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Tiotiu A, De Meulder B, Vaillant P, Mouton-Faivre C, Jaussaud R. Suboptimal Response to Biologics in Severe Asthma-A Marker of Humoral Immunodeficiencies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1840-1849.e3. [PMID: 38548169 DOI: 10.1016/j.jaip.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Asthmatic patients with antibody deficiencies (AD) have more severe disease and higher risk of exacerbations. No data exist about the efficacy of biologics in severe asthma (SA) patients with AD. OBJECTIVE To evaluate the efficacy of biologics in SA patients with and without AD. METHODS A case-control real-life study was conducted including 68 patients divided into 2 groups: group 1 with SA-AD and group 2 with SA. RESULTS Treatment with biologics for 6 months was effective for decreasing the number of exacerbations, hospitalizations, and emergency department (ED) visits and improving the Asthma Control Questionnaire (ACQ) score; biologics also proved a systemic corticosteroid-sparing effect. Despite benefits, the number of exacerbations, hospitalizations, and ED visits, the mean ACQ score, and the cumulative dose of systemic corticosteroids remain higher in group 1 than in group 2, with lower lung function parameters. The rates of responses in group 1 were inferior to those in group 2, with a decrease by ≥50% of exacerbation rate in 76% versus 97% of patients (P = .006), no hospitalization in 44% versus 91% of patients (P < .001), no ED visit in 56% versus 82% of patients (P = .018), a significant improvement of the ACQ score by ≥0.5 in 68% versus 100% of patients (P < .001), and an increase of forced expiratory volume in the first second by >10% in 32% versus 65% of patients (P = .007). CONCLUSIONS Despite evident benefits, SA patients with AD have suboptimal responses to biologics compared with those immunocompetent. A multidisciplinary approach is necessary to optimize the management of these patients in practice.
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Affiliation(s)
- Angelica Tiotiu
- Department of Pneumology, University Hospital Saint-Luc, University of Louvain, Brussels, Belgium; Pole Pneumology, ENT and Dermatology-LUNS, Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium.
| | | | - Pierre Vaillant
- Department of Pneumology, University Hospital of Nancy, Nancy, France
| | | | - Roland Jaussaud
- Department of Internal Medicine, University Hospital of Nancy, Nancy, France; Faculty of Medicine, University of Lorraine, Nancy, France
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Jang JH, Kim JH, Park HS. Current Issues in the Management of IgG Subclass Deficiencies in Adults With Chronic Respiratory Diseases. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:562-579. [PMID: 37827977 PMCID: PMC10570785 DOI: 10.4168/aair.2023.15.5.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023]
Abstract
Primary immunodeficiency diseases (PIDs) are uncommon in adults; however, immunoglobulin G subclass deficiency (IGGSCD) is often found in a subset of adult patients with chronic respiratory diseases. As quantitative laboratory tests are used to diagnose IGGSCD, the clinical significance of IGGSCD remains controversial. However, respiratory infection is a common presenting feature of IGGSCD, and respiratory complications are responsible for subsequent morbidities, such as severe asthma, bronchiectasis, chronic obstructive airway diseases, and mortality. This review summarizes the current epidemiological data for PIDs, focusing on IGGSCD in the adult population. In addition, the investigation, treatment, and management strategies are detailed, including distinct issues faced by patients with chronic airway disease and their physicians in the proper diagnosis and treatment of IGGSCD.
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Affiliation(s)
- Jae-Hyuk Jang
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Korea.
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Sohn H, Kim JH, Jang JH, Kim SH, Park HS. Functional Defects in B Lymphocytes in Asthmatic Patients With IgG Subclass Deficiency. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:536-538. [PMID: 37153979 DOI: 10.4168/aair.2023.15.4.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/31/2022] [Accepted: 01/11/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Hyeukjun Sohn
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jae-Hyuk Jang
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, Korea
| | - Seung-Hyun Kim
- Translational Research Laboratory for Inflammatory Disease, Clinical Trial Center, Ajou University Medical Center, Suwon, Korea.
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, Korea.
