Reduced rhinovirus-specific antibodies are associated with acute exacerbations of chronic obstructive pulmonary disease requiring hospitalisation - PubMed (original) (raw)

Comparative Study

Reduced rhinovirus-specific antibodies are associated with acute exacerbations of chronic obstructive pulmonary disease requiring hospitalisation

Stephanie T Yerkovich et al. BMC Pulm Med. 2012.

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are often linked to respiratory infections. However, it is unknown if COPD patients who experience frequent exacerbations have impaired humoral immunity. The aim of this study was to determine if antibodies specific for common respiratory pathogens are associated with AECOPD.

Methods: Plasma was obtained from COPD patients when clinically stable. AECOPD requiring hospitalisation were recorded. IgG1 antibodies to H. Influenzae outer membrane protein 6 (P6), pneumococcal surface protein C (PspC) and the VP1 viral capsid protein of rhinovirus were measured.

Results: COPD patients who had an AECOPD (n = 32) had significantly lower anti-VP1 IgG1 antibody levels when stable compared to COPD patients who did not have an AECOPD (n = 28, p = 0.024). Furthermore, the number of hospitalisations was inversely proportional to anti-VP1 antibody levels (r = -0.331, p = 0.011). In contrast, antibodies specific for P6 and PspC were present at similar concentrations between groups. Plasma IL-21, a cytokine important for B-cell development and antibody synthesis, was also lower in COPD patients who had an AECOPD, than in stable COPD patients (p = 0.046).

Conclusion: Deficient humoral immunity specific for rhinoviruses is associated with AECOPD requiring hospitalisation, and may partly explain why some COPD patients have an increased exacerbation risk following respiratory viral infections.

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Figures

Figure 1

Figure 1

Anti-rhinovirus IgG 1 antibodies in COPD. (A) IgG1 antibody levels specific to rhinovirus (VP1) are plotted for stable and exacerbation-prone COPD patients with the medians indicated. The lower limit of detection is highlighted with a dotted line. Significance was assessed by Mann–Whitney test with significant differences indicated. (B) The relationship between the number of hospitalisations and IgG1 antibody levels specific to rhinovirus (VP1) is shown with the regression line. The correlation was assessed using the Spearman rank test.

Figure 2

Figure 2

IgG 1 antibodies to common bacterial respiratory pathogens in COPD IgG 1 antibody levels to (A) H. influenzae (P6) and (B) pneumococcal surface antigen (PspC) are plotted for stable and exacerbation-prone COPD patients, with the medians indicated. The lower limit of detection is highlighted with a dotted line

Figure 3

Figure 3

Circulating IL-21 is lower in exacerbation-prone COPD patients Plasma IL-21 levels are plotted for (A) stable and exacerbation-prone COPD patients with the median indicated and (B) against the number of hospital admissions. Significant differences are indicated.

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