University of Oulu

Pia Holma, Paula Pesonen, Minna K. Karjalainen, Marjo-Riitta Järvelin, Sara Väyrynen, Eeva Sliz, Anni Heikkilä, Mikko R.J. Seppänen, Johannes Kettunen, Juha Auvinen, Timo Hautala, Low and high serum IgG associates with respiratory infections in a young and working age population, eBioMedicine, Volume 94, 2023, 104712, ISSN 2352-3964,

Low and high serum IgG associates with respiratory infections in a young and working age population

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Author: Holma, Pia1; Pesonen, Paula2; Karjalainen, Minna K.2,3;
Organizations: 1Research Unit of Internal Medicine and Biomedicine, University of Oulu and Oulu University Hospital, Division of Infectious Diseases, Oulu, Finland
2Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
3Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
4Department of Epidemiology and Biostatistics, MRC Center for Environment & Health, School of Public Health, Imperial College London, London, UK
5Rare Disease Center and Pediatric Research Center, Children and Adolescents, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
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Language: English
Published: Elsevier, 2023
Publish Date: 2023-09-29


Background: We investigated health consequences and genetic properties associated with serum IgG concentration in a young and working age general population.

Methods: Northern Finland Birth Cohort 1966 (NFBC1966, n = 12,231) health data have been collected from birth to 52 years of age. Relationships between life-long health events, medications, chronic conditions, lifestyle, and serum IgG concentration measured at age 46 years (n = 5430) were analysed. Regulatory mechanisms of serum IgG concentration were considered.

Findings: Smoking and genetic variation (FCGR2B and TNFRSF13B) were the most important determinants of serum IgG concentration. Laboratory findings suggestive of common variable immunodeficiency (CVID) were 10-fold higher compared to previous reports (73.7 per 100,000 vs 0.6–6.9 per 100,000). Low IgG was associated with antibiotic use (relative risk 1.285, 95% CI 1.001–1.648; p = 0.049) and sinus surgery (relative risk 2.257, 95% CI 1.163–4.379; p = 0.016). High serum IgG was associated with at least one pneumonia episode (relative risk 1.737, 95% CI 1.032–2.922; p = 0.038) and with total number of pneumonia episodes (relative risk 2.167, 95% CI 1.443–3.254; p < 0.001).

Interpretation: CVID-like laboratory findings are surprisingly common in our unselected study population. Any deviation of serum IgG from normal values can be harmful; both low and high serum IgG may indicate immunological insufficiency. Critical evaluation of clinical presentation must accompany immunological laboratory parameters.

Funding: Oulu University Hospital VTR, CSL Behring, Foundation for Pediatric Research.

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Series: EBioMedicine
ISSN: 2352-3964
ISSN-E: 2352-3964
ISSN-L: 2352-3964
Volume: 94
Article number: 104712
DOI: 10.1016/j.ebiom.2023.104712
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Funding: Northern Finland Birth Cohort organisation is acknowledged for the study cohort follow-up and data collection. ES: received support from Academy of Finland. MRJS: received support from Paediatric Research Center, Helsinki University Hospital. TH: received support for analysis of immunological parameters from CSL Behring and Oulu University Hospital VTR.
Copyright information: © 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (