• Andrea Cristina Pereira, Cristina M Kokron, Beatriz Mangueira Saraiva Romagnolo, Claudia Simeire Albertini Yagi, SaldivaPaulo Hilário NascimentoPH, Geraldo Lorenzi Filho, and Elnara Marcia Negri.
• Pathology Department, Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil. andreacrisp03@terra.com.br
• Clinics (Sao Paulo). 2009 Jan 1; 64 (12): 115511601155-60.

IntroductionCommon 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.ObjectiveThe 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.MethodThe 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).ResultsPatients 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).ConclusionWe 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.

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