Observational studyPloS one2018
Lower serum IgA is associated with COPD exacerbation risk in SPIROMICS.
Observational study in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Subpopulations and Intermediate Outcome Measures in COPD Study
Prevalence of Humoral Immune Deficiency in Patients With Frequent Exacerbations of COPD, and the Effect of Immunoglobulin Replacement on Future Exacerbations
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Levels of immunoglobulin isotypes in serum and respiratory samples of patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.Respiratory research · 2026Pooled it
- Association of mannose-binding lectin, ficolin-2 and immunoglobulin concentrations with future exacerbations in patients with chronic obstructive pulmonary disease: secondary analysis of the randomized controlled REDUCE trial.Respiratory research · 2021Trial
- Increased total plasma TGF-β1 levels and deregulated IgA-IgM axis in chronic obstructive pulmonary disease.Journal of medical biochemistry · 2026Article
- Serum IgA isotypes are associated with percent emphysema, wall thickness and lung function decline.Thorax · 2025Article
- Associations of serum and bronchoalveolar immunoglobulins with lung microbiota diversity, B-cell memory phenotypes, and COPD morbidity and exacerbations.Respiratory research · 2025Observational
- Serum Immunoglobulin G Levels Are Associated with Risk for Exacerbations: An Analysis of SPIROMICS.American journal of respiratory and critical care medicine · 2025Article
- Development and Validation of Machine Learning-Based Models for Prediction of Intensive Care Unit Admission and In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2024Article
- The genetics and epidemiology of N- and O-immunoglobulin A glycomics.Genome medicine · 2024Article
- Serum immunoglobulin levels in group E of chronic obstructive pulmonary disease: insights for clinical management and immunoglobulin therapy strategies.BMC pulmonary medicine · 2024Observational
- Chronic obstructive pulmonary disease (COPD) and COPD-like phenotypes.Frontiers in medicine · 2024Review
- SIgA in various pulmonary diseases.European journal of medical research · 2023Review
- Reduced quantity and function of pneumococcal antibodies are associated with exacerbations of COPD in SPIROMICS.Clinical immunology (Orlando, Fla.) · 2023Article
- Article
- A new hope? Possibilities of therapeutic IgA antibodies in the treatment of inflammatory lung diseases.Frontiers in immunology · 2023Review
- Relationships between Airway Remodeling and Clinical Characteristics in COPD Patients.Biomedicines · 2022Article
- Review
- Serum Immunoglobulins, Pneumonia Risk, and Lung Function in Middle-Aged and Older Individuals: A Population-Based Cohort Study.Frontiers in immunology · 2022Article
- The Role of IgA in Chronic Upper Airway Disease: Friend or Foe?Frontiers in allergy · 2022Review
- Prediction of Acute COPD Exacerbation in the Swiss Multicenter COPD Cohort Study (TOPDOCS) by Clinical Parameters, Medication Use, and Immunological Biomarkers.Respiration; international review of thoracic diseases · 2022Article
- Epithelial Barrier Dysfunction in Chronic Respiratory Diseases.Frontiers in physiology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundDecreased 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.
methodsData 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.
resultsMean 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).
conclusionsSubnormal 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.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.