Correlation of α1-antitrypsin (A1AT), Complement component C5a and Secretory Immunoglobulin A (sIgA) with pulmonary complications; 20 years after sulfur mustard exposure, Sardasht-Iran Cohort Study

Background: Little is known about pulmonary complications induced by Sulfur Mustard (SM), as a chemical warfare agent,especially considering its long term effects. The present study was carried out to investigate the association of α1-antitrypsin(A1AT), Complement component C5a, and Secretory Immunoglobulin A (sIgA) with long-term pulmonary complications on SMexposedindividuals, 20 years after the exposure. Methods and materials : Sardasht-Iran Cohort Study (SICS) is a historical cohort study on 372 SM-exposed individuals and 128age-matched unexposed participants. The clinical evaluations and Spirometry were performed on all the participants according toAmerican Thoracic Society Criteria. Also, we assessed the salivary levels of A1AT, C5a, and sIgA using ELISA assay. Results: The results indicated significant associations between salivary levels of A1AT, C5a, and sIgA with chronic cough in theexposed victims. Also, there were associations between C5a and sIgA with dyspnea in SM-exposed victims with chronic coughcompared with those in the exposed victims without chronic cough. The salivary levels of C5a significantly decreased in severepulmonary involvement. Moreover, a significant relationship was observed between the salivary levels of C5a and pulmonaryfunction testes. Conclusion: According to the findings, the salivary level of C5a might reflect the severity of pulmonary involvements followingSM exposure. A1AT, as a protective agent, has correlations with cough and dyspnea. Although no strong correlation was foundbetween the salivary levels of these factors with persistence of pulmonary complications, they can be effective in the developmentand progression of pathological changes in the lungs of the SM-exposed victims.