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Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach. J Clin Med 2023; 12:jcm12062294. [PMID: 36983294 PMCID: PMC10059265 DOI: 10.3390/jcm12062294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Bronchial asthma is the most frequent inflammatory non-communicable condition affecting the airways worldwide. It is commonly associated with concomitant conditions, which substantially contribute to its burden, whether they involve the lung or other districts. The present review aims at providing an overview of the recent acquisitions in terms of asthma concomitant systemic conditions, besides the commonly known respiratory comorbidities. The most recent research has highlighted a number of pathobiological interactions between asthma and other organs in the view of a shared immunological background underling different diseases. A bi-univocal relationship between asthma and common conditions, including cardiovascular, metabolic or neurodegenerative diseases, as well as rare disorders such as sickle cell disease, α1-Antitrypsin deficiency and immunologic conditions with hyper-eosinophilia, should be considered and explored, in terms of diagnostic work-up and long-term assessment of asthma patients. The relevance of that acquisition is of utmost importance in the management of asthma patients and paves the way to a new approach in the light of a personalized medicine perspective, besides targeted therapies.
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5
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Bakhtiari E, Nekouhi S, Zibaee S, Rakhshandeh H, Sayedi SJ. Effect of camel milk in asthmatic children: A double-blind randomized pilot study. Pediatr Pulmonol 2022; 57:2834-2838. [PMID: 36018547 DOI: 10.1002/ppul.26110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/24/2022] [Accepted: 08/09/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Asthma is one of the prevalent diseases in children. There is some evidence regarding the benefits of camel milk in asthma. The present study was carried out to evaluate the effect of camel milk on asthmatic children. PATIENTS AND METHODS A randomized double-blind pilot study was operated in 2018 in a tertiary center. Sixty children aged more than 6 years with not well-controlled asthma were included. The intervention was consisting of 200-ml camel milk or placebo daily for 2 months. The medication regimen and spirometry parameters were assessed before and after the intervention. Data were analyzed using SPSS software. RESULTS A total of 57 patients completed the trial. Patients were similar in demographic and baseline characteristics (p > 0.05). There was a significant difference between groups after intervention in use of inhaled corticosteroids (96.7% vs. 70.4%, p value = 0.01), short-acting beta-agonists (53.3% vs. 29.6%, p value = 0.0001) and long-acting beta-agonists (53.3% vs. 40.7%, p value = 0.04) in control and intervention, respectively. The percent of changes in forced expiratory volume (FEV1) in the control and intervention groups was 18.54 ± 14.89 and 21.89 ± 17.83, respectively (p = 0.19). The percent of changes in FEV1/forced vital capacity (FVC) in the control and intervention groups was 8.11 ± 7.12 and 11.11 ± 8.33, respectively (p = 0.14). CONCLUSION In our pilot study, some children with asthma may benefit from camel milk. Further studies would be useful to evaluate this hypothesis.
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Affiliation(s)
- Elham Bakhtiari
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soudabeh Nekouhi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Zibaee
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Mashhad, Iran
| | - Hasan Rakhshandeh
- Pharmacological Research Center of Medicinal Plant, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed J Sayedi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Vivarelli E, Matucci A, Parronchi P, Liotta F, Cosmi L, Rossi O, Cavigli E, Alessandra V. Primary antibody deficiencies represent an underestimated comorbidity in asthma patients: efficacy of immunoglobulin replacement therapy in asthma control. J Asthma 2022; 60:1227-1236. [PMID: 36282045 DOI: 10.1080/02770903.2022.2140435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Primary antibody deficiencies (PAD) are an underestimated comorbidity in asthma and its treatment could improve disease control. METHODS a retrospective cohort of asthmatics, affected by IgG subclass deficiency or unclassified antibody deficiency and treated with low-dose intravenous immunoglobulin replacement therapy (IRT) was recruited. Demographic and clinical data, chest CT scan, blood eosinophils, atopy, chronic oral corticosteroid (OCS) therapy were evaluated at baseline. Asthma exacerbations, lower respiratory tract infections (LRTI), upper respiratory tract infections (URTI) and asthma-related hospitalizations were assessed after one and two years of IRT. RESULTS 57 moderate-to-severe asthmatics were enrolled, mostly affected by T2 low asthma (39/57, 68.4%). After one year, IRT was effective in improving, irrespective of bronchiectasis, atopy, eosinophils and PAD type: 1) trough IgG (826.9 ± 221.3 vs 942.2 ± 195.1 mg/dl; p < 0.0001) and IgG subclasses (IgG1 355.4 ± 88.4 vs 466.7 ± 122.3, p < 0.0001; IgG2 300.1 ± 130.1 vs 347.6 ± 117.3, p < 0.0005) serum levels. 2) asthma exacerbations (6.4 ± 4.1 vs 2.4 ± 1.9, p < 0.0001), LRTI (4.3 ± 3.9 vs 1.3 ± 1.5, p < 0.0001) and hospitalization rate (0.26 ± 0.7 vs 0.05 ± 0.2, p < 0.01). These results persisted after 2 years of therapy. Estimated mean cumulative OCS exposure was reduced by 4500 mg over the 2-year period. CONCLUSIONS low-dose IRT is effective in improving asthma control and lessening OCS burden in asthmatics affected by PAD.
