Bas Smits, Netherlands

UMC Utrecht Laboratory of Translational Immunology

Presenter of 1 Presentation

Poster Display Immune dysregulation & autoimmunity

THE EFFECTS OF IMMUNOGLOBULIN REPLACEMENT THERAPY AND IMMUNE DYSREGULATION ON THE ADAPTIVE IMMUNE SYSTEM IN A LONGITUDINAL COHORT OF CVID PATIENTS.

Lecture Time
10:54 - 10:55
Room
Poster Area
Date
19.09.2019, Thursday
Session Time
10:00 - 17:00
Board Number
110
Presentation Topic
Immune dysregulation & autoimmunity

Abstract

Background and Aims

CVID is characterised by recurrent infections, for which patients receive IRT. Besides infections, CVID patients are prone to develop immune dysregulation (ID) and commonly use immunomodulating medication. The adaptive immune system has an important role in the pathophysiology of CVID and ID and shifts in both the T – and B-cell compartments have previously been described. This study further characterises the phenotype of CVID patients with ID and investigates the effect of IRT.

Methods

For this longitudinal study, 89 CVID patients were included and immunophenotypical data was collected. To cluster cell types principal component analysis (PCA) was performed, followed by paired sample analysis to calculate mean differences in individual cell types after IRT initiation. Finally, non-linear mixed model analysis was used to analyse possible confounders and the effect of ID.

Results

PCA consisted of four components, although none of these clustered on IRT the naive T-cell component clustered on ID. B-cells were lower after IRT initiation (298.59 vs 382.05, p<0.001), and there was a remarkable switch from naive to effector/memory in both the CD4 and CD8 T-cell compartments from ID patients, which was stable over time. Via multivariate analysis no remarkable confounders were found.

Conclusions

IRT reduces the number of B-cells in patients with CVID, without changing the subtype ratio. This possibly means that future study design does not need to correct for IRT status. Moreover, this study further implicates the effector/memory T cells as an important marker for ID that is stable during disease progression.

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