BACKGROUND: Little is known on the participation of immunoglobulin isotypes and subclasses in the pathogenesis of the severe disease caused by the pandemic influenza virus (influenza A(H1N1)pdm09). OBJECTIVES: (1) To evaluate the association between plasma levels of IgG1, IgG2, IgG3, IgG4, IgA, IgM, IgE and outcome in patients with severe pandemic influenza. (2) To evaluate the association between immunoglobulin and cytokine levels in these patients. STUDY DESIGN: 40 critically ill patients with community acquired pneumonia and influenza A(H1N1)pdm09 infection were recruited from November 2010 to February 2011. Plasma samples were collected during the first 24h following admission to the ICU. Immunoglobulins and 17 major cytokines were profiled in plasma. RESULTS: 15 patients died (37.5%). When the association between clinical variables and prognosis was assessed, prior immunosuppression, APACHE II score, levels of IgG2 and levels of IgM were associated with outcome in a univariate Cox regression analysis. Kaplan Meier analysis showed that patients with levels of IgG2 and IgM < 59 and<58 mg/dl respectively died earlier. Multivariate Cox regression analysis showed that APACHE II score and levels of IgM were the best predictors of outcome, being levels of IgM a protective factor against mortality. IgM was the immunoglobulin showing the largest number of negative correlations with cytokine levels. CONCLUSIONS: Our results support a central role of IgM in preventing uncontrolled inflammatory response and mortality in severe pandemic influenza. Early assessment of IgM could contribute to guide clinical decisions in these patients.
BACKGROUND: Little is known on the participation of immunoglobulin isotypes and subclasses in the pathogenesis of the severe disease caused by the pandemic influenza virus (influenza A(H1N1)pdm09). OBJECTIVES: (1) To evaluate the association between plasma levels of IgG1, IgG2, IgG3, IgG4, IgA, IgM, IgE and outcome in patients with severe pandemic influenza. (2) To evaluate the association between immunoglobulin and cytokine levels in these patients. STUDY DESIGN: 40 critically ill patients with community acquired pneumonia and influenza A(H1N1)pdm09 infection were recruited from November 2010 to February 2011. Plasma samples were collected during the first 24h following admission to the ICU. Immunoglobulins and 17 major cytokines were profiled in plasma. RESULTS: 15 patients died (37.5%). When the association between clinical variables and prognosis was assessed, prior immunosuppression, APACHE II score, levels of IgG2 and levels of IgM were associated with outcome in a univariate Cox regression analysis. Kaplan Meier analysis showed that patients with levels of IgG2 and IgM < 59 and<58 mg/dl respectively died earlier. Multivariate Cox regression analysis showed that APACHE II score and levels of IgM were the best predictors of outcome, being levels of IgM a protective factor against mortality. IgM was the immunoglobulin showing the largest number of negative correlations with cytokine levels. CONCLUSIONS: Our results support a central role of IgM in preventing uncontrolled inflammatory response and mortality in severe pandemic influenza. Early assessment of IgM could contribute to guide clinical decisions in these patients.
Authors: Katherine Adams; Mark W Tenforde; Shreya Chodisetty; Benjamin Lee; Eric J Chow; Wesley H Self; Manish M Patel Journal: Hum Vaccin Immunother Date: 2021-11-10 Impact factor: 3.452
Authors: Tobias Welte; R Phillip Dellinger; Henning Ebelt; Miguel Ferrer; Steven M Opal; Mervyn Singer; Jean-Louis Vincent; Karl Werdan; Ignacio Martin-Loeches; Jordi Almirall; Antonio Artigas; Jose Ignacio Ayestarán; Sebastian Nuding; Ricard Ferrer; Gonzalo Sirgo Rodríguez; Manu Shankar-Hari; Francisco Álvarez-Lerma; Reimer Riessen; Josep-Maria Sirvent; Stefan Kluge; Kai Zacharowski; Juan Bonastre Mora; Harald Lapp; Gabriele Wöbker; Ute Achtzehn; David Brealey; Axel Kempa; Miguel Sánchez García; Jörg Brederlau; Matthias Kochanek; Henrik Peer Reschreiter; Matthew P Wise; Bernd H Belohradsky; Iris Bobenhausen; Benjamin Dälken; Patrick Dubovy; Patrick Langohr; Monika Mayer; Jörg Schüttrumpf; Andrea Wartenberg-Demand; Ulrike Wippermann; Daniele Wolf; Antoni Torres Journal: Intensive Care Med Date: 2018-04-09 Impact factor: 17.440
Authors: Claudia Devito; Rada Ellegård; Tina Falkeborn; Lennart Svensson; Mats Ohlin; Marie Larsson; Kristina Broliden; Jorma Hinkula Journal: Sci Rep Date: 2018-07-05 Impact factor: 4.379
Authors: Raquel Almansa; Mar Justel; Lorenzo Socias; Paula Ramírez; David Andaluz-Ojeda; Angel Estella; Ana Loza; Jesús Blanco; Jose Ángel Berezo; Sara Rosich; Catia Cillòniz; Antoni Torres; Raul Ortiz de Lejarazu; Ignacio Martin-Loeches; Jesus F Bermejo-Martin Journal: J Clin Virol Date: 2013-12-12 Impact factor: 3.168
Authors: Mari C de la Torre; Pere Torán; Mateu Serra-Prat; Elisabet Palomera; Estel Güell; Ester Vendrell; Joan Carles Yébenes; Antoni Torres; Jordi Almirall Journal: BMJ Open Respir Res Date: 2016-11-28