Memory B cells in common variable immunodeficiency: clinical associations and sex differences.
Common variable immunodeficiency (CVID) is a heterogeneous syndrome characterized by impaired antibody responses, recurrent infections, inflammatory, autoimmune and malignancy-related conditions. We evaluated the relationship between memory B cell phenotype, sex, age at diagnosis, immunologic and clinical conditions in 105 CVID subjects from one medical center. Reduced numbers of switched memory B cells (cutoff <or=0.55% of B cells) were an independent risk factor of granulomas, autoimmune diseases and splenomegaly (p<0.001). Not previously noted, CVID females had significantly more switched memory cells (p=0.007) than males. Splenectomized subjects did not have fewer IgM memory B cells and these numbers were not related to the development of lung disease, as previously proposed. Lower baseline serum IgG was an independent predictor of pneumonia (p=0.007) and severe infections (p=0.001). We conclude that outcomes in CVID depend on an interplay of factors including sex, numbers of switched memory B cells, and baseline serum IgG and IgA levels.
Sánchez-Ramón
Silvia
S
Department of Medicine, Pediatrics and Immunobiology Center, Mount Sinai Medical School, New York, NY 10029, USA.
Radigan
Lin
L
Yu
Joyce E
JE
Bard
Susan
S
Cunningham-Rundles
Charlotte
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood; D015551:Autoimmunity; D016175:B-Lymphocyte Subsets / Q000276:immunology* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000276:immunology* / Q000378:metabolism / Q000601:surgery; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007156:Immunologic Memory; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000276:immunology* / Q000378:metabolism; D012727:Sex Characteristics; D013156:Splenectomy; D013163:Splenomegaly / Q000276:immunology
D000906:Antibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines