B LYMPHOCYTES MEMORY AND LECTINA UNION TO MANOSA: FACTORS ASSOCIATED WITH THE CLINICAL VARIABILITY IN COMMON VARIABLE IMMUNODEFICIENCY AND DEFICITS IGA.Author:
DETKOVA DRAHOMÍRA.
Year:
2005.
University:
AUTÓNOMA DE BARCELONA [
www.uab.es].
Place of defense: FACULTAD DE MEDICINA DEPARTAMENTO DE MEDICINA UAB.
Place of preparation: UNIVERSIDAD AUTONOMA DE BARCELONA.
Summary: The Common variable immunodeficiency (1DVC) and Deficit IgA are primary immunodeficiencies (IDPs) more frequent. They are characterized by a defect in the production of antibodies due to anomalies still unidentified terminal differentiation of B lymphocytes Both IDP are very clinical heterogeneity in the incidence, severity and progression of infections and autoimmune diseases. Among the factors that could be associated with a worse evolution of these diseases are B lymphocytes and memory lectina union to manosa (MBl). The B lymphocytes (LB) memory is a key element in the process of production of antibodies and the human peripheral blood there are two subpopulations of lB Memory: 1 .- same isotipo and 2, - changing isotipo. According to the proportion of these subpopulations in peripheral blood, it is possible to classify patients with IDVC into 3 major groups: 1) Group BM2 includes patients with a number of lB memory and without changing isotipo similar to the healthy controls, 2) Group BM1 includes patients with a significant reduction in the lB memory change isotipo and finally, and 3) Group BMO includes patients who have a significant reduction of the two types of memory lB. We have studied 41 adult patients diagnosed with IDVC, as determined by the committee of experts from the WHO pas IDP (group IUIS). There is a correlation between defects LB memory and the phenotypic severity clinic patients. The BMO group, 55% of patients with recurrent respiratory infections, developed bronchiectasis with expectoration usual, compared with 27% of patients in group BM1 and 0% of the group BM2 (p greater 0.05). The BMO group, 50% of patients with gastrointestinal symptoms, developed the malabsorption syndrome, compared with 19% of the group BM1 and 0% of BM2 (p greater 0.05). Signs of linfoproliferación were more frequent in the group BMO (50%) than in group BM1 (16%) YBM2 (14%), (p greater 0.05). The lectina union to manosa (MBl) is a serum protein can recognize pathogens with the surface rich in manosa and initiate an immune response to eliminate (activation of phagocytosis and complement). The deficit MBl, whose prevalence is estimated at between 5 and 10% of the general Caucasian population, has been associated with the development of autoimmune and infectious complications in various pathologies. We studied the influence of MBl in clinical variability of 41 patients with common variable immunodeficiency (IDVC) and 46 patients with IgA Deficit (DigA). The detection of plasma MBl was conducted by teams ELlSA of Antibodyshop; (Denmark). Genotypic analysis was performed using equipment INNO-LiPA MBl2 of Innogenetics (Belgium). Prevalence deficit MBl among patients with IDVC was 9.7% (4 / 41) And the DigA of 8.7% (4 / 46). Three of the 4 patients with IDVC and deficits MBl concomitant had chronic lung disease or malabsorption syndrome and one of the 4 patients with DigA and deficits MBl suffered pneumonia repetition. Other patients with deficit MBl (1 IDVC and 3 DigA) were virtually asymptomatic. Prevalence deficit MBl among the patients included in our study was not superior to that described for the general Caucasian population. Possibly, the low number of patients with deficits MBl prevents assess the impact of variability in the same clinic patients.
