The loss of IgM memory B cells correlates with clinical disease in common variable immunodeficiency - 18/08/11
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, Maria Manuela Rosado, PhD a, , Simona Donnanno, MD b, Vanessa Guazzi, MD b, Annarosa Soresina, MD c, Antonella Meini, MD c, Alessandro Plebani, MD c, Fernando Aiuti, MD b, Isabella Quinti, MD bReprint requests: Rita Carsetti, MD, Research Center, Ospedale Pediatrico Bambino Gesù (IRCCS), Piazza S. Onofrio 4, 00165 Rome, Italy.Rome and Brescia, Italy
Abstract |
Background |
Recurrent lower respiratory tract infections caused by encapsulated bacteria might cause permanent organ damage in patients with common variable immunodeficiency (CVID). Despite the profound hypogammaglobulinemia, some patients do not experience bacterial pneumonia. We have shown that IgM memory B cells and natural antibodies play an important role in the defense against encapsulated bacteria.
Objective |
In this study we addressed the question of whether the apparent paradox of patients with severe hypogammaglobulinemia but no increased frequency of respiratory infections can be explained by the presence of IgM memory B cells and anti-pneumococcal polysaccharide (anti-PnPS) IgM.
Methods |
We measured the frequency of memory B cells and the levels of anti-PnPS IgM antibodies in 26 patients with CVID with recurrent bacterial pneumonia and bronchiectasis (group 1) and 22 who never had pneumonia and showed no lung lesions (group 2). An additional 6 patients had a clinical history of recurrent pneumonia without lung abnormalities at computed tomographic scanning.
Results |
Patients of group 1 lacked IgM memory B cells and failed to produce anti-PnPS IgM antibodies, and those of group 2 had a normal frequency of IgM memory B cells and produced anti-PnPS IgM antibodies.
Conclusions |
IgM memory B cells and anti-PnPS IgM antibodies protect patients with CVID from bacterial pneumonia. Evaluation of these 2 parameters discriminates patients with low or high risk of recurrent infections caused by encapsulated bacteria and low or high risk of bronchiectasis. Identification of high-risk individuals at diagnosis might help in the planning of a more effective therapeutic strategy and prevent permanent organ damage
Le texte complet de cet article est disponible en PDF.Key words : Common variable immunodeficiency, IgM memory B cells, bacterial pneumonia, bronchiectasis, natural antibodies, capsular polysaccharide, pneumococcal vaccine
Abbreviations used : CT, CVID, IVIG, PnPS
Plan
| Supported by a program grant from the Italian Ministry of Health N. 3AI/F3 to R. Carsetti, EC project QLG-CT-2001-01536 to A. Plebani, Cofin Murst 2002, Facoltà la Sapienza 2002-2003 to F. Aiuti. M. M. Rosado is supported by a Marie-Curie Fellowship by the European Community (QLK2-CT-2001-51093). V. Guazzi and S. Donnanno are supported by a Doctor in Research on “Science of immunological Therapies” grant, University of Rome, “La Sapienza.” |
Vol 115 - N° 2
P. 412-417 - février 2005 Retour au numéro
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