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Immunodeficiency, malabsorption and secretory diarrhea. A new syndrome.

Described here is a patient with severe watery diarrhea associated with common variable immunodeficiency. Malabsorption for fat, bile acids, vitamin B12 and xylose was demonstrated, but the patient failed to respond to all the usual therapeutic maneuvers. The diarrhea responded only to high dose steroid therapy. Intestinal perfusion studies showed a hitherto undescribed, presumably acquired, glucose-stimulated water, sodium and chloride secretion in the jejunum and ileum, whereas normal fluid and electrolyte transport occurred from bicarbonate and mannitol solutions. Glucose absorption itself …

Immunodeficiency in childhood.

Primary immunodeficiency disorders (PIDs) continue to illuminate mechanisms of human immunity and hypersensitivity. New discoveries in common variable immunodeficiency, the most enigmatic of PID syndromes, reveal molecular pathways of importance in human antibody production. FOXP3 mutations demonstrate the essential role that T-regulatory cells play in controlling autoantibody formation and disease. Interleukin-1 receptor-associated kinase 4 deficiency emphasizes the key role that innate immunity plays in the defense of bacterial disease occurring early in life. With respect to therapy, subcut…

Investigation of adult immunodeficiency and indications for immunoglobulin replacement therapy.

Adults presenting with recurrent infections require an approach that allows exclusion of underlying immunodeficiency. While secondary causes of immunodeficiency are the most common, primary immunodeficiency disease (PID) may present for the first time in adults. Failure to consider this diagnosis in adults and children leads to a major diagnostic delay. Recurrent localised infections generally suggest an underlying anatomical rather than an immune defect. PIDs that are most commonly encountered include common variable immunodeficiency, immunoglobulin (Ig) A deficiency, and IgG subclass deficie

Mucosal regulatory and effector T-cell imbalance in CVID-associated enteropathy.

BACKGROUND: Common variable immunodeficiency (CVID) frequently presents with gastrointestinal complications, yet the immunopathogenesis of CVID-associated enteropathy remains poorly understood. OBJECTIVE: This study aimed to investigate intestinal T cell subset distributions and intracellular cytokine profiles in order to better understand mucosal immune alterations associated with enteropathy in CVID. METHODS: Duodenal and ileal biopsy specimens were obtained from CVID patients with enteropathy (EP, n=11) and without enteropathy (EN, n=13), patients with Crohn's disease (CD, n=9), and healt…

Serum sBCMA в первичном и вторичном дефиците антител.

B-клеточное антигенное созревание (BCMA) — рецептор поверхности клетки, регулирующий активацию, распространение и выживание клеток B. BCMA может быть отделена от поверхности клеток, производя растворимую BCMA (SBCMA), которая была изучена как биомаркер болезней в системном волчании эритематосуса, множестве склероза и миеломе. Снижение концентраций SBCMA связано с остротой различных основных недостатков антител. Мы изучили взаимосвязь между концентрациями SBCMA, юморальными иммунными реакциями на вакцинацию SARS-COV-2 и осложнениями при заболеваниях у 107 человек с первичным (PAD) и вторичным д

Совпадение в аннотации оригинала
B-cell maturation antigen (BCMA) is a B cell surface receptor that regulates B cell activation, proliferation and survival. BCMA can be clea … ntrols and asymptomatic selective IgA deficiency. Individuals with X- linked agammaglobulinemia and common variable immunodeficiency (CVID) demonstrated the lowest serum concentrations of sBCMA. sBCMA concentrations in SAD were highly variable. Amongst individuals with CVID, peripheral blood CD19 count, but not sBCMA concentrations discriminated SARS-CoV-2 vaccine responders. sBC …

TNFRSF13B Diversification Fueled by B Cell Responses to Environmental Challenges-A Hypothesis.

