IgM levels in plasma predict outcome in severe pandemic influenza

Justel, Mar; Socías, Lorenzo; Almansa, Raquel; Ramírez, Paula; Gallegos, Maria C; Fernández, Victoria; Gordón, Mónica; Andaluz‐Ojeda, David; Nogales, Leonor; Rojo, Silvia; Vallès, Jordi; Estella, Ángel; Loza, Ana; León, Cristóbal; López-Mestanza, Cristina; Blanco, Jesús; Berezo, José Ángel; Rosich, Sara; Cillóniz, Catia; Lejarazu, Raúl Ortíz de; Martín‐Loeches, Ignacio; Bermejo-Martín, Jesús F.

doi:10.1016/j.jcv.2013.09.006

Cited by 36 publications

(36 citation statements)

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“…In addition, measurements of IgM levels in patients with sepsis and viral infections showed that non-survivors had lower levels of IgM compared to survivors [34,32]. These results highlight the importance of IgM in the host defense mechanism.…”

Section: Discussionmentioning

confidence: 75%

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Concept for a study design in patients with severe community-acquired pneumonia: A randomised controlled trial with a novel IGM-enriched immunoglobulin preparation – The CIGMA study

Welte

Dellinger

Ebelt

et al. 2015

Respiratory Medicine

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Section: Discussionmentioning

confidence: 75%

“…Results in patients with severe sepsis progressing to septic shock and in patients with viral infections showed that non-survivors had lower levels of IgM compared to survivors [34,32]. De la Torre et al [31] described for the first time that CAP patients had lower immunoglobulin levels compared with healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Concept for a study design in patients with severe community-acquired pneumonia: A randomised controlled trial with a novel IGM-enriched immunoglobulin preparation – The CIGMA study

Welte

Dellinger

Ebelt

et al. 2015

Respiratory Medicine

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“…Although Gordon et al 11 21 established an association between acute low values of IgG2 and severe infection by influenza H1N1 virus, they could not determine whether this was due to the virus itself or to other factors of severity. On the other hand, Justel et al 23 observed that patients with severe disease caused by influenza A (H1N1) and low levels of IgG2 and IgM on ICU admission died sooner. In our study, we detected no differences in serum levels of IgM, perhaps because we excluded immunosuppressed patients.…”

Section: Discussionmentioning

confidence: 99%

Serum levels of immunoglobulins and severity of community-acquired pneumonia

et al. 2016

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InstructionThere is evidence of a relationship between severity of infection and inflammatory response of the immune system. The objective is to assess serum levels of immunoglobulins and to establish its relationship with severity of community-acquired pneumonia (CAP) and clinical outcome.MethodsThis was an observational and cross-sectional study in which 3 groups of patients diagnosed with CAP were compared: patients treated in the outpatient setting (n=54), patients requiring in-patient care (hospital ward) (n=173), and patients requiring admission to the intensive care unit (ICU) (n=191).ResultsSerum total IgG (and IgG subclasses IgG1, IgG2, IgG3, IgG4), IgA and IgM were measured at the first clinical visit. Normal cutpoints were defined as the lowest value obtained in controls (≤680, ≤323, ≤154, ≤10, ≤5, ≤30 and ≤50 mg/dL for total IgG, IgG1, IgG2, IgG3, IgG4, IgM and IgA, respectively). Serum immunoglobulin levels decreased in relation to severity of CAP. Low serum levels of total IgG, IgG1 and IgG2 showed a relationship with ICU admission. Low serum level of total IgG was independently associated with ICU admission (OR=2.45, 95% CI 1.4 to 4.2, p=0.002), adjusted by the CURB-65 severity score and comorbidities (chronic respiratory and heart diseases). Low levels of total IgG, IgG1 and IgG2 were significantly associated with 30-day mortality.ConclusionsPatients with severe CAP admitted to the ICU showed lower levels of immunoglobulins than non-ICU patients and this increased mortality.

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“…This finding indicated the central role of IgM in preventing uncontrolled inflammatory response and mortality. The early assessment of IgM could contribute to directing clinical decisions in these patients [46].…”

Section: Non-cytokine Biomarkers In Capmentioning

confidence: 99%

Relevant Cytokines in the Management of Community-Acquired Pneumonia

Rendón

Rendón-Ramírez

Rosas-Taraco

2016

Curr Infect Dis Rep

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Community-acquired pneumonia (CAP) is the leading cause of infectious death in the world. Immune dysregulation during acute lung infection plays a role in lung injury and the systemic inflammatory response. Cytokines seem to be major players in severe lung infection cases. Here, we present a review of published papers in the last 3 years regarding this topic. The cytokine response during pneumonia is different in bacterial vs viral infections; some of these cytokines correlate with clinical severity scales such as CURB65 or SOFA. Treatment focused in the cytokine environment is an interesting area that could impact the prognosis of CAP. Some of the agents that have been studied as co-adjuvant therapy are corticosteroids, macrolides, and linezolid, but anyone of those have shown a clear or proven efficacy or have been recommended as a part of the standard of care for CAP. More studies designed to define the role of immunomodulatory agents, such as co-adjuvant therapy in pneumonia, are needed.

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IgM levels in plasma predict outcome in severe pandemic influenza

Cited by 36 publications

References 10 publications

Concept for a study design in patients with severe community-acquired pneumonia: A randomised controlled trial with a novel IGM-enriched immunoglobulin preparation – The CIGMA study

Concept for a study design in patients with severe community-acquired pneumonia: A randomised controlled trial with a novel IGM-enriched immunoglobulin preparation – The CIGMA study

Serum levels of immunoglobulins and severity of community-acquired pneumonia

Relevant Cytokines in the Management of Community-Acquired Pneumonia

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