TY - JOUR T1 - Comparison of different sets of immunological tests to identify treatable immunodeficiencies in adult bronchiectasis patients JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00388-2021 SP - 00388-2021 AU - Stefano Aliberti AU - Francesco Amati AU - Andrea Gramegna AU - Barbara Vigone AU - Martina Oriano AU - Giovanni Sotgiu AU - Marco Mantero AU - Edoardo Simonetta AU - Laura Saderi AU - Anna Stainer AU - Serena Tammaro AU - Paola Marchisio AU - Eva Polverino AU - James D. Chalmers AU - Francesco Blasi Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/09/29/23120541.00388-2021.abstract N2 - Background Reported prevalence of immunodeficiencies in bronchiectasis patients is variable depending on the frequency and extent of immunological tests performed. ERS Guidelines recommend a minimum bundle of tests. Broadening the spectrum of immunological tests could increase the number of patients diagnosed with an immunodeficiency and those who could receive specific therapy. The primary objective of the present study was to assess the performance of different sets of immunological tests in diagnosing any, primary, secondary, or treatable immunodeficiencies in adults with bronchiectasis.Methods An observational, cross-sectional study was conducted at the Bronchiectasis Program of the Policlinico University Hospital in Milan, Italy, from September 2016 to June 2019. Adult outpatients with a clinical and radiological diagnosis of bronchiectasis underwent the same immunological screening during the first visit when clinically stable consisting of: complete blood count, IgA, IgG, IgM, IgG subclasses, total IgE, lymphocyte subsets, and HIV antibodies. The primary endpoint was the prevalence of patients with any immunodeficiencies using five different sets of immunological tests.Results A total of 401 bronchiectasis patients underwent the immunological screening. A significantly different prevalence of bronchiectasis patients diagnosed with any, primary, or secondary immunodeficiencies was found across different bundles. 44.6% bronchiectasis patients had a diagnosis of immunodeficiency using when IgG subclasses and lymphocyte subset are added to the minimum bundle suggested by the guidelines.Conclusion A 4-fold increase in the diagnosis of immunodeficiencies can be found in adults with bronchiectasis when IgG subclasses and lymphocyte subsets are added to the bundle of tests recommended by guidelines.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Stefano Aliberti reports grants or contracts from INSMED Incorporated, CHIESI, Fisher & Paykel, outside the submitted work. Royalties or licenses from McGRAW HILL, outside the submitted work. Consulting fees from INSMED Incorporated, INSMED Italy, INSMED Ireland Ltd, ZAMBON, AstraZeneca UK Limited, CSL Behring GmbH, Grifols, Fondazione Charta, Boehringer Ingelheim, CHIESI, ZCUBE Srl, and MENARINI, outside the submitted work. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GlaxoSmithKline Spa, outside the submitted work. Participation on a Data Safety Monitoring Board or Advisory Board for INSMED Incorporated, INSMED Italy, and AstraZeneca UK Limited, outside the submitted work.Conflict of interest: Francesco Amati has nothing to disclose.Conflict of interest: Andrea Gramegna has nothing to disclose.Conflict of interest: Barbara Vigone has nothing to disclose.Conflict of interest: Martina Oriano has nothing to disclose.Conflict of interest: Giovanni Sotgiu has nothing to disclose.Conflict of interest: Marco Mantero has nothing to disclose.Conflict of interest: Edoardo Simonetta has nothing to disclose.Conflict of interest: Laura Saderi has nothing to disclose.Conflict of interest: Anna Stainer has nothing to disclose.Conflict of interest: Serena Tammaro has nothing to disclose.Conflict of interest: Paola Marchisio has nothing to disclose.Conflict of interest: Eva PolverinoConflict of interest: James Chalmers reports grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, personal fees from Chiesi, grants and personal fees from GlaxoSmithKline, grants from Gilead Sciences, grants and personal fees from Insmed, personal fees from Novartis, personal fees from Zambon, outside the submitted work.Conflict of interest: Francesco Blasi reports grants and personal fees from AstraZeneca, Chiesi, GSK, Pfizer and Insmed, outside the submitted work. Personal fees from Guidotti, Grifols, Mundipharma, Novarts and Zambon, outside the submitted work. Grants from Pfizer, outside the submitted work. ER -