Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia

William W. Siljan; Jan C. Holter; Ståle H. Nymo; Einar Husebye; Thor Ueland; Lillemor Skattum; Vidar Bosnes; Peter Garred; Stig S. Frøland; Tom E. Mollnes; Pål Aukrust; Lars Heggelund

doi:10.1093/ofid/ofy002

Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia

William W. Siljan^*, Jan C. Holter, Ståle H. Nymo, Einar Husebye, Thor Ueland, Lillemor Skattum, Vidar Bosnes, Peter Garred, Stig S. Frøland, Tom E. Mollnes, Pål Aukrust, Lars Heggelund

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin

4 Citationer (Scopus)

55 Downloads (Pure)

Abstract

Background. Disease severity and outcome in community-acquired pneumonia (CAP) depend on the host and on the challenge of the causal microorganism(s). We measured levels of immunoglobulins (Igs) and complement in 257 hospitalized adults with CAP and examined the association of low levels of Igs or complement to microbial etiology, disease severity, and short-term and long-term outcome. Methods. Serum Igs were analyzed in blood samples obtained at admission and at 6 weeks postdischarge if admission levels were low. Serum complement deficiencies were screened with a total complement activity enzyme-linked immunosorbent assay (ELISA), with further analyzes performed if justified. Disease severity was assessed by the CURB-65 severity score. Short-term outcome was defined as a composite end point of intensive care unit (ICU) admission and 30-day mortality, and long-term outcome as 5-year all-cause mortality. Results. At admission, 87 (34%) patients had low levels of at least 1 Ig, with low IgG2 as the most prevalent finding (55/21%). IgG levels were lower in bacterial than viral CAP (8.48 vs 9.97 g/L, P = .023), but low Igs were not associated with microbial etiology. Fifty-five (21%) patients had low lectin pathway activity, of which 33 (13%) were mannose-binding lectin (MBL) deficient. Low admission levels of any Ig or MBL were not associated with disease severity, short-term outcome, or long-term outcome. Excluding patients defined as immunocompromised from analysis did not substantially affect these results. Conclusion. In hospitalized adults with CAP, low admission levels of Igs or complement were in general not associated with microbial etiology, disease severity, short-term outcome, or long-term outcome.

Originalsprog	Engelsk
Artikelnummer	ofy002
Tidsskrift	Open Forum Infectious Diseases
Vol/bind	5
Udgave nummer	2
Antal sider	7
ISSN	2328-8957
DOI	https://doi.org/10.1093/ofid/ofy002
Status	Udgivet - 2018

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10.1093/ofid/ofy002Licens: CC BY-NC-ND

Low Levels of Immunoglobulins and Mannose-Binding Lectin Are Not Associated With Etiology, Severity, or Outcome in Community-Acquired PneumoniaForlagets udgivne version, 298 KBLicens: CC BY-NC-ND

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Siljan, W. W., Holter, J. C., Nymo, S. H., Husebye, E., Ueland, T., Skattum, L., Bosnes, V., Garred, P., Frøland, S. S., Mollnes, T. E., Aukrust, P., & Heggelund, L. (2018). Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia. Open Forum Infectious Diseases, 5(2), Artikel ofy002. https://doi.org/10.1093/ofid/ofy002

Siljan, WW, Holter, JC, Nymo, SH, Husebye, E, Ueland, T, Skattum, L, Bosnes, V, Garred, P, Frøland, SS, Mollnes, TE, Aukrust, P & Heggelund, L 2018, 'Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia', Open Forum Infectious Diseases, bind 5, nr. 2, ofy002. https://doi.org/10.1093/ofid/ofy002

@article{728fb00a7f324a0e934f6297157d08be,

title = "Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia",

abstract = "Background. Disease severity and outcome in community-acquired pneumonia (CAP) depend on the host and on the challenge of the causal microorganism(s). We measured levels of immunoglobulins (Igs) and complement in 257 hospitalized adults with CAP and examined the association of low levels of Igs or complement to microbial etiology, disease severity, and short-term and long-term outcome. Methods. Serum Igs were analyzed in blood samples obtained at admission and at 6 weeks postdischarge if admission levels were low. Serum complement deficiencies were screened with a total complement activity enzyme-linked immunosorbent assay (ELISA), with further analyzes performed if justified. Disease severity was assessed by the CURB-65 severity score. Short-term outcome was defined as a composite end point of intensive care unit (ICU) admission and 30-day mortality, and long-term outcome as 5-year all-cause mortality. Results. At admission, 87 (34%) patients had low levels of at least 1 Ig, with low IgG2 as the most prevalent finding (55/21%). IgG levels were lower in bacterial than viral CAP (8.48 vs 9.97 g/L, P = .023), but low Igs were not associated with microbial etiology. Fifty-five (21%) patients had low lectin pathway activity, of which 33 (13%) were mannose-binding lectin (MBL) deficient. Low admission levels of any Ig or MBL were not associated with disease severity, short-term outcome, or long-term outcome. Excluding patients defined as immunocompromised from analysis did not substantially affect these results. Conclusion. In hospitalized adults with CAP, low admission levels of Igs or complement were in general not associated with microbial etiology, disease severity, short-term outcome, or long-term outcome.",

