IgM levels in plasma predict outcome in severe pandemic influenza

Mar Justel; Lorenzo Socias; Raquel Almansa; Paula Ramírez; Maria C. Gallegos; Victoria Fernandez; Monica Gordon; David Andaluz-Ojeda; Leonor Nogales; Silvia Rojo; Jordi Vallés; Angel Estella; Ana Loza; Cristobal León; Cristina Lopez-Mestanza; Jesús Blanco; Jose Ángel Berezo; Sara Rosich; Catia Cillòniz; Antoni Torres; Raul Ortiz de Lejarazu; Ignacio Martin-Loeches; Jesus F. Bermejo-Martin

doi:10.1016/j.jcv.2013.09.006

IgM levels in plasma predict outcome in severe pandemic influenza

Mar Justel, Lorenzo Socias, Raquel Almansa, Paula Ramírez, Maria C. Gallegos, Victoria Fernandez, Monica Gordon, David Andaluz-Ojeda, Leonor Nogales, Silvia Rojo, Jordi Vallés, Angel Estella, Ana Loza, Cristobal León, Cristina Lopez-Mestanza, Jesús Blanco, Jose Ángel Berezo, Sara Rosich, Catia Cillòniz, Antoni TorresRaul Ortiz de Lejarazu, Ignacio Martin-Loeches, Jesus F. Bermejo-Martin

Research output: Contribution to journal › Original Article › peer-review

32 Scopus citations

Abstract

Background: Little is known on the participation of immunoglobulin isotypes and subclasses in the pathogenesis of the severe disease caused by the pandemic influenza virus (influenza A(H1N1)pdm09). Objectives: (1) To evaluate the association between plasma levels of IgG1, IgG2, IgG3, IgG4, IgA, IgM, IgE and outcome in patients with severe pandemic influenza. (2) To evaluate the association between immunoglobulin and cytokine levels in these patients. Study design: 40 critically ill patients with community acquired pneumonia and influenza A(H1N1)pdm09 infection were recruited from November 2010 to February 2011. Plasma samples were collected during the first 24. h following admission to the ICU. Immunoglobulins and 17 major cytokines were profiled in plasma. Results: 15 patients died (37.5%). When the association between clinical variables and prognosis was assessed, prior immunosuppression, APACHE II score, levels of IgG2 and levels of IgM were associated with outcome in a univariate Cox regression analysis. Kaplan Meier analysis showed that patients with levels of IgG2 and IgM. <. 59 and. <. 58. mg/dl respectively died earlier. Multivariate Cox regression analysis showed that APACHE II score and levels of IgM were the best predictors of outcome, being levels of IgM a protective factor against mortality. IgM was the immunoglobulin showing the largest number of negative correlations with cytokine levels. Conclusions: Our results support a central role of IgM in preventing uncontrolled inflammatory response and mortality in severe pandemic influenza. Early assessment of IgM could contribute to guide clinical decisions in these patients.

Original language	American English
Pages (from-to)	564-567
Number of pages	4
Journal	Journal of Clinical Virology
Volume	58
Issue number	3
DOIs	https://doi.org/10.1016/j.jcv.2013.09.006
State	Indexed - Nov 2013
Externally published	Yes

Bibliographical note

Funding Information:
The authors acknowledge the support of “ Instituto de Salud Carlos III- Fondo de Investigaciones Sanitarias, FIS ” and Health Council, Junta de Castilla y León (JCYL-IECSCYL-SACYL): Programa de Investigación Comisionada en Gripe , GR09/0021 , GR09/0022 .

Keywords

Critical
Cytokines
Immunoglobulins
Influenza
Prognosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jcv.2013.09.006

Cite this

Justel, M., Socias, L., Almansa, R., Ramírez, P., Gallegos, M. C., Fernandez, V., Gordon, M., Andaluz-Ojeda, D., Nogales, L., Rojo, S., Vallés, J., Estella, A., Loza, A., León, C., Lopez-Mestanza, C., Blanco, J., Berezo, J. Á., Rosich, S., Cillòniz, C., ... Bermejo-Martin, J. F. (2013). IgM levels in plasma predict outcome in severe pandemic influenza. Journal of Clinical Virology, 58(3), 564-567. https://doi.org/10.1016/j.jcv.2013.09.006

@article{ce31be8f1de0459a8e8bf6102818c4a6,

title = "IgM levels in plasma predict outcome in severe pandemic influenza",

abstract = "Background: Little is known on the participation of immunoglobulin isotypes and subclasses in the pathogenesis of the severe disease caused by the pandemic influenza virus (influenza A(H1N1)pdm09). Objectives: (1) To evaluate the association between plasma levels of IgG1, IgG2, IgG3, IgG4, IgA, IgM, IgE and outcome in patients with severe pandemic influenza. (2) To evaluate the association between immunoglobulin and cytokine levels in these patients. Study design: 40 critically ill patients with community acquired pneumonia and influenza A(H1N1)pdm09 infection were recruited from November 2010 to February 2011. Plasma samples were collected during the first 24. h following admission to the ICU. Immunoglobulins and 17 major cytokines were profiled in plasma. Results: 15 patients died (37.5%). When the association between clinical variables and prognosis was assessed, prior immunosuppression, APACHE II score, levels of IgG2 and levels of IgM were associated with outcome in a univariate Cox regression analysis. Kaplan Meier analysis showed that patients with levels of IgG2 and IgM. <. 59 and. <. 58. mg/dl respectively died earlier. Multivariate Cox regression analysis showed that APACHE II score and levels of IgM were the best predictors of outcome, being levels of IgM a protective factor against mortality. IgM was the immunoglobulin showing the largest number of negative correlations with cytokine levels. Conclusions: Our results support a central role of IgM in preventing uncontrolled inflammatory response and mortality in severe pandemic influenza. Early assessment of IgM could contribute to guide clinical decisions in these patients.",

keywords = "Critical, Cytokines, Immunoglobulins, Influenza, Prognosis",

author = "Mar Justel and Lorenzo Socias and Raquel Almansa and Paula Ram{\'i}rez and Gallegos, {Maria C.} and Victoria Fernandez and Monica Gordon and David Andaluz-Ojeda and Leonor Nogales and Silvia Rojo and Jordi Vall{\'e}s and Angel Estella and Ana Loza and Cristobal Le{\'o}n and Cristina Lopez-Mestanza and Jes{\'u}s Blanco and Berezo, {Jose {\'A}ngel} and Sara Rosich and Catia Cill{\`o}niz and Antoni Torres and {de Lejarazu}, {Raul Ortiz} and Ignacio Martin-Loeches and Bermejo-Martin, {Jesus F.}",

note = "Funding Information: The authors acknowledge the support of “ Instituto de Salud Carlos III- Fondo de Investigaciones Sanitarias, FIS ” and Health Council, Junta de Castilla y Le{\'o}n (JCYL-IECSCYL-SACYL): Programa de Investigaci{\'o}n Comisionada en Gripe , GR09/0021 , GR09/0022 . ",

year = "2013",

month = nov,

doi = "10.1016/j.jcv.2013.09.006",

language = "American English",

volume = "58",

pages = "564--567",

journal = "Journal of Clinical Virology",

issn = "1386-6532",

publisher = "Elsevier B.V.",

number = "3",

}

Justel, M, Socias, L, Almansa, R, Ramírez, P, Gallegos, MC, Fernandez, V, Gordon, M, Andaluz-Ojeda, D, Nogales, L, Rojo, S, Vallés, J, Estella, A, Loza, A, León, C, Lopez-Mestanza, C, Blanco, J, Berezo, JÁ, Rosich, S, Cillòniz, C, Torres, A, de Lejarazu, RO, Martin-Loeches, I & Bermejo-Martin, JF 2013, 'IgM levels in plasma predict outcome in severe pandemic influenza', Journal of Clinical Virology, vol. 58, no. 3, pp. 564-567. https://doi.org/10.1016/j.jcv.2013.09.006

TY - JOUR

T1 - IgM levels in plasma predict outcome in severe pandemic influenza

AU - Justel, Mar

AU - Socias, Lorenzo

AU - Almansa, Raquel

AU - Ramírez, Paula

AU - Gallegos, Maria C.

