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Zita Trávníčková

FUNCTIONAL INVESTIGATION OF ANTIBODY PRODUCTION IN COMMON VARIABLE IMMUNODEFICIENCY (CVID) PATIENTS UNDER IMMUNOGLOBULIN SUBSTITUTION. Zita Trávníčková Department of Clinical Immunology and Allergology of St. Anne ´s University Hospital and Medical Faculty of Masaryk University Brno

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Zita Trávníčková

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  1. FUNCTIONAL INVESTIGATION OF ANTIBODY PRODUCTION IN COMMON VARIABLE IMMUNODEFICIENCY (CVID) PATIENTS UNDER IMMUNOGLOBULIN SUBSTITUTION Zita Trávníčková Department ofClinicalImmunologyandAllergologyof St. Anne´s University HospitalandMedicalFacultyof Masaryk University Brno ESID PragueSpring Meeting 2009

  2. ELISPOT assay in PID functional investigation of B cells Detection of specific antibody production on B cell level independent on substitution Ig therapy

  3. EXPERIMENTAL DESIGN SUBJECTS • 37 CVID patients (15 males, 24 females, agerange20 - 74 years) • 81 healthydonors (28 males, 53 females, agerange 14-74 years) VACCINATION • ALTEANA (Sevapharmaa.s., Prague, Czech Republic) • PNEUMO 23 (Sanofi Pasteur, Lyon, France) ELISPOT(isolated MNC ofperipheralblood, calculated on CD19+) • day 0, day 7, weeks 4-11

  4. HEALTHY DONORS Vaccination with PROTEIN antigen 50 controls (16 males, 34 females, age range 22 – 72 years) Vaccination with POLYSACHARIDE antigen 10 controls ( 4 males, 6 females, age range 15 – 46 years) Vaccination with PROTEIN and POLYSACHARIDE antigen 21 controls (8 males, 13 females, age range 14 – 50 years)

  5. CVID PATIENTS Vaccination with PROTEIN and POLYSACHARIDE antigen 37 patients (15 males, 24 females, age range 20 - 74 years)

  6. EUROclassB-cells (Blood 2008) > 1% B cells  group B+ • 1% B cells •  group B- • 2% switchedmemory B cells •  groupsmB+ • 2% switched memory B cells •  group smB-  10% CD 21low B cells group smB-21lo  10% CD 21low B cells group smB+21lo < 10% CD 21low B cells group smB+21norm < 10% CD 21low B cells group smB-21norm

  7. CVID EUROclassB cells group B+ 37 patients group B- group smB+ 16 patients group smB- 21 patients group smB+21lo 10 patients group smB-21lo 12 patients group smB+21norm 6 patients group smB-21norm 9 patients

  8. ELISPOT CVID BEFORE VACCINATION

  9. ELISPOT CVID DAY 7 AFTER VACCINATION

  10. ELISPOT CVID 4-11 WEEKS AFTER VACCINATION

  11. ELISPOT CVID BEFORE VACCINATION

  12. ELISPOT CVID DAY 7 AFTER VACCINATION

  13. CVID 4-11 WEEKS AFTER VACCINATION ELISPOT

  14. CONCLUSIONS The ELISPOT assayissensitive functional test fordeterminationofspecificantibodyproduction in PIDpatientsundersubstitutionimmunoglobulintherapy. In well-defined CVID patientsalmost no detectableperipheral B-cellsproducingspecific IgG, IgA and IgM antibodiesagains Tet. Tox. and PCP wereobserved. Ifthe IgG response wasdetectableafter Tet. Tox. vaccination most patientsbut not allwerecharacterized as smB+21norm according to EUROclass.

  15. 2009 SPECIAL THANKS TO CO-WORKERSDepartment of Clinical Immunology and AllergologySt. Anne´s University hospital and Medical Faculty of Masaryk University in Brno prof. MUDr. Jiří Litzman, CSc. MUDr. Vojtěch Thon, Ph.D. Mgr. Marcela Vlková, Ph.D. 1910 St. Anne´s University Hospital Brno

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