Altered serum cytokine signature in common variable immunodeficiency

Abstract

Purpose: Common variable immunodeficiency (CVID) is the most frequent form of primary symptomatic hypogammaglobulinemia. CVID patients display a number of abnormalities in lymphocyte subpopulations including chronic T-cell activation and decreased numbers of circulating CD4(+) T cells and NK cells. We and others have recently shown that CVID is associated with increased concentration of soluble CD14 (sCD14) and other factors indicating limited microbial translocation.

Methods: To address the mechanisms of chronic immune activation in CVID, we performed a detailed analysis of cytokine serum levels in 36 patients with CVID, 52 patients with selective IgA deficiency (IgAD), and 56 healthy volunteers.

Results: We show that CVID is associated with elevated serum levels of CXCL-10/IP-10, IL-1R antagonist, TNF-α, IL-10, IL-12 (p40), CCL-2/MCP-1, G-CSF, and CCL-11/eotaxin. The detected cytokine signature is consistent with an ongoing activation of cells of myeloid lineage. In contrast, the levels of cytokines typically produced by CD4(+) T helper cells of Th1 (IFN-γ, IL-2), Th2 (IL-9, IL-13), and Th17 (IL-17) subtypes were suppressed in CVID patients compared to healthy donors.

Conclusions: Presented data suggest that the altered cytokine profile observed in patients with CVID may be attributed to the activation of monocyte-macrophage and granulocyte lineages, possibly driven by the translocation of bacterial components across the gastrointestinal or respiratory tracts mucosal barrier.

Figure 1. Analysis of cytokine profile in the serum of CVID and IgA patients

Serum concentration of factors that are upregulated (A) or downregulated (B) in CVID and IgA patients are presented. Horizontal line indicates median; Mann-Whitney rank sum test was used for statistical evaluation.

Figure 2. Significant differences in serum levels of determined cytokines/chemokines in patients with or without diarrhea, splenomegaly, granuloma, bronchiectasis, and autoimmunity

There were no differences comparing patients with and without hepatopathy. Horizontal line indicates median, Mann-Whitney rank sum test was used for statistical evaluation.