Cohort study of patients with asthma and immunodeficiency

Background: The relation between bronchial asthma and immunodeficiency has been described previously. Associated are deficits of IgG subclasses and MBL (Mannose Binding Lectin). These patients can present with severe asthma due to repeated respiratory infections. Aims: We describe the clinical and functional profiles of patients with asthma and immunodeficiency and their respective type of deficit. Methods: We included 76 adult patients diagnosed with bronchial asthma according to GINA criteria (Global Initiative for Asthma) and immunodeficiency (with immunological tests). We evaluated: Grade of control, atopy, severeness of asthma, number of exacerbations in previous year. We found the most frequent types of immunodeficiency and their differences. Results: Mean age was 63 (±8) years, 78% (59) female, non-smokers: 83 %( 63), atopy 45%(34). Severe Asthma: 64% (49). Moderate Asthma: 24% (18). Mild Asthma: 12%(9). Fully controlled: 52% (40). Partly controlled: 20% (15). Uncontrolled: 28 %( 21). Number of exacerbations in previous year: 2 (±2). Most frequent type of immunodeficiency was MBL with 63% (48), in 31 % of patients (15) associated with a deficit of IgG1. Subclasses: Deficit of IgG1: 32% (24), IgG4 in 11% (8), deficits in more than one subtype of IgG 14,5% (11). Patients with shortages of both MBL and IgG1 had more exacerbations 5 (±2) and presented severe asthma in 80% (12) and uncontrolled asthma in 67% (10). Conclusions: We found association between immunodeficiency and asthma in an ample group of patients, the most common deficit was MBL. The patients with deficits of both MBL and IgG1 presented with the most severe symptoms. Immunological studies in patients with asthma and frequent exacerbations are needed.