Lower serum IgA is associated with COPD exacerbation risk in SPIROMICS
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Putcha, N, et al. Lower Serum Iga Is Associated with Copd Exacerbation Risk In Spiromics. Public Library of Science, 2018. https://doi.org/10.17615/0c38-et42APA
Putcha, N., Paul, G., Azar, A., Wise, R., O&Apos;Neal, W., Dransfield, M., Woodruff, P., Curtis, J., Comellas, A., Drummond, M., Lambert, A., Paulin, L., Fawzy, A., Kanner, R., Paine, R., Han, M., Martinez, F., Bowler, R., Barr, R., & Hansel, N. (2018). Lower serum IgA is associated with COPD exacerbation risk in SPIROMICS. Public Library of Science. https://doi.org/10.17615/0c38-et42Chicago
Putcha, N., G.G Paul, A Azar, R.A Wise, W.K O&Apos;Neal, M.T Dransfield, P.G Woodruff et al. 2018. Lower Serum Iga Is Associated with Copd Exacerbation Risk In Spiromics. Public Library of Science. https://doi.org/10.17615/0c38-et42- Creator
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Putcha, N.
- Other Affiliation: Johns Hopkins University
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Paul, G.G.
- Other Affiliation: Johns Hopkins University
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Azar, A.
- Other Affiliation: Johns Hopkins University
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Wise, R.A.
- Other Affiliation: Johns Hopkins University
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O'Neal, W.K.
- Affiliation: School of Medicine
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Dransfield, M.T.
- Other Affiliation: University of Alabama at Birmingham
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Woodruff, P.G.
- Other Affiliation: University of San Francisco
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Curtis, J.L.
- Other Affiliation: University of Michigan, Medical School
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Comellas, A.P.
- Other Affiliation: University of Iowa
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Drummond, M.B.
- Affiliation: School of Medicine
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Lambert, A.A.
- Other Affiliation: Johns Hopkins University
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Paulin, L.M.
- Other Affiliation: Johns Hopkins University
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Fawzy, A.
- Other Affiliation: Johns Hopkins University
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Kanner, R.E.
- Other Affiliation: University of Utah Health Sciences Center
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Paine, R.
- Other Affiliation: Department of Veterans Affairs Medical Center
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Han, M.K.
- Other Affiliation: University of Michigan
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Martinez, F.J.
- Other Affiliation: Weill Cornell Medical College
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Bowler, R.P.
- Other Affiliation: National Jewish Health
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Barr, R.G.
- Other Affiliation: Columbia University
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Hansel, N.N.
- Other Affiliation: Johns Hopkins University
- Abstract
- Background Decreased but measurable serum IgA levels (70 mg/dL) have been associated with risk for infections in some populations, but are unstudied in COPD. This study tested the hypothesis that subnormal serum IgA levels would be associated with exacerbation risk in COPD. Methods Data were analyzed from 1,049 COPD participants from the observational cohort study SPIROMICS (535 (51%) women; mean age 66.1 (SD 7.8), 338 (32%) current smokers) who had baseline serum IgA measured using the Myriad RBM biomarker discovery platform. Exacerbation data was collected prospectively (mean 944.3 (SD 281.3) days), and adjusted linear, logistic and zero-inflated negative binomial regressions were performed. Results Mean IgA was 269.1 mg/dL (SD 150.9). One individual had deficient levels of serum IgA (<7 mg/dL) and 25 (2.4%) had IgA level 70 mg/dL. Participants with IgA 70 mg/dL were younger (62 vs. 66 years, p = 0.01) but otherwise similar to those with higher IgA. In adjusted models, IgA 70 mg/dL was associated with higher exacerbation incidence rates (IRR 1.71, 95% CI 1.01-2.87, p = 0.044) and greater risk for any severe exacerbation (OR 2.99, 95% CI 1.30-6.94, p = 0.010). In adjusted models among those in the lowest decile (<120 mg/ dL), each 10 mg/dL decrement in IgA (analyzed continuously) was associated with more exacerbations during follow-up (β 0.24, 95% CI 0.017-0.46, p = 0.035). Conclusions Subnormal serum IgA levels were associated with increased risk for acute exacerbations, supporting mildly impaired IgA levels as a contributing factor in COPD morbidity. Additionally, a dose-response relationship between lower serum IgA and number of exacerbations was found among individuals with serum IgA in the lowest decile, further supporting the link between serum IgA and exacerbation risk. Future COPD studies should more comprehensively characterize immune status to define the clinical relevance of these findings and their potential for therapeutic correction.
- Date of publication
- 2018
- Keyword
- DOI
- Identifier
- PMID 29649230
- https://dx.doi.org/10.1371/journal.pone.0194924
- Resource type
- Article
- Rights statement
- In Copyright
- License
- Attribution 3.0 United States
- Journal title
- PLoS ONE
- Journal volume
- 13
- Journal issue
- 4
- Language
- English
- ISSN
- 1932-6203
- Publisher
- Public Library of Science
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