Increased Prevalence of Gastrointestinal Viruses and Diminished Secretory Immunoglobulin a Levels in Antibody Deficiencies

Purpose Gastrointestinal disease occurs frequently in antibody deficiencies. This study aims to explore the relation between gastrointestinal infections and mucosal homeostasis in patients with antibody deficiencies. Methods We performed an observational study including 54 pediatric antibody deficient patients (48 % CVID, 41 % CVID-like, 11 % XLA) and 66 healthy controls. Clinical symptom scores and stool samples were collected prospectively. Stool samples were evaluated for bacteria, parasites, viruses, secretory IgA- and for calprotectin levels. Results were compared between patients and controls. Results 24 % of antibody deficient patients versus 9 % of healthy controls tested positive for gastrointestinal viruses (p = 0.028). Fecal calprotectin levels were significantly higher in virus positive patients compared to virus negative patients (p = 0.002). However, in controls, fecal calprotectin levels were similar between virus positive and virus negative controls. Moreover, gastrointestinal virus positive patients had low serum IgA levels in 13/14 cases (94 %) versus 40/62 (62 %) patients in the virus negative patient group (p = 0.04). The virus positive patient group also displayed significantly lower secretory IgA levels in stool (median 13 ug/ml) than patients without gastrointestinal viruses detected or healthy controls (median 155 ug/ml) (p = 0.046). Conclusion We here report an increased prevalence of gastrointestinal viruses and gastrointestinal complaints in antibody deficient patients. Patients that tested positive for gastrointestinal viruses showed diminished serum- and secretory IgA levels, and only in patients, virus positivity was associated with signs of mucosal inflammation. These findings suggest that particularly patients with low IgA are at risk for longstanding replication of gastrointestinal viruses, which may eventually result in CVID-related enteropathy..

Medienart:

E-Artikel

Erscheinungsjahr:

2014

Erschienen:

2014

Enthalten in:

Zur Gesamtaufnahme - volume:34

Enthalten in:

Journal of clinical immunology - 34(2014), 8 vom: 19. Aug., Seite 962-970

Sprache:

Englisch

Beteiligte Personen:

van de Ven, A. A. J. M. [VerfasserIn]
Janssen, W. J. M. [VerfasserIn]
Schulz, L. S. [VerfasserIn]
van Loon, A. M. [VerfasserIn]
Voorkamp, K. [VerfasserIn]
Sanders, E. A. M. [VerfasserIn]
Kusters, J. G. [VerfasserIn]
Nierkens, S. [VerfasserIn]
Boes, M. [VerfasserIn]
Wensing, A. M. J. [VerfasserIn]
van Montfrans, J. M. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.45$jImmunologie

Themen:

Antibody deficiencies
CVID
Gastrointestinal viruses
IgA
Inflammation

Anmerkungen:

© Springer Science+Business Media New York 2014

doi:

10.1007/s10875-014-0087-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2115435796

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