Authors: VAN SCHOOR, J.¹; TOOGOOD, J. H.²; PAUWELS, R. A.¹

Source: Clinical & Experimental Allergy, Volume 27, Number 2, February 1997 , pp. 192-195(4)

Publisher: Wiley-Blackwell

Abstract:

Background Glucocorticosteroid (GCS) treatment lowers serum IgG and IgG subclass (IgG-SC) levels, but the minimal dose and duration of administration at which this occurs is not known.

Objective The aim of this study was to define the daily dose of a 2-week course of GCS at which IgG(-SC) suppression occurs.

Methods The effects of three GCS treatment schemes on serum IgG(-SC) levels in healthy adults were studied in a double-blind, randomized trial. Group 1 (n=10) was treated with 40 mg oral prednisolone/day, group 2 (n=10) with 10 mg oral prednisolone/day and group 3 (n=10) with 3.2 mg inhaled budesonide/day. Blood sampling was performed at baseline and at the end of the 2-week treatment period.

Results In group 1, IgG1, IgG2 and IgG3 levels were significantly decreased after treatment, while in group 2 this was only so for IgG3. In both groups, the decrease of total IgG tended towards or just reached significance. In group 3, no statistically significant changes were observed.

Conclusion A course of 40 mg oral prednisolone/day for 2 weeks induces significant suppression of serum IgG-SC levels; lower doses cause more subtle changes, indicating that GCS-induced IgG-SC suppression is a dose-dependent phenomenon. Short courses of very high doses of inhaled budesonide appear to be devoid of this side-effect.

Keywords: Immunoglobulin G subclasses; budesonide; prednisolone; glucocorticosteroid systemic effects; asthma; COPD

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1365-2222.1997.d01-490.x

Affiliations: 1: Department of Respiratory Diseases, University Hospital, Ghent, Belgium, 2: Department of Medicine, University of Western Ontario, London, Ontario, Canada

Publication date: 1997-02-01

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