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Clinical Chemistry 53: 124-130, 2007. First published November 16, 2006; 10.1373/clinchem.2007.075861
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(Clinical Chemistry. 2007;53:124-130.)
© 2007 American Association for Clinical Chemistry, Inc.

Clinical Immunology

Coexistence of (Partial) Immune Defects and Risk of Recurrent Respiratory Infections

Xavier Bossuyt1,a, Leen Moens1, Erna Van Hoeyveld1, Axel Jeurissen1, Guy Bogaert2, Kate Sauer3, Marijke Proesmans3, Marc Raes3 and Kris De Boeck3

Departments of1 Laboratory Medicine and Immunology, 2 Urology; and 3 Pediatrics, University Hospital Leuven, Leuven, Belgium.

aAddress correspondence to this author at: Laboratory Medicine, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium. Fax: 0032-377931; e-mail: Xavier.bossuyt{at}uz.kuleuven.be.

Background: Respiratory infections are major causes of morbidity and mortality, but determinants of susceptibility are poorly defined. We studied whether and to what extent immunologic and genetic factors are associated with increased susceptibility to respiratory infections.

Methods: We evaluated the prevalence of IgA, IgM, IgG, and IgG subclass deficiencies, impairment in the antibody response against pneumococcal polysaccharides, G2m(n) allotypes, Fc{gamma}RIIa polymorphisms, partial C2 and partial C4 deficiency, promoter polymorphisms in MBL2, and lymphocyte subset deficiencies in a control population and in consecutive children with recurrent respiratory infections.

Results: IgA and/or IgG subclass deficiency was found in 27 of 55 patients (49%) and 6 of 43 controls (14%) (P = 0.0006). An impaired antibody response to polysaccharides was found in 7 patients (19%) and in 0 of 37 controls (P = 0.002). The Gm(n)marker was absent in 25 of 55 patients (45%) and 6 of 42 controls (14%) (P = 0.009). The MBL2 variants O/O, A/O, and A/A occurred in 9, 14, and 32 of the 55 patients, respectively, and in 1, 19, and 23 of the 43 controls, respectively (P = 0.05). There was no increase in the prevalence of partial C4 deficiency, C2 deficiency, lymphocyte subset deficiency, or Fc{gamma}RIIa polymorphism in the patients compared to the controls. A combination of at least 2 immune defects was found in 31 of 55 patients (56%) and in 4 of 42 controls (11.6%) (P <0.0001).

Conclusion: Specific antipolysaccharide antibody deficiency, IgA and/or IgG subclass deficiency, Gm(n) allotype, and MBL2 genotype are susceptibility factors for recurrent respiratory infections, and coexistence of several immune defects is the strongest risk factor in this study.




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Clin. Chem., February 1, 2007; 53(2): 159 - 160.
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