B cell differentiation and memory are controlled by the transmembrane activator and CAML interactor (TACI), a receptor encoded by TNFRSF13B. TNFRSF13B mutations are frequently found in common variable immunodeficiency (CVID) and in IgA -deficiency; yet, ~98% of those with mutant TNFRSF13B are healthy. Indeed, TNFRSF13B is among the 5% most polymorphic genes in man. Other mammals evidence polymorphism at comparable loci. We hypothesize that TNFRSF13B diversity might promote rather than detract from well-being by controlling key elements of innate immunity. We shall discuss how extraordinary div…

30-Year Review of Pediatric- and Adult-Onset CVID: Clinical Correlates and Prognostic Indicators.

PURPOSE: To evaluate mortality risk factors in pediatric-onset common variable immunodeficiency disorders (CVID), we evaluated the largest single-institution cohort of pediatric-onset CVID patients. Previous publications on CVID have provided valuable descriptive data, but lack risk stratification to guide physicians in management of these patients. METHODS: Retrospective chart review of 198 subjects with CVID at a single institution, of whom 91 had disease onset at a pediatric age. Clinical and laboratory data were collected at diagnosis and in follow-up. Odds ratios and Fisher tests were ut…

Epstein-Barr virus-associated smooth muscle tumours after transplantation, infection with human immunodeficiency virus and congenital immunodeficiency syndromes.

Smooth muscle tumours (SMT) after transplantation (PTSMT) or associated with congenital immunodeficiency syndromes (CI-SMT) and human immunodeficiency virus (HIV-SMT) are rare. The majority of PTSMT and CI-SMT are associated with Epstein-Barr virus (EBV), while some HIV-SMT can be EBV-negative. SMT in immunodeficient states may present with unspecific symptoms which are mainly related to tumour localisation. In PTSMT, >50% of tumours manifest in the liver/transplant liver, but in general PTSMT, HIV-SMT and CI-SMT can occur at any site as single or multiple tumours. Multiple tumour manifestatio

Impaired release of antimicrobial peptides into nasal fluid of hyper-IgE and CVID patients.

BACKGROUND: Patients with primary immunodeficiency (PID) often suffer from frequent respiratory tract infections. Despite standard treatment … re increased in response to pathogenic bacteria. However, this increase was absent in patients with common variable immunodeficiency (CVID) and Hyper-IgE syndrome (HIES), despite the presence of pathogenic bacteria. Furthermore, stimulation of PBMCs revealed that both HIES and CVID patients exhibited an impaired production of IL-17A. CONCLUSION: CVID and HIES patients appear to …

Regression of systemic lupus erythematosus after development of an acquired toll-like receptor signaling defect and antibody deficiency.

Toll-like receptor 9 (TLR-9) and TLR-7 may have a role in the production of anti-DNA and anti-RNA autoantibodies, respectively, but murine models do not clearly demonstrate their contribution to the development of systemic lupus erythematosus (SLE). Herein we describe a patient with SLE who had long-lasting remission of her autoimmune disease after development of an antibody deficiency resembling common variable immunodeficiency (CVID). After CVID had developed, anti-double-stranded DNA antibodies disappeared, although antinuclear antibodies remained positive for >10 years. In vitro studies re…

[Role of a host in spontaneous recovery from viral hepatitis C: genetic predetermined factors].

The impact of both congenital and specific human immune responses on the invasion of viruses is determined by a broad spectrum of genetically determined parameters. The review attempts to characterize the influence of genetic determinants on the outcome of human hepatitis C viral (HCV) infection. The increased rate of convalescence is associated with female sex and white ethnicity. Hereditary immune disorders/deficiency lead to the reduced probability of spontaneous convalescence and the complicated course of a chronic stage of the disease. The carriage of some HLA haplotypes and gene alleles,

Common variable immune deficiency (CVID) presenting as an autoimmune disease: role of memory B cells.

