Association between primary immunodeficiency and asthma exacerbation in adult asthmatics

Other Titles
Association between primary immunodeficiency and asthma exacerbation in adult asthmatics
Authors
So-Hee LeeGa-Young BanSu-Chin KimChang-Gyu ChungHyun-Young LeeJi-Ho LeeHae-Sim Park
Department
Dept. of Internal Medicine (내과학)
Issue Date
2020
Citation
The Korean Journal of Internal Medicine, Vol.35(2) : 449-456, 2020
ISSN
2005-6648
Abstract
Background/Aims: Primary immunodef iciency (PID) is a serious comorbid condition in adult asthmatics that have frequent exacerbations, which requires monthly replacement of intravenous immunoglobulin (IVIG). However, the prevalence and clinical significance of PID in adult asthmatics in Korea have not yet been reported. The aim of this study is to assess the prevalence of PID and its association with asthma exacerbation in Korean adult asthmatics. Methods: A total of 2,866 adult asthmatics were enrolled in this study. The PID group was defined as subjects who had lower levels of immunoglobulin G (IgG)/ A/M and/or IgG subclass presenting with recurrent respiratory infections. Serum samples were assayed for total IgG/A/M by immunoturbidimetry, and IgG subclasses by nephelometry. Results: Of the 2,866 asthmatic patients enrolled, 157 (5.49%) had PID (classified as the PID group), while those without PID was classified as the non-PID group. IgG subclass deficiency (58%) is most prevalent, among which IgG3 subclass deficiency was most common (58%). The relative risk of asthma exacerbation was 1.70 times higher in the PID group compared to the non-PID group (1.696; 95% confidence interval, 1.284 to 2.239; p < 0.001); the prevalence of severe asthma was significantly higher in the PID group than in the non-PID group (32.48% vs. 13.00%, p < 0.001). Thirty-five among 157 patients in the PID group d maintained IVIG to prevent asthma exacerbation. Conclusions: It is suggested that PID, especially IgG3 subclass deficiency, is a significant risk factor for asthma exacerbation. Screening of IgG subclass levels and IVIG replacement should be considered in the management in adult asthmatics.
Keywords
AsthmaImmunologic deficiency syndromesPrevalenceAsthma exacerbationImmunoglobulins
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42693
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
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Full Text
http://kjim.org/journal/view.php?doi=10.3904/kjim.2018.413
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