AU - Fernandez, Victoria

AU - Gordon, Monica

AU - Andaluz-Ojeda, David

AU - Nogales, Leonor

AU - Rojo, Silvia

AU - Vallés, Jordi

AU - Estella, Angel

AU - Loza, Ana

AU - León, Cristobal

AU - Lopez-Mestanza, Cristina

AU - Blanco, Jesús

AU - Berezo, Jose Ángel

AU - Rosich, Sara

AU - Cillòniz, Catia

AU - Torres, Antoni

AU - de Lejarazu, Raul Ortiz

AU - Martin-Loeches, Ignacio

AU - Bermejo-Martin, Jesus F.

N1 - Funding Information: The authors acknowledge the support of “ Instituto de Salud Carlos III- Fondo de Investigaciones Sanitarias, FIS ” and Health Council, Junta de Castilla y León (JCYL-IECSCYL-SACYL): Programa de Investigación Comisionada en Gripe , GR09/0021 , GR09/0022 .

PY - 2013/11

Y1 - 2013/11

N2 - Background: Little is known on the participation of immunoglobulin isotypes and subclasses in the pathogenesis of the severe disease caused by the pandemic influenza virus (influenza A(H1N1)pdm09). Objectives: (1) To evaluate the association between plasma levels of IgG1, IgG2, IgG3, IgG4, IgA, IgM, IgE and outcome in patients with severe pandemic influenza. (2) To evaluate the association between immunoglobulin and cytokine levels in these patients. Study design: 40 critically ill patients with community acquired pneumonia and influenza A(H1N1)pdm09 infection were recruited from November 2010 to February 2011. Plasma samples were collected during the first 24. h following admission to the ICU. Immunoglobulins and 17 major cytokines were profiled in plasma. Results: 15 patients died (37.5%). When the association between clinical variables and prognosis was assessed, prior immunosuppression, APACHE II score, levels of IgG2 and levels of IgM were associated with outcome in a univariate Cox regression analysis. Kaplan Meier analysis showed that patients with levels of IgG2 and IgM. <. 59 and. <. 58. mg/dl respectively died earlier. Multivariate Cox regression analysis showed that APACHE II score and levels of IgM were the best predictors of outcome, being levels of IgM a protective factor against mortality. IgM was the immunoglobulin showing the largest number of negative correlations with cytokine levels. Conclusions: Our results support a central role of IgM in preventing uncontrolled inflammatory response and mortality in severe pandemic influenza. Early assessment of IgM could contribute to guide clinical decisions in these patients.

AB - Background: Little is known on the participation of immunoglobulin isotypes and subclasses in the pathogenesis of the severe disease caused by the pandemic influenza virus (influenza A(H1N1)pdm09). Objectives: (1) To evaluate the association between plasma levels of IgG1, IgG2, IgG3, IgG4, IgA, IgM, IgE and outcome in patients with severe pandemic influenza. (2) To evaluate the association between immunoglobulin and cytokine levels in these patients. Study design: 40 critically ill patients with community acquired pneumonia and influenza A(H1N1)pdm09 infection were recruited from November 2010 to February 2011. Plasma samples were collected during the first 24. h following admission to the ICU. Immunoglobulins and 17 major cytokines were profiled in plasma. Results: 15 patients died (37.5%). When the association between clinical variables and prognosis was assessed, prior immunosuppression, APACHE II score, levels of IgG2 and levels of IgM were associated with outcome in a univariate Cox regression analysis. Kaplan Meier analysis showed that patients with levels of IgG2 and IgM. <. 59 and. <. 58. mg/dl respectively died earlier. Multivariate Cox regression analysis showed that APACHE II score and levels of IgM were the best predictors of outcome, being levels of IgM a protective factor against mortality. IgM was the immunoglobulin showing the largest number of negative correlations with cytokine levels. Conclusions: Our results support a central role of IgM in preventing uncontrolled inflammatory response and mortality in severe pandemic influenza. Early assessment of IgM could contribute to guide clinical decisions in these patients.

KW - Critical

KW - Cytokines

KW - Immunoglobulins

KW - Influenza

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=84886284120&partnerID=8YFLogxK

U2 - 10.1016/j.jcv.2013.09.006

DO - 10.1016/j.jcv.2013.09.006

M3 - Original Article

C2 - 24076102

AN - SCOPUS:84886284120

SN - 1386-6532

VL - 58

SP - 564

EP - 567

JO - Journal of Clinical Virology

JF - Journal of Clinical Virology

IS - 3

ER -

IgM levels in plasma predict outcome in severe pandemic influenza

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

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Cite this