title: Enhanced formation of giant cells in common variable immunodeficiency: Relation to granulomatous disease.
abstract: Peripheral monocytes from patients with common variable immunodeficiency (CVID) had on average a 2 fold greater tendency to form giant cells in medium without additional cytokines. Giant cell formation was faster and 3 to 5 fold higher in most CVID cells compared to normal. Addition of IL4, GMCSF, IFNγ, TNFa and both T cell and monocyte conditioned media promoted monocyte fusion of some CVID individuals over 5 fold the normal average level, with combinations of cytokines and monokines acting synergistically. The reduction of normal giant cell formation by anti-IFNγ antibody and a greater tendency of CVID cells to fuse in immunoglobulin conditioned media suggests that standard IVIg treatment contributes to granuloma formation. CVID and normal giant cells expressed similar levels of phenotypic molecules and had similar phagocytic activity. Monocytes from many CVID patients have an elevated tendency to fuse which may explain the high incidence of granulomatous complications in CVID.
authors.affiliation: Department of Immunology, University College London, Royal Free Hospital NHS Trust, Pond Street, Hampstead NW3 2QG, London. Electronic address: t.scott-taylor@londonmet.ac.uk.
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Scott-Taylor
authors.affiliation: Faculty of Sciences, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE.
authors.forename: Karen
authors.initials: K
authors.lastname: Whiting
authors.affiliation: Department of Haematology, St George's University of London, Cranmer Terrace SW17 0RE, London.
authors.forename: Ruth
authors.initials: R
authors.lastname: Pettengell
authors.affiliation: Department of Immunology, University College London, Royal Free Hospital NHS Trust, Pond Street, Hampstead NW3 2QG, London.
authors.forename: David A
authors.initials: DA
authors.lastname: Webster
mesh_terms: D000328:Adult; D000368:Aged; D017074:Common Variable Immunodeficiency / Q000276:immunology*; D005260:Female; D015726:Giant Cells / Q000276:immunology*; D006099:Granuloma / Q000276:immunology*; D006105:Granulomatous Disease, Chronic / Q000276:immunology*; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology; D015847:Interleukin-4 / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4; D007371:Interferon-gamma
keywords: Common variable immunodeficiency; Giant cells; Monocyte fusion; Multinucleate; Syncytia