Common variable immunodeficiency (CVID) is a clinically heterogeneous disorder. Most often patients present with recurrent sinopulmonary infections, although it may present with autoimmune manifestations. Immune cytopenias, particularly thrombocytopenia and hemolytic anemia, are the most commonly observed. While the pathophysiology of CVID remains elusive, in many patients it may be due to an intrinsic B cell defect. Memory B cells (CD27+) in particular, have been noted to correlate with certain aspects of the disease. High numbers of IgM+ memory B cells appear to correlate with the presence o…

The broad spectrum of autoimmune lymphoproliferative disease: molecular bases, clinical features and long-term follow-up in 31 patients.

Autoimmune lymphoproliferative disorders, including autoimmune lymphoproliferative syndrome (ALPS) and Dianzani autoimmune lymphoproliferati … atients developed antibody deficiency and their clinical pictures overlapped those of subjects with common variable immunodeficiency (CVID). We postulate the existence of a disorder that involves the Fas pathway and displays the characteristics of both autoimmune lymphoproliferative disease and CVID.

Viruses and bacteria in bronchial samples from patients with primary hypogammaglobulinemia.

Viruses and bacteria in bronchoalveolar lavage fluids, protected specimen brush samples, and bronchial biopsies from 14 patients with primary hypogammaglobulinemia (11 patients with common variable immunodeficiency [CVID] and three patients with X-linked agammaglobulinemia [XLA]) were analyzed. At the time of the study, the patients had no signs of acute respiratory infections, and no antibiotics were administered. In addition to routine bacterial and viral cultures, polymerase chain reaction tests were used for the detection of adenovirus, cytomegalovirus (CMV), herpes simplex virus 1, entero…

Improving screening for antibody deficiency using calculated globulin and serum protein electrophoresis.

PURPOSE: Antibody deficiencies, particularly Common Variable Immunodeficiency (CVID), represent a major health concern due to comorbidities linked to delayed diagnosis. Calculated globulin (CG) and the gammaglobulins derived from serum protein electrophoresis have been proposed as reliable indices for screening hypogammaglobulinemia. This study aimed to establish optimal cut-offs for CG and the gammaglobulins to identify patients with low IgG among hospitalized adolescents and adults from Algeria. METHODS: Serum samples and clinical data were collected from hospitalized patients aged over 10 …

Intrinsic functional defects in B cells of patients with NFKB2 mutations.

Mutations in the human nuclear factor-κB2 gene (NFKB2) are associated with common variable immunodeficiency (CVID) or combined immunodeficiency diseases (CID), characterized by B-cell lymphopenia, hypogammaglobulinemia, and T-cell dysfunction. This study investigated whether B cells with NFKB2 mutations exhibit intrinsic impairments in activation, class-switch recombination, and differentiation. We analyzed five patients from four unrelated families with CVID, each carrying a heterozygous NFKB2 mutation: P1 (C.2595_2614del, p.A867Gfs*12), P2 (C.2597G > A, p.S866N), P3 (C.2540dupT, p.R848Efs*38…

A large deletion in a non-coding regulatory region leads to NFKB1 haploinsufficiency in two adult siblings.

Mutations in NFkB pathway genes can cause inborn errors of immunity (IEI), with NFKB1 haploinsufficiency being a significant etiology for common variable immunodeficiency (CVID). Indeed, mutations in NFKB1 are found in 4 to 5% of in European and United States CVID cohorts, respectively; CVID representing almost ¼ of IEI patients in European countries registries. This case study presents a 49-year-old patient with respiratory infections, chronic diarrhea, immune thrombocytopenia, hypogammaglobulinemia, and secondary lymphoma. Comprehensive genetic analysis, including high-throughput sequencing …

Functionally impaired antibody response to BNT162b2 booster vaccination in CVID IgG responders.

BACKGROUND: Although previous studies described the production of IgG antibodies in a subgroup of patients with common variable immunodeficiency (CVID) following messenger RNA vaccinations with BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (CVID responders), the functionality of these antibodies in terms of avidity as measured by the dissociation rate constant (kdis) and the antibody response to booster immunization has not been studied. OBJECTIVE: We sought to analyze in CVID responders and healthy individuals, the avidity of anti-SARS-CoV-2 serum antibodies and their…