Serum Immunoglobulins, Pneumonia Risk, and Lung Function in Middle-Aged and Older Individuals: A Population-Based Cohort Study

Samer R. Khan, Anna Vanoverschelde, Lies Lahousse, Robin P. Peeters, P. Martin van Hagen, Guy Brusselle, Layal Chaker, Virgil A.S.H. Dalm*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction: Immunoglobulins (Igs) play a pivotal role in host defense and prevention of pneumonia. Aging influences serum Ig levels, but the association between Igs and pneumonia in community-dwelling older individuals remains unknown. We evaluated the association of serum IgA, IgG, and IgM with pneumonia and lung function in middle-aged and older individuals. Methods: We performed Cox and negative binomial regression analyses for the association of Igs with incident pneumonia and pneumonia-related mortality, and recurrent pneumonia respectively. We performed logistic regression analyses for the association between Igs and lung function values. Associations were adjusted for age, sex, smoking, comorbidities, and serum C-reactive protein. Results: We included 8,766 participants (median age 62.2 years, 57% women, median follow-up 9.8 years). Higher IgA (hazard ratio [HR]: 1.15; 95% confidence interval [95% CI]: 1.00-1.32) and IgG (HR: 1.13; 95% CI: 1.06-1.19) were associated with an increased pneumonia risk. Higher IgG was associated with an increased risk of pneumonia-related mortality (HR: 1.08; 95% CI: 1.01-1.16) and recurrent pneumonia (incidence rate ratio: 1.04; 95% CI: 1.00-1.09). Higher IgA and IgG were also associated with lower forced expiratory volume in one second (FEV1), lower forced vital capacity (FVC), and an increased odds of preserved ratio impaired spirometry (PRISm, i.e. FEV1 <80% and FEV1/FVC ratio ≥70%). No association was seen with an obstructive spirometry pattern. Discussion: Higher serum IgA and IgG levels were associated with pneumonia, pneumonia-related mortality, and PRISm in middle-aged and older individuals from the general population. Future studies should validate our findings and elucidate underlying pathophysiology.

Original languageEnglish
Article number868973
JournalFrontiers in Immunology
Volume13
DOIs
Publication statusPublished - 2 Jun 2022

Bibliographical note

Funding Information:
This work was supported by Takeda Pharmaceutical Company Limited [grant number IIR-NLD-002671 to V.A.S.H. Dalm]. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. The Rotterdam Study was supported by the Erasmus Medical Center, Erasmus University Rotterdam, the Netherlands Organization for Scientific Research (NWO), the Netherlands Organisation for Health Research and Development (ZonMw), the Netherlands Heart Foundation, the Research Institute for Diseases in the Elderly (RIDE); the Netherlands Genomics Initiative (NGI), the Ministry of Education, Culture and Science; the Ministry of Health Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. Lung research was financially supported by the Fund for Scientific Research Flanders [grant number 3G037618].

Publisher Copyright:
Copyright © 2022 Khan, Vanoverschelde, Lahousse, Peeters, van Hagen, Brusselle, Chaker and Dalm.

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