Hypogammaglobulinemia in steroid-dependent asthmatics correlates with the daily dose of oral prednisolone.
BACKGROUND
Steroid-induced adverse effects including suppression of humoral immunity should be considered in steroid-dependent severe asthma. Only a few studies have determined the exact steroid dose that could potentially suppress humoral immunity in asthmatics.


METHODS
Randomly selected 100 adult asthmatics treated with inhaled beclomethasone dipropionate (BDP) were classified into three groups based on the dose of steroid to determine the serum IgG, IgA and IgM levels by radioimmunoassay. Relationships between serum immunoglobulin levels and the daily dose and duration of oral prednisolone (PSL) therapy were examined.


RESULTS
None of the patients on inhaled corticosteroid alone had hypogammaglobulinemia. Patients on oral PSL at a dose >12.5 mg/day for at least 1 year had low serum IgG. There was no significant correlation between the duration of oral PSL therapy and serum IgG.


CONCLUSIONS
Oral PSL can potentially suppress humoral immunity in severe asthma. In asthmatics, hypogammaglobulinemia could develop in those on a daily dose of PSL >12.5 mg, but is independent of the duration of such treatment. No suppression of humoral immunity was noted on inhaled corticosteroid therapy alone, either at low or high dose.
Kawano
Tetsuya
T
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Matsuse
Hiroto
H
Obase
Yasushi
Y
Kondo
Yuki
Y
Machida
Ikuko
I
Tomari
Shinya
S
Mitsuta
Kazuko
K
Fukushima
Chizu
C
Shimoda
Terufumi
T
Kohno
Shigeru
S
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D000361:Agammaglobulinemia / Q000139:chemically induced*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000145:classification; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D007136:Immunoglobulins; D011239:Prednisolone; D001507:Beclomethasone