheim (Germany)Yvonne J Huang - University of MichiganMartin Stampfli - Hamilton Health SciencesPrescott Woodruff - University of California, San FranciscoAlexander Schaub - CSL (Switzerland)Mark Dransfield - University of Alabama at BirminghamAshraf Fawzy - Johns Hopkins HospitalNadia N Hansel - Johns Hopkins University
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.211(2), pp.215-221
- DOI
- 10.1164/rccm.202311-2184OC
- PMID
- 39441116
- PMCID
- PMC11812537
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Publisher
- AMER THORACIC SOC
- Grant note
- NIH/NHLBI: T 32 HL 007534, U01 HL137880, U24 HL141762, R01 HL182622, R01 HL144718, HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, HHSN268200900020C AmgenAstraZeneca/MedImmuneForest Research Institute Inc.Ikaria Inc.Nycomed GmbHTheravance BiopharmaMylan/ViatrisBayerBellerophon TherapeuticsBoehringer-Ingelheim Pharmaceuticals Inc.Chiesi Farmaceutici S.p.A.GenentechGlaxoSmithKlineGrifols Therapeutics Inc.MGC DiagnosticsNovartis Pharmaceuticals CorporationPolareanProterixBioRegeneron Pharmaceuticals Inc.SanofiSunovionTakeda Pharmaceutical Company
Supported by contracts from the NIH/NHLBI (HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, and HHSN268200900020C) , grants from the NIH/NHLBI (T 32 HL 007534, U01 HL137880, U24 HL141762, R01 HL182622, and R01 HL144718) , and contributions made through the Foundation for the NIH and the COPD Foundation from Amgen, AstraZeneca/MedImmune, Bayer, Bellerophon Therapeutics, Boehringer-Ingelheim Pharmaceuticals Inc., Chiesi Farmaceutici S.p.A., Forest Research Institute Inc., Genentech, GlaxoSmithKline, Grifols Therapeutics Inc., Ikaria Inc., MGC Diagnostics, Novartis Pharmaceuticals Corporation, Nycomed GmbH, Polarean, ProterixBio, Regeneron Pharmaceuticals Inc., Sanofi, Sunovion, Takeda Pharmaceutical Company, and Theravance Biopharma and Mylan/Viatris.
- Language
- English
- Electronic publication date
- 10/23/2024
- Date published
- 02/2025
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984740059702771
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