IgG2 as an independent risk factor for mortality in patients with community-acquired pneumonia
JOURNAL OF CRITICAL CARE
Authors: de la Torre, Mari C.; Palomera, Elisabet; Serra-Prat, Mateu; Gueell, Estel; Carles Yebenes, Joan; Bermejo-Martin, Jesus F.; Almirall, Jordi
Abstract
Background: Mortality in patients with community-acquired pneumonia (CAP) remains high despite improvements in treatment. Objective: To determine immunoglobulin levels in patients with CAP and impact on disease severity and mortality. Methodology: Observational study. Hospitalized patients with CAP were followed up for 30 days. Levels of immunoglobulin G (IgG) and subclasses, immunoglobulin A (IgA) and immunoglobulin M (IgM) were measured in serum within 24 hours of CAP diagnosis. Results: Three hundred sixty-two patients with CAP were enrolled - 172 ward-treated and 190 intensive care unit-treated. Intensive care unit-treated patients had significantly lower values of IgG1, IgG2, IgG3 subclasses, and IgA than ward-treated patients. Thirty-eight patients died before 30 days. Levels of IgG2 were significantly lower in non-survivors than survivors ( P= .004) and IgG2 <301 mg/dL was associated with poorer survival according to both the bivariate (hazard ratio 4.47; P < .001) and multivariate (HR 3.48; P = .003) analyses. Conclusions: Patients with CAP with IgG2 levels <301 mg/dL had a poorer prognosis and a higher risk of death. Our study suggests the usefulness of IgG2 to predict CAP evolution and to provide support measures or additional treatment. (C) 2016 Elsevier Inc. All rights reserved.
Development of a high-throughput bead based assay system to measure HIV-1 specific immune signatures in clinical samples
JOURNAL OF IMMUNOLOGICAL METHODS
Authors: Liechti, Thomas; Kadelka, Claus; Ebner, Hanna; Friedrich, Nikolas; Kouyos, Roger D.; Guenthard, Huldrych F.; Trkola, Alexandra
Abstract
The monitoring and assessment of a broadly neutralizing antibody (bnAb) based HIV-1 vaccine require detailed measurements of HIV-1 binding antibody responses to support the detection of correlates of protection. Here we describe the development of a flexible, high-throughput rnicrosphere based multiplex assay system that allows monitoring complex binding antibody signatures. Studying a panel of 13 HIV-1 antigens in a parallel assessment of different IgG subclasses (IgG1, IgG2 and IgG3) we demonstrate the potential of our strategy. The technical advances we describe include means to improve antigen reactivity using directed neutravidin-biotin immobilization of antigens and biotin saturation to reduce background. A particular emphasis of our study was to provide tools for the assessment of reproducibility and stability of the assay system and strategies to control for variations allowing the application in high throughput assays, where reliability of single measurements needs to be guaranteed.