Serum IgG Concentrations in Adult Patients Experiencing Virus-Induced Severe Asthma Exacerbations

J Allergy Clin Immunol Pract. May-Jun 2019;7(5):1507-1513.e1. doi: 10.1016/j.jaip.2018.12.028. Epub 2019 Jan 14.

Abstract

Background: Patients experiencing severe asthma exacerbations have a poorer quality of life and an increase in morbidity and mortality. Viruses are frequently involved in asthma exacerbations.

Objective: To determine the value of measuring serum IgG concentrations in asthma exacerbations and assess their link with viral infections in patients hospitalized for asthma.

Methods: Patients hospitalized for asthma exacerbation were included in an observational study from January 1, 2015, to December 31, 2015. Serum IgG concentrations on admission were compared between patients with a positive upper airway viral sample and those with a negative viral sample.

Results: Among the 82 patients included, those with positive viral nasopharyngeal samples (n = 40) presented with lower serum IgG concentrations during exacerbation than those with a negative viral sample (n = 42) (10.1 ± 2.3 g/L vs 11.5 ± 3.6 g/L; P < .05). The median concentration of serum IgG was lower in patients hospitalized for more than 3 days compared with those hospitalized for less than 3 days (10.0 g/L [8.2-12.4] vs 11.4 g/L [10.1-12.8]; P < .05) and in patients who received oral corticosteroid therapy for more than 5 days compared with those treated with oral steroids for less than 5 days (10.1 g/L [8.3-12.2] vs 11.6 g/L [10.0-13.8]; P < .05).

Conclusions: Serum IgG level was significantly lower when asthma exacerbations were associated with positive viral samples. The patients with lower serum IgG concentrations required longer hospitalizations and longer courses of steroids.

Keywords: Asthma; Exacerbation; IgG; Virus.

Publication types

  • Observational Study

MeSH terms

  • Administration, Oral
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Asthma / drug therapy
  • Asthma / immunology*
  • Asthma / physiopathology
  • Asthma / virology
  • Coronavirus Infections / immunology
  • Disease Progression
  • Enterovirus Infections / immunology
  • Female
  • Hospitalization
  • Humans
  • Immunoglobulin G / immunology*
  • Influenza, Human / immunology
  • Length of Stay*
  • Male
  • Middle Aged
  • Multiplex Polymerase Chain Reaction
  • Nasopharynx / virology
  • Paramyxoviridae Infections / immunology
  • Picornaviridae Infections / immunology
  • Respiratory Syncytial Virus Infections / immunology
  • Respiratory Tract Infections / immunology*
  • Severity of Illness Index
  • Virus Diseases / immunology*

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin G