IgG subclasses in the serum and sputum from patients with bronchiectasis
Respiratory Research Laboratories, Department of
Medicine, University of Birmingham, UK
Correspondence to: Dr S L Hill, Lung Investigation Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK.
Received 12 January 1995; Returned to authors 17 May 1995; Revised version received 21 January 1998; Accepted for publication 21 January 1998
BACKGROUND
IgG subclass deficiency is often
associated with recurrent pulmonary infections. The prevalence of
deficiency in a large well characterised group of patients with
bronchiectasis has not previously been established.
METHODSSerum IgG subclass concentrations in 89 patients with bronchiectasis were compared with those obtained from a
group of 82 age and sex matched normal healthy controls. Sputum IgG
subclass concentrations were also assessed in 44 of the patients.
Albumin was measured as a marker of protein transudation from plasma to determine the degree of local IgG subclass production.
RESULTSThe serum concentrations of
IgG1, IgG2 and IgG3 were increased
in the patients compared with the control group whereas
IgG4 concentrations were not. There was an overall
incidence of deficiency of 1% for subclasses 1-3 and 5% for subclass
4 in patients with bronchiectasis based on observed concentrations
being below the lower limit of the control group range. The
concentrations of IgG subclasses in sputum were partly dependent upon
the degree of inflammation as assessed by the macroscopic appearance of
purulence. A comparison of the ratio of sputum:serum subclass
concentration and sputum:serum albumin, however, revealed that all of
the subclasses were present at greater concentrations than could be
accounted for by transudation alone.
CONCLUSIONSA new normal control range for
serum IgG subclasses has been established and from this range it was
found that IgG subclass deficiency in a group of unselected patients
with bronchiectasis was comparatively rare. A significant degree of
local IgG production was also suggested in the lungs of these patients.
© 1998 by Thorax
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