keywords = "Complement, Etiology, Immunoglobulin, Mannose-binding lectin, Mannose-binding protein-associated serine proteases, Mortality, Pneumonia",

author = "Siljan, {William W.} and Holter, {Jan C.} and Nymo, {St{\aa}le H.} and Einar Husebye and Thor Ueland and Lillemor Skattum and Vidar Bosnes and Peter Garred and Fr{\o}land, {Stig S.} and Mollnes, {Tom E.} and P{\aa}l Aukrust and Lars Heggelund",

year = "2018",

doi = "10.1093/ofid/ofy002",

language = "English",

volume = "5",

journal = "Open Forum Infectious Diseases",

issn = "2328-8957",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia

AU - Siljan, William W.

AU - Holter, Jan C.

AU - Nymo, Ståle H.

AU - Husebye, Einar

AU - Ueland, Thor

AU - Skattum, Lillemor

AU - Bosnes, Vidar

AU - Garred, Peter

AU - Frøland, Stig S.

AU - Mollnes, Tom E.

AU - Aukrust, Pål

AU - Heggelund, Lars

PY - 2018

Y1 - 2018

N2 - Background. Disease severity and outcome in community-acquired pneumonia (CAP) depend on the host and on the challenge of the causal microorganism(s). We measured levels of immunoglobulins (Igs) and complement in 257 hospitalized adults with CAP and examined the association of low levels of Igs or complement to microbial etiology, disease severity, and short-term and long-term outcome. Methods. Serum Igs were analyzed in blood samples obtained at admission and at 6 weeks postdischarge if admission levels were low. Serum complement deficiencies were screened with a total complement activity enzyme-linked immunosorbent assay (ELISA), with further analyzes performed if justified. Disease severity was assessed by the CURB-65 severity score. Short-term outcome was defined as a composite end point of intensive care unit (ICU) admission and 30-day mortality, and long-term outcome as 5-year all-cause mortality. Results. At admission, 87 (34%) patients had low levels of at least 1 Ig, with low IgG2 as the most prevalent finding (55/21%). IgG levels were lower in bacterial than viral CAP (8.48 vs 9.97 g/L, P = .023), but low Igs were not associated with microbial etiology. Fifty-five (21%) patients had low lectin pathway activity, of which 33 (13%) were mannose-binding lectin (MBL) deficient. Low admission levels of any Ig or MBL were not associated with disease severity, short-term outcome, or long-term outcome. Excluding patients defined as immunocompromised from analysis did not substantially affect these results. Conclusion. In hospitalized adults with CAP, low admission levels of Igs or complement were in general not associated with microbial etiology, disease severity, short-term outcome, or long-term outcome.

AB - Background. Disease severity and outcome in community-acquired pneumonia (CAP) depend on the host and on the challenge of the causal microorganism(s). We measured levels of immunoglobulins (Igs) and complement in 257 hospitalized adults with CAP and examined the association of low levels of Igs or complement to microbial etiology, disease severity, and short-term and long-term outcome. Methods. Serum Igs were analyzed in blood samples obtained at admission and at 6 weeks postdischarge if admission levels were low. Serum complement deficiencies were screened with a total complement activity enzyme-linked immunosorbent assay (ELISA), with further analyzes performed if justified. Disease severity was assessed by the CURB-65 severity score. Short-term outcome was defined as a composite end point of intensive care unit (ICU) admission and 30-day mortality, and long-term outcome as 5-year all-cause mortality. Results. At admission, 87 (34%) patients had low levels of at least 1 Ig, with low IgG2 as the most prevalent finding (55/21%). IgG levels were lower in bacterial than viral CAP (8.48 vs 9.97 g/L, P = .023), but low Igs were not associated with microbial etiology. Fifty-five (21%) patients had low lectin pathway activity, of which 33 (13%) were mannose-binding lectin (MBL) deficient. Low admission levels of any Ig or MBL were not associated with disease severity, short-term outcome, or long-term outcome. Excluding patients defined as immunocompromised from analysis did not substantially affect these results. Conclusion. In hospitalized adults with CAP, low admission levels of Igs or complement were in general not associated with microbial etiology, disease severity, short-term outcome, or long-term outcome.

KW - Complement

KW - Etiology

KW - Immunoglobulin

KW - Mannose-binding lectin

KW - Mannose-binding protein-associated serine proteases

KW - Mortality

KW - Pneumonia

U2 - 10.1093/ofid/ofy002

DO - 10.1093/ofid/ofy002

M3 - Journal article

C2 - 29410975

AN - SCOPUS:85044430553

SN - 2328-8957

VL - 5

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

IS - 2

M1 - ofy002

ER -

Low levels of immunoglobulins and mannose-binding lectin are not associated with etiology, severity, or outcome in community-acquired pneumonia

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