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(Chest. 1999;116:1625-1631.)
© 1999 American College of Chest Physicians

Delayed Type of Hypersensitivity and Late Allergic Reactions in Patients with Stable COPD*

Inger Dahlén, MD; Eva Lindberg, MD; Christer Janson, MD and Gunnemar Stålenheim, MD

* From the Department of Medical Sciences, Respiratory Medicine, and Allergology, Akademiska sjukhuset, Uppsala University, Sweden.

Correspondence to: Inger Dahlén, MD, Department of Medical Sciences, Respiratory Medicine, and Allergology, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; e-mail: inger.dahlen{at}lungmed.uu.se

Background: Malnutrition, a common feature among patients with COPD, has adverse effects on the immune system. Delayed type of hypersensitivity (DTH) tests have been used to evaluate the nutritional and immune status of patients and to predict outcome in various conditions. DTH is known to be and late allergic reaction (LAR) has been suggested to be dependent on T-lymphocyte function.

Study objectives: To compare DTH and LAR tests in COPD patients and healthy controls, to investigate whether skin tests have any value in estimating nutritional status and outcome in COPD patients, and to see whether there is any relationship between DTH and LAR.

Methods: Twenty-five patients with stable COPD and 20 healthy controls were tested for DTH and LAR. The patients were investigated with spirometry and anthropometric measurements and were followed for 1 year.

Results: Both the LAR and DTH reactions were diminished in the patient group (p < 0.001) compared with controls. The skin tests did not correlate with anthropometric parameters. DTH correlated to lung function, which was expressed as FEV1 (percent predicted) (r = 0.56; p < 0.01), and LAR correlated to the number of exacerbations (at 3 months, r = - 0.61; p < 0.01). No correlation was found between LAR and DTH reactions.

Conclusions: We conclude that patients with COPD in stable condition have diminished DTHs and LARs. Our results indicate that the magnitude of the LAR may be a prognostic marker in patients with COPD.

Key Words: anthropometry • COPD • delayed hypersensitivity • immunocompetence • late allergic reaction • nutritional status






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