Bronchiectasis is a chronic debilitating condition characterized by abnormally and permanently dilated pulmonary airways. The main symptoms are chronic cough with daily tenacious sputum production and recurrent respiratory infections.
Humoral immunity involves both the major immunoglobulin classes IgM, IgG, IgA and IgG subclasses (IgG1, IgG2, IgG3 and IgG4). Impaired specific antibody responses to encapsulated pyogenic bacteria such as Hib and pneumococcus have also been reported.
The present work was conducted in Chest department at Benha University Hospital between March 2011 and December 2013 to study humoral immunity in patients with bronchiectasis and to find the relation with the disease if any.
Forty two subjects were included in this study, 28 bronchiectasis patients (18 males and 10 females), 8 diseased controls (6 males and 2 females) and 6 healthy controls (all were females).
All patients were submitted to full history taking (including smoking history), full clinical examination, ventilatory function tests by the flow volume measurement, chest X- ray PA view for early screening of bronchiectasis and to exclude other pulmonary disorders, HRCT of the chest for accurate diagnosis of bronchiectasis and its anatomical sites, measurement of serum IgA, IgM, IgG and IgG4 by radial immunodiffusion plate method, general laboratory tests ( CBC, ESR, Liver and kidney functions, while healthy subjects underwent ventilatory function tests by the flow volume measurement, chest X- ray PA (for exclusion of chest problems), measurement of serum IgA, IgM, IgG and IgG4 by radial immunodiffusion plate and general laboratory tests (CBC, ESR, Liver and kidney functions).
It was found that, 7.3%, 3.6%, 14.2% and 21.5% of patients have subnormal levels for IgA, IgM, IgG and IgG4 respectively. While 64.2% showed elevated IgA and IgG and 35.7% showed elevated IgM. IgG4was not elevated in any patients. So bronchiectasis was commonly associated with increased rather than lowered serum immunoglobulin levels.
Bronchiectasis cases had significantly higher serum IgA and IgG levels in comparison to controls (positives and negatives), with no significant difference between them regarding other immunoglobulins.
Bronchiectasis cases and positive controls had significantly higher seum IgA and IgG in comparison to healthy controls, with no significant difference among them regarding other immunoglobulins.
Multilobar and unilobar bronchiecatasis cases had significantly higher serum IgA and IgG levels than healthy controls, with no significant difference between the two groups regarding IgM and IgG4.
No significant difference between Multilobar bronchiectasis and diseased controls regarding the serum immunoglobulins.
No significant correlation between FEV1% and serum immunoglobulins in bronchiectasis patients, although the relation was inverse with IgA and IgM and direct with IgG and IgG4.
No significant correlation between FEF25-75% and serum immunoglobulins in bronchiectasis patients, although it was inverse with IgA and IgM and direct with IgG and IgG4.
There was significant direct correlation between serum immunoglobulins and percentage of lung affection by bronchiectasis except for serum IgG4 (the correlation with it was direct but non- significant). |
