title: Analysis of the sputum and inflammatory alterations of the airways in patients with common variable immunodeficiency and bronchiectasis.
abstract: BACKGROUND
  Common variable immunodeficiency is characterized by defective antibody production and recurrent pulmonary infections. Intravenous immunoglobulin is the treatment of choice, but the effects of Intravenous immunoglobulin on pulmonary defense mechanisms are poorly understood.
  
  
  OBJECTIVE
  The aim of this study was to verify the impact of intravenous immunoglobulin on the physical properties of the sputum and on inflammatory alterations in the airways of patients with Common variable immunodeficiency associated with bronchiectasis.
  
  
  METHODS
  The present study analyzed sputum physical properties, exhaled NO, inflammatory cells in the sputum, and IG titers in 7 patients with Common variable immunodeficiency and bronchiectasis with secretion, immediately before and 15 days after Intravenous immunoglobulin. A group of 6 patients with Common variable immunodeficiency and bronchiectasis but no sputum was also studied for comparison of the basal IgG level and blood count. The 13 patients were young (age=36+/-17 years) and comprised predominantly of females (n=11).
  
  
  RESULTS
  Patients with secretion presented significantly decreased IgG and IgM levels. Intravenous immunoglobulin was associated with a significant decrease in exhaled NO (54.7 vs. 40.1 ppb, p<0.05), sputum inflammatory cell counts (28.7 vs. 14.6 cells/mm(3), p<0.05), and a significant increase in respiratory mucus transportability by cough (42.5 vs. 65.0 mm, p < 0.05).
  
  
  CONCLUSIONS
  We concluded that immunoglobulin administration in Common variable immunodeficiency patients results in significant improvement in indexes of inflammation of the airways with improvement in the transportability of the respiratory mucus by cough.
authors.affiliation: Pathology Department, Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil. andreacrisp03@terra.com.br
authors.forename: Andrea Cristina
authors.initials: AC
authors.lastname: Pereira
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Kokron
authors.forename: Beatriz Mangueira Saraiva
authors.initials: BM
authors.lastname: Romagnolo
authors.forename: Claudia Simeire Albertini
authors.initials: CS
authors.lastname: Yagi
authors.forename: Paulo Hilário Nascimento
authors.initials: PH
authors.lastname: Saldiva
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi Filho
authors.forename: Elnara Marcia
authors.initials: EM
authors.lastname: Negri
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D002452:Cell Count; D017074:Common Variable Immunodeficiency / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D003371:Cough / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D009079:Mucociliary Clearance / Q000502:physiology*; D009093:Mucus / Q000502:physiology; D009569:Nitric Oxide / Q000032:analysis; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D013183:Sputum / Q000166:cytology / Q000187:drug effects / Q000276:immunology; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D009569:Nitric Oxide