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Affiliation(s)
| | - Andrea Matucci
- Immunoallergology Unit, Careggi University Hospital, Florence, Italy
| | - Paola Parronchi
- Department of Experimental and Clinical Medicine, Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Liotta
- Department of Experimental and Clinical Medicine, Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Cosmi
- Department of Experimental and Clinical Medicine, Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Italy
| | - Oliviero Rossi
- Immunoallergology Unit, Careggi University Hospital, Florence, Italy
| | - Edoardo Cavigli
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
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7
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El-Sayed ZA, El-Ghoneimy DH, Ortega-Martell JA, Radwan N, Aldave JC, Al-Herz W, Al-Nesf MA, Condino-Neto A, Cole T, Eley B, Erwa NH, Espinosa-Padilla S, Faria E, Rosario Filho NA, Fuleihan R, Galal N, Garabedian E, Hintermeyer M, Imai K, Irani C, Kamal E, Kechout N, Klocperk A, Levin M, Milota T, Ouederni M, Paganelli R, Pignata C, Qamar FN, Quinti I, Qureshi S, Radhakrishnan N, Rezaei N, Routes J, Singh S, Siniah S, Abdel-Hakam Taha I, Tanno LK, Van Dort B, Volokha A, Sullivan K. Allergic manifestations of inborn errors of immunity and their impact on the diagnosis: A worldwide study. World Allergy Organ J 2022; 15:100657. [PMID: 35783543 PMCID: PMC9218584 DOI: 10.1016/j.waojou.2022.100657] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background Allergies have long been observed in Inborn Errors of Immunity (IEI) and might even be the first presentation resulting in delayed diagnosis or misdiagnosis in some cases. However, data on the prevalence of allergic diseases among IEI patients are limited and contradictory. Objective To provide a worldwide view of allergic diseases, across a broad spectrum of IEI, and their impact on the timely diagnosis of IEI. Methods This is a worldwide study, conceived by the World Allergy Organization (WAO) Inborn Errors of Immunity Committee. A questionnaire was developed and pilot-tested and was sent via email to collect data from 61 immunology centers known to treat pediatric and/or adult IEI patients in 41 countries. In addition, a query was submitted to The United States Immunodeficiency Network (USIDNET) at its website. Results Thirty centers in 23 countries caring for a total 8450 IEI patients responded. The USIDNET dataset included 2332 patients. Data from responders showed that a median (IQR) of 16.3% (10-28.8%) of patients experienced allergic diseases during the course of their IEI as follows: 3.6% (1.3-11.3%) had bronchial asthma, 3.6% (1.9-9.1%) atopic dermatitis, 3.0% (1.0-7.8%) allergic rhinitis, and 1.3% (0.5-3.3%) food allergy. As per the USIDNET data, the frequency of allergy among IEI patients was 68.8% (bronchial asthma in 46.9%). The percentage of IEI patients who presented initially with allergic disorders was 8% (5-25%) and diagnosis delay was reported in 7.5% (0.9-20.6%). Predominantly antibody deficiencies had the highest frequency of allergic disease followed by combined immunodeficiency with a frequency of 40.3% (19.2-62.5%) and 20.0% (10-32%) respectively. As per the data of centers, anaphylaxis occurred in 25/8450 patients (0.3%) whereas per USIDNET dataset, it occurred in 249/2332 (10.6%); drugs and food allergy were the main causes in both datasets. Conclusions This multinational study brings to focus the relation between allergic diseases and IEI. Major allergies do occur in IEI patients but were less frequent than the general population. Initial presentation with allergy could adversely affect the timely diagnosis of IEI. There is a need for policies to raise awareness and educate primary care and other referring specialties on the association of allergic diseases with IEI. This study provides a network among centers for future prospective studies in the field.
