Primary immunodeficienciesInflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
Section snippets
Patients and control subjects
A total of 74 patients with CVID (33 male; mean age, 50 ± 15 years) attending the Royal Free Hospital diagnosed according to established criteria12, 13 were recruited. All but 1 patient were receiving immunoglobulin therapy.
A total of 27 healthy subjects (9 male; mean age, 40 ± 12 years) were recruited and their CMV status determined by using a CMV-specific IgG assay (VIDAS; BioMérieux, Marcy L-Etoile, France). Exposure to CMV in patients with CVID was assessed by measuring IFN-γ production by
CMV infection is associated with inflammatory disease in CVID
We asked whether exposure to CMV was associated with the inflammatory complications characteristic of a subset of patients with CVID. By using CD4+ T-cell responses to CMV-infected cell lysates11 to identify CMV-infected patients because serologic confirmation of CMV exposure is impossible in immunoglobulin-deficient individuals, we found a highly significant association between CMV exposure and inflammatory complications (see this article’s Table E1 in the Online Repository at //www.jacionline.org
Discussion
Inflammatory disease is a significant and persistent burden for many patients with CVID. In this study, we have demonstrated that (1) inflammatory disease is significantly more prevalent in patients with evidence of CMV exposure; (2) CMV-specific CD8+ T-cell frequencies are specifically elevated in patients with inflammatory CVID; (3) CMV-specific CD8+ T cells from patients with inflammatory CVID show evidence of substantial proliferation in vivo and respond rapidly to antigen in vitro; and (4)
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2016, Drug and Alcohol DependenceCitation Excerpt :A proportion of patients from this study had high CD8+ T-cell count. This finding is consistent with a previous study (Arosa et al., 2000) and has been related to immune activation in viral infections (Da-Cruz et al., 2002; Marashi et al., 2011). In our study, high number of CD8+ cells was associated with history of IDU and the majority of those with history of IDU had HCV infection.
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The UCL MRC Centre for Medical Molecular Virology is supported by a Centre Grant from the Medical Research Council. Part of this work was supported by a Wellcome Trust Grant to V.C.E. and colleagues and a grant from the Primary Immunodeficiency Association to A.D.W. Work in C.S.-N.’s laboratory is supported by the Swedish Medical Research Foundation. Research in P.K.’s laboratory is funded by the Medical Research Council, the Wellcome Trust, the James Martin 21st Century School, and the NIHR Biomedical Research Centre Programme. S.M.M. received a scholarship from the Tehran University of Medical Sciences and was supported by a PhD studentship from the Iranian Ministry of Health.
Disclosure of potential conflict of interest: S. Workman has received honoraria from Octopharma. C. Soderberg-Naucler and V. C. Emery have received research support from Roche, RATOS, Oxypharma, and the Swedish Medical Research Council. The rest of the authors have declared that they have no conflict of interest.
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These authors contributed equally to this work.