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Clin Immunol. 2017 Jul;180:111-119. doi: 10.1016/j.clim.2017.05.008. Epub 2017 May 6.

Recurrent respiratory tract infections (RRTI) in the elderly: A late onset mild immunodeficiency?

Author information

1
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: E.van_de_Vosse@lumc.nl.
2
Department of Paediatrics, Laboratory for Immunology, Leiden University Medical Center, Leiden, The Netherlands.
3
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
4
Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands.
5
Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
6
Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany.

Abstract

Elderly with late-onset recurrent respiratory tract infections (RRTI) often have specific anti-polysaccharide antibody deficiency (SPAD). We hypothesized that late-onset RRTI is caused by mild immunodeficiencies, such as SPAD, that remain hidden through adult life. We analyzed seventeen elderly RRTI patients and matched controls. We determined lymphocyte subsets, expression of BAFF receptors, serum immunoglobulins, complement pathways, Pneumovax-23 vaccination response and genetic variations in BAFFR and MBL2. Twelve patients (71%) and ten controls (59%) had SPAD. IgA was lower in patients than in controls, but other parameters did not differ. However, a high percentage of both patients (53%) and controls (65%) were MBL deficient, much more than in the general population. Often, MBL2 secretor genotypes did not match functional deficiency, suggesting that functional MBL deficiency can be an acquired condition. In conclusion, we found SPAD and MBL deficiency in many elderly, and conjecture that at least the latter arises with age.

KEYWORDS:

B-cell activating factor; Elderly; Immunodeficiency; Late onset; Mannose binding lectin; Respiratory tract infection; Specific anti-polysaccharide deficiency

PMID:
28487087
DOI:
10.1016/j.clim.2017.05.008
[Indexed for MEDLINE]
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