Low percentages of regulatory T cells in common variable immunodeficiency (CVID) patients with autoimmune diseases and its association with increased numbers of CD4+CD45RO+ T and CD21low B cells.

BACKGROUND: Common variable immunodeficiency (CVID) is a heterogeneous group of primary antibody deficiencies defined by marked reductions in serum IgG, IgA and/or IgM levels and recurrent bacterial infections. Some patients are associated with defects in T cells and regulatory T cells (Tregs), resulting in recurrent viral infections and early-onset autoimmune disease. METHODS: We analyzed whether there is an association between Tregs cells (CD4+CD25+CD127low and CD4+CD25+FoxP3+); memory T cells (CD4+CD45RO+); memory B cells (CD19+CD27-IgD-); and CD21low B cells (CD19+CD38lowCD21low); as well as autoimmune manifestations in 36 patients with CVID (25 women and 11 men, mean age 24 years), all by flow cytometry. RESULTS: Fourteen patients presented with autoimmune diseases (AI) (39%), including 11 with autoimmune thrombocytopenia (ITP) (31%); two with vitiligo (6%); one with systemic lupus erythematosus (LES) (3%); and one with multiple sclerosis (MS) (3%). CVID patients with AI had a reduced proportion of Tregs (both CD4+CD25+CD127low and FoxP3+ cells) compared with healthy controls. CVID patients with AI had expanded CD21low B cell populations compared with patients who did not have AI. A correlation between increased CD4+CD45RO T cell populations and reduced Tregs was also observed. CONCLUSIONS: Our results showed that 39% of patients with CVID had AI and reduced Tregs populations. Research in this area might provide noteworthy data to better understand immune dysfunction and dysregulation related to CVID.

[In vitro and in vivo acari tests]. / Pruebas in vitro e in vivo a ácaros.

We studied 40 children with one o more perennial allergic diseases (bronchial asthma, allergic rhinitis, and/or atopic dermatitis) to assess the value in our country of in vivo and in vitro tests more frequently used in the diagnosis of allergy, such as total serum IgE, specific allergen IgE (RAST) and prick skin test in patients sensitives to D. pteronissinus, D. farinae or both. All patients had positive prick skin tests. Total serous IgE was elevated in 95% of cases with poor correlation coefficient (r) between prick skin test reactivity and total serous IgE concentration with no statistical significance. On the other hand, 95% of patients showed a positive RAST with a correlation coefficient of 0.31 (p less than 0.05). We concluded that in our country clinical history and prick skin tests are sufficiently accurate in a reasonable way to make a diagnosis of allergic etiology in patients sensitives to mites of the house dust.

Respiratory allergy in Mexican patients with cystic fibrosis.

BACKGROUND: the purpose of this study was to investigate the presence of respiratory allergy in 30 Mexican patients bearing cystic fibrosis (CF). METHODS AND RESULTS: all patients completed a clinical history, had a physical examination, total serum IgE, nasal and blood eosinophils determinations and evaluation of skin prick tests for 36 allergens. In 26.6% of the patients included in the study was detected respiratory allergy diagnosed on clinical and laboratory analyses. Skin prick tests of 11 (36.6%) of the patients were positive to at least one allergen and Aspergillus fumigatus (A. fumigatus) was the most frequently observed allergen in 23% of the cases. CONCLUSIONS: we have demonstrated in this study that Mexican patients also present a coexistence of respiratory allergy in patients bearing CF.