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Affiliation(s)
- Zeinab A. El-Sayed
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Dalia H. El-Ghoneimy
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | | | - Nesrine Radwan
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Juan C. Aldave
- Allergy and Clinical Immunology, Hospital Nacional Edgardo Rebagliati Martins, Peru
| | - Waleed Al-Herz
- Allergy and Clinical Immunology Unit, Pediatric Department, AlSabah Hospital, Faculty of Medicine, Kuwait University, Kuwait
| | - Maryam A. Al-Nesf
- Department of Pediatrics, Pulmonary Division- Allergy and Immunology Section, Qatar
| | - Antonio Condino-Neto
- Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Theresa Cole
- Department of Allergy and Immunology- Royal Children's Hospital, Australia
| | - Brian Eley
- Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital and the Department of Paediatrics and Child Health, University of Cape Town, South Africa
| | - Nahla H.H. Erwa
- Allergy and Immunology Unit- Soba University Hospital and Faculty of Medicine, University of Khartoum, Sudan
| | | | - Emilia Faria
- Immunoallergy Department, Coimbra Hospital and University Centre (CHUC), Portugal
| | | | - Ramsay Fuleihan
- Pediatric Allergy, Immunology and Rheumatology, Columbia University Medical Center, New York, USA
| | - Nermeen Galal
- Department of Pediatrics- Division of Immunology, Cairo University, Egypt
| | | | - Mary Hintermeyer
- Department of Allergy and Clinical Immunology- Children's Hospital of Wisconsin, Medical College of Wisconsin, USA
| | - Kohsuke Imai
- Department of Pediatrics-Tokyo Medical and Dental University, Japan
| | - Carla Irani
- Department of Internal Medicine and Clinical Immunology, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Ebtihal Kamal
- Allergy and Immunology Unit- Soba University Hospital and Faculty of Medicine, University of Khartoum, Sudan
| | - Nadia Kechout
- Department of Immunology, Pasteur Institute of Algeria, Algeria
| | - Adam Klocperk
- Department of Immunology, University Hospital Motol and the 2nd Faculty of Medicine, Charles University, Czech Republic
| | - Michael Levin
- Division of Pediatric Allergy, University of Cape Town, South Africa
| | - Tomas Milota
- Department of Immunology, University Hospital Motol and the 2nd Faculty of Medicine, Charles University, Czech Republic
| | - Monia Ouederni
- Department of Pediatrics, Immuno-hematology and Stem Cell Transplantation- Bone Marrow Transplantation Center Tunisia
| | - Roberto Paganelli
- Department of Medicine and Sciences of Aging, University “G. D’Annunzio”, Chieti-Pescara – and YDA, Institute of Clinical Immunotherapy and Advanced Biological Treatments, Pescara, Italy
| | | | - Farah N. Qamar
- Department of Pediatrics and Child Health- Aga Khan University Hospital, Karachi, Pakistan
| | - Isabella Quinti
- Department of Molecular Medicine, PID Reference Centre, Sapienza University of Rome, Italy
| | - Sonia Qureshi
- Department of Pediatrics and Child Health- Aga Khan University Hospital, Karachi, Pakistan
| | - Nita Radhakrishnan
- Department of Pediatric Hematology Oncology, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute Noida, Delhi NCR 201303, India
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - John Routes
- Department of Allergy and Clinical Immunology- Children's Hospital of Wisconsin, Medical College of Wisconsin, USA
| | - Surjit Singh
- Department of Pediatrics and Chief, Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sangeetha Siniah
- Hospital Tunku Azizah, Women and Children Hospital Kuala Lumpur, Malaysia
| | | | - Luciana K. Tanno
- Department of Pulmonology, Division of Allergy, University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA11, INSERM, University of Montpellier, Montpellier, France
- WHO Collaborating Centre on Classification Scientific Support, Montpellier, France
| | - Ben Van Dort
- Department of Allergy and Immunology- Royal Children's Hospital, Australia
| | - Alla Volokha
- Department of Pediatric Infectious Diseases and Immunology- Shupyk National Medical Academy of Postgraduate Education, Ukraine
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Lauret S, Noel-Savina E, Prévot G, Guibert N, Reber L, Brouquières D, Didier A, Guilleminault L. Are serum immunoglobulin concentrations a predictive biomarker of response to anti-IL5/IL5Rα therapies? Respir Med Res 2022; 81:100882. [PMID: 34983012 DOI: 10.1016/j.resmer.2021.100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Approval of biologics has recently revolutionized T2 severe asthma management. However, predictive biomarkers remain highly needed to improve patient's selection. OBJECTIVE This study aims to determine whether serum immunoglobulins (Igs) levels might be predictive biomarkers of response to anti-interleukin-5 (IL5)/IL5Rα therapies. METHODS Severe asthma patients eligible for mepolizumab or benralizumab were included herein. Serum immunoglobulin quantification was performed at baseline before mepolizumab or benralizumab initiation. After a 6-month treatment of mepolizumab or benralizumab, patients presented a second serum immunoglobulin quantification. The treatment response was evaluated by the GETE (Global Evaluation of Treatment Effectiveness) score at 6 months. RESULTS A total of 50 patients were included. Median age was 56 [IQR 48.8-65.3] and 50% were females. Compared to baseline, a significant increase in IgG was observed at 6 months (9.2 [7.8-10.2] g/l vs 10.1 [8.8-11.1] g/l, p = 0.04). The area under the ROC curve was 0.58 [95%IC 0.40-0.77] for blood eosinophil count (p = 0.37), 0.75 [95%IC: 0.58-0.92] for serum IgG concentration (p = 0.009) for predicting the treatment response. According to the Youden index, serum IgG concentration ≥ 9.2 g/l predicts the response to anti-IL5 therapies with a sensitivity of 76.9% and a specificity of 75.7%. CONCLUSION Baseline serum IgG concentrations may be a useful tool to predict the response to anti-IL5/IL5Rα therapies but should be confirmed in larger clinical trials. Interestingly, anti-IL5/IL5Rα therapies are associated with a significant increase in serum IgG concentrations at 6 months.
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Affiliation(s)
- Simon Lauret
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France
| | - Elise Noel-Savina
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France
| | - Grégoire Prévot
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France
| | - Nicolas Guibert
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France
| | - Laurent Reber
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity),Inserm U1291, University of Toulouse, CNRS U5282
| | - Danièle Brouquières
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France
| | - Alain Didier
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity),Inserm U1291, University of Toulouse, CNRS U5282
| | - Laurent Guilleminault
- Department of respiratory medicine, Toulouse University Hospital Centre, Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity),Inserm U1291, University of Toulouse, CNRS U5282.
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9
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Kim JH, Jang JH, Lee SH, Yang EM, Jang SH, Jung KS, Park HS. Specific Antibody Deficiency in Adult Patients With IgG or IgG Subclass Deficiency. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:271-283. [PMID: 33474861 PMCID: PMC7840874 DOI: 10.4168/aair.2021.13.2.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 11/23/2022]
Abstract
Purpose Specific antibody deficiency (SAD) involves a deficient response to a polysaccharide vaccine despite having normal immunoglobulin levels. The failure of the polysaccharide response can be observed as a component of various primary antibody deficiencies. However, only a few studies have described the clinical and immunological profiles in SAD and/or other primary immunodeficiencies (PIDs) in adults. Methods A total of 47 patients who had a clinical history suggestive of antibody deficiency or had already been diagnosed with various antibody deficiencies were enrolled. Polysaccharide responses to 7 pneumococcal serotypes (4, 6B, 9V, 14, 18C, 19F and 23F) were measured using the World Health Organization enzyme-linked immunosorbent assay (WHO-ELISA), and postvaccination immunoglobulin G (IgG) titers were compared to clinical and laboratory parameters. Results Based on the American Academy of Allergy, Asthma, and Immunology (AAAAI) criteria for the WHO-ELISA, 11 (23.4%) patients were diagnosed as having SAD. Sixteen-three percent of them had combined with other types of PID, such as IgG subclass deficiency and hypogammaglobulinemia. Postvaccination IgG titers for the serotypes 4/9V/18C correlated with IgG2 (P = 0.012, P = 0.001, and P = 0.004) and for 6B/9V/14 with IgG3 (P = 0.003, P = 0.041, and P = 0.036, respectively). The IgG3 subclass levels negatively correlated with forced expiratory volume in 1 second (FEV1, %) and FEV1/forced vital capacity (P < 0.001 and P = 0.001, respectively). Conclusion SAD can be diagnosed in patients with normal IgG levels as well as in those deficient in IgG or the IgG3 subclass, implicating that restricted responses to Streptococcus pneumoniae polysaccharide antigens commonly exist in patients with predominantly antibody deficiency.
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Affiliation(s)
- Joo Hee Kim
- Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jae Hyuk Jang
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - So Hee Lee
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Eun Mi Yang
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Seung Hun Jang
- Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Ki Suck Jung
- Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hae Sim Park
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
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10
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Maghsoudloo M, Azimzadeh Jamalkandi S, Najafi A, Masoudi-Nejad A. An efficient hybrid feature selection method to identify potential biomarkers in common chronic lung inflammatory diseases. Genomics 2020; 112:3284-3293. [PMID: 32540493 DOI: 10.1016/j.ygeno.2020.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/21/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022]
Abstract
Asthma, chronic obstructive pulmonary disease (COPD), and idiopathic pulmonary fibrosis (IPF) are three serious lung inflammatory diseases. The understanding of the pathogenesis mechanism and the identification of potential prognostic biomarkers of these diseases can provide the patients with more efficient treatments. In this study, an efficient hybrid feature selection method was introduced in order to extract informative genes. We implemented an ontology-based ranking approach on differentially expressed genes following a wrapper method. The examination of the different gene ontologies and their combinations motivated us to propose a biological functional-based method to improve the performance of further wrapper methods. The results identified: TOM1L1, SRSF1, and GIT2 in asthma; CHCHD4, PAIP2, CRLF3, UBQLN4, TRAK1, PRELID1, VAMP4, CCM2, and APBB1IP in COPD; and TUFT1, GAB2, B4GALNT1, TNFRSF17, PRDM8, and SETDB2 in IPF as the potential biomarkers. The proposed method can be used to identify hub genes in other high-throughput datasets.
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Affiliation(s)
- Mazaher Maghsoudloo
- Laboratory of Systems Biology and Bioinformatics (LBB), Department of Bioinformatics, Kish International Campus, University of Tehran, Kish Island, Iran; Laboratory of Systems Biology and Bioinformatics (LBB), Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | | | - Ali Najafi
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Tehran, Iran
| | - Ali Masoudi-Nejad
- Laboratory of Systems Biology and Bioinformatics (LBB), Department of Bioinformatics, Kish International Campus, University of Tehran, Kish Island, Iran; Laboratory of Systems Biology and Bioinformatics (LBB), Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
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Tiotiu A, Salvator H, Jaussaud R, Jankowski R, Couderc LJ, Catherinot E, Devillier P. Efficacy of immunoglobulin replacement therapy and azithromycin in severe asthma with antibody deficiency. Allergol Int 2020; 69:215-222. [PMID: 31812484 DOI: 10.1016/j.alit.2019.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although antibody deficiency (AD) is a well-known cause of recurrent respiratory infections, there are few data on its impact in adults with asthma. The objective of the present study was to assess outcomes in adults with severe asthma and AD after treatment with either azithromycin or subcutaneous immunoglobulins (SCIg). METHODS We performed a 5-year, prospective, observational, two-centre study of adults with severe asthma and AD in France. Bronchiectasis was ruled out by high-resolution computed tomography. Patients were treated for one year with either azithromycin (250 mg every other day) or SCIg (0.4-0.6 g/kg/months, weekly). All patients were evaluated for exacerbations, asthma control and lung function at baseline and then one year after treatment initiation. RESULTS Thirty-nine patients with severe asthma were included in the study: 14 had been treated with azithromycin and 25 had been treated with SCIg. Before the initiation of treatment for AD, all patients had an Asthma Control Questionnaire (ACQ-7) score > 1.5 (mean ± SD: 2.71 ± 0.53) despite treatment at GINA step 4 or 5, and had a high exacerbation rate requiring oral corticosteroids and/or rescue antibiotics (∼7.2 ± 2.1/patient/year). One year after treatment initiation, we observed a significantly higher FEV1 (mean: 0.18 ± 0.22 L) and ACQ-7 score (1.26 ± 0.68), and a significantly lower exacerbation rate (1.63 ± 1.24/patient/year). CONCLUSIONS Treatment of AD dramatically improved asthma outcomes - suggesting that adults with severe asthma and recurrent respiratory infections should be screened and (if appropriate) treated for AD.
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