title: T and B lymphocyte abnormalities in bone marrow biopsies of common variable immunodeficiency.
abstract: In common variable immunodeficiency (CVID) defects in early stages of B-cell development, bone marrow (BM) plasma cells and T lymphocytes have not been studied systematically. Here we report the first morphologic and flow cytometric study of B- and T-cell populations in CVID BM biopsies and aspirates. Whereas the hematopoietic compartment showed no major lineage abnormalities, analysis of the lymphoid compartment exhibited major pathologic alterations. In 94% of the patients, BM plasma cells were either absent or significantly reduced and correlated with serum immunoglobulin G levels. Biopsies from CVID patients had significantly more diffuse and nodular CD3(+) T lymphocyte infiltrates than biopsies from controls. These infiltrates correlated with autoimmune cytopenia but not with other clinical symptoms or with disease duration and peripheral B-cell counts. Nodular T-cell infiltrates correlated significantly with circulating CD4(+)CD45R0(+) memory T cells, elevated soluble IL2-receptor and neopterin serum levels indicating an activated T-cell compartment in most patients. Nine of 25 patients had a partial block in B-cell development at the pre-B-I to pre-B-II stage. Because the developmental block correlates with lower transitional and mature B-cell counts in the periphery, we propose that these patients might form a new subgroup of CVID patients.
authors.affiliation: Department of Rheumatology & Clinical Immunology, University Medical Centre, Freiburg, Germany.
authors.forename: Manuella L Gomes
authors.initials: ML
authors.lastname: Ochtrop
authors.forename: Sigune
authors.initials: S
authors.lastname: Goldacker
authors.forename: Annette M
authors.initials: AM
authors.lastname: May
authors.forename: Marta
authors.initials: M
authors.lastname: Rizzi
authors.forename: Ruth
authors.initials: R
authors.lastname: Draeger
authors.forename: Dieter
authors.initials: D
authors.lastname: Hauschke
authors.forename: Claudia
authors.initials: C
authors.lastname: Stehfest
authors.forename: Klaus
authors.initials: K
authors.lastname: Warnatz
authors.forename: Heike
authors.initials: H
authors.lastname: Goebel
authors.forename: Katja
authors.initials: K
authors.lastname: Technau-Ihling
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.forename: Ulrich
authors.initials: U
authors.lastname: Salzer
authors.forename: Hermann
authors.initials: H
authors.lastname: Eibel
authors.forename: Michael
authors.initials: M
authors.lastname: Schlesier
authors.forename: Hans Hartmut
authors.initials: HH
authors.lastname: Peter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000473:pathology*; D001706:Biopsy; D001854:Bone Marrow Cells / Q000473:pathology*; D015331:Cohort Studies; D017074:Common Variable Immunodeficiency / Q000276:immunology* / Q000473:pathology*; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000473:pathology*; D055815:Young Adult