tetano
Editor, Senior Moderator
Clin Vaccine Immunol. 2010 Dec 1. [Epub ahead of print]
Lower serum immunoglobulin G2 level is associated with cytokine dysregulation in severe cases of pandemic H1N1 2009 influenza.
Chan JF, To KK, Tse H, Lau CC, Li IW, Hung IF, Chan KH, Cheng VC, Lai TS, Woo PC, Chan EY, Yuen KY.
Department of Microbiology, Queen Mary Hospital, State Key Laboratory of Emerging Infectious Diseases, Research Centre of Infection and Immunology, Carol Yu Centre for Infection, Department of Medicine, Queen Mary Hospital, Department of Medicine and Geriatrics, Princess Margaret Hospital, and Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Abstract
The majority of patients with pandemic influenza H1N1 2009 had mild illness but some including those with no risk factors for severe disease may succumb to this infection. Besides viral factors such as the D222/225G substitution of the haemagglutinin, host factors such as IgG2 subclass deficiency was recently reported to be associated with severe disease in a cohort of Australian patients besides other known risk factors including underlying chronic illness, extremes of age and pregnancy. We conducted a case-control study on 38 Asian patients with respiratory failure due to severe pandemic influenza and compared with 36 mild cases. None had selective IgG2 deficiency but the level of IgG2 subclass was significantly lower in the severe cases (3.55g/L vs 4.75g/L, P=0.002) whereas the levels of IgG1, IgG3 and IgG4 were not significantly different from the mild cases. Previous studies suggested that some IgHG2 and FcγRIIa genotypes were associated with IgG2 deficiency. The alleleic frequency of the IgHG2 genotypes in our severe cases were not correlated with their levels of IgG2 while that of FcγRIIa was not significantly different from the general Han Chinese population (P=0.216). Only the overall cytokine/chemokine profile (P=0.029) and serum globulin level (P=0.005) were found to be independently associated with the IgG2 level by multivariate analysis. The lower IgG2 level in our severe group might be related to cytokine dysregulation rather than being a significant risk factor for severe pandemic influenza. The importance of this finding on therapeutic intervention will require further studies in larger cohorts of patients.
PMID: 21123524 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21123524
Lower serum immunoglobulin G2 level is associated with cytokine dysregulation in severe cases of pandemic H1N1 2009 influenza.
Chan JF, To KK, Tse H, Lau CC, Li IW, Hung IF, Chan KH, Cheng VC, Lai TS, Woo PC, Chan EY, Yuen KY.
Department of Microbiology, Queen Mary Hospital, State Key Laboratory of Emerging Infectious Diseases, Research Centre of Infection and Immunology, Carol Yu Centre for Infection, Department of Medicine, Queen Mary Hospital, Department of Medicine and Geriatrics, Princess Margaret Hospital, and Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Abstract
The majority of patients with pandemic influenza H1N1 2009 had mild illness but some including those with no risk factors for severe disease may succumb to this infection. Besides viral factors such as the D222/225G substitution of the haemagglutinin, host factors such as IgG2 subclass deficiency was recently reported to be associated with severe disease in a cohort of Australian patients besides other known risk factors including underlying chronic illness, extremes of age and pregnancy. We conducted a case-control study on 38 Asian patients with respiratory failure due to severe pandemic influenza and compared with 36 mild cases. None had selective IgG2 deficiency but the level of IgG2 subclass was significantly lower in the severe cases (3.55g/L vs 4.75g/L, P=0.002) whereas the levels of IgG1, IgG3 and IgG4 were not significantly different from the mild cases. Previous studies suggested that some IgHG2 and FcγRIIa genotypes were associated with IgG2 deficiency. The alleleic frequency of the IgHG2 genotypes in our severe cases were not correlated with their levels of IgG2 while that of FcγRIIa was not significantly different from the general Han Chinese population (P=0.216). Only the overall cytokine/chemokine profile (P=0.029) and serum globulin level (P=0.005) were found to be independently associated with the IgG2 level by multivariate analysis. The lower IgG2 level in our severe group might be related to cytokine dysregulation rather than being a significant risk factor for severe pandemic influenza. The importance of this finding on therapeutic intervention will require further studies in larger cohorts of patients.
PMID: 21123524 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21123524