Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus

Background: Common variable immunodeficiency is the most common primary immunodeficiency. A subset of patients has debilitating inflammatory complications. Objectives: We investigated the role of cytomegalovirus (CMV), and the T-cell response targeted at this virus, in this inflammatory disease. Met...

Full description

Bibliographic Details
Main Authors: Marashi, S, Raeiszadeh, M, Workman, S, Rahbar, A, Soderberg-Naucler, C, Klenerman, P, Chee, R, Webster, A, Milne, R, Emery, VC
Format: Journal article
Language:English
Published: 2011
_version_ 1826287501127450624
author Marashi, S
Raeiszadeh, M
Workman, S
Rahbar, A
Soderberg-Naucler, C
Klenerman, P
Chee, R
Webster, A
Milne, R
Emery, VC
author_facet Marashi, S
Raeiszadeh, M
Workman, S
Rahbar, A
Soderberg-Naucler, C
Klenerman, P
Chee, R
Webster, A
Milne, R
Emery, VC
author_sort Marashi, S
collection OXFORD
description Background: Common variable immunodeficiency is the most common primary immunodeficiency. A subset of patients has debilitating inflammatory complications. Objectives: We investigated the role of cytomegalovirus (CMV), and the T-cell response targeted at this virus, in this inflammatory disease. Methods: Phenotypic and functional assays were used to profile CMV-specific T cells in patients with common variable immunodeficiency with and without inflammatory complications. Highly sensitive immunohistochemistry was used to detect CMV antigens at sites of inflammation. Results: Cytomegalovirus was significantly associated with inflammatory disease, which occurred in 31 of 43 (72%) virus-exposed patients and 8 of 31 (26%) naive patients (P = .0001). CMV pp65-NLVPMVATV epitope-specific CD8+ T-cell frequencies were significantly elevated in inflammatory patients, but these cells did not show evidence of exhaustion, with low levels of programmed death-1 and high T-cell receptor avidity. Rather, they showed features consistent with high in vivo functionality and proliferative activity including reduced levels of the anti-inflammatory marker CD73 (1.67% of NLV+ cells were CD73 + vs 42.01% in noninflammatory patients; P = .004) and increased Ki-67 expression (37% vs 2% in noninflammatory patients; P < .0001). In vitro, the CMV-specific T cells showed high antigen-specific proliferative potential compared with cells from noninflammatory patients. By using sensitive immunohistochemistry, we detected for the first time viral antigen at the sites of inflammation, indicative of active viral replication. Conclusion: Our data strongly support a direct role for CMV and a hyperreactive CMV-specific immune response in the debilitating chronic inflammatory complications of common variable immunodeficiency. © 2011 American Academy of Allergy, Asthma and Immunology.
first_indexed 2024-03-07T01:59:38Z
format Journal article
id oxford-uuid:9ce4f008-e3a5-418e-9a6b-195a5b48644e
institution University of Oxford
language English
last_indexed 2024-03-07T01:59:38Z
publishDate 2011
record_format dspace
spelling oxford-uuid:9ce4f008-e3a5-418e-9a6b-195a5b48644e2022-03-27T00:39:25ZInflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirusJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9ce4f008-e3a5-418e-9a6b-195a5b48644eEnglishSymplectic Elements at Oxford2011Marashi, SRaeiszadeh, MWorkman, SRahbar, ASoderberg-Naucler, CKlenerman, PChee, RWebster, AMilne, REmery, VCBackground: Common variable immunodeficiency is the most common primary immunodeficiency. A subset of patients has debilitating inflammatory complications. Objectives: We investigated the role of cytomegalovirus (CMV), and the T-cell response targeted at this virus, in this inflammatory disease. Methods: Phenotypic and functional assays were used to profile CMV-specific T cells in patients with common variable immunodeficiency with and without inflammatory complications. Highly sensitive immunohistochemistry was used to detect CMV antigens at sites of inflammation. Results: Cytomegalovirus was significantly associated with inflammatory disease, which occurred in 31 of 43 (72%) virus-exposed patients and 8 of 31 (26%) naive patients (P = .0001). CMV pp65-NLVPMVATV epitope-specific CD8+ T-cell frequencies were significantly elevated in inflammatory patients, but these cells did not show evidence of exhaustion, with low levels of programmed death-1 and high T-cell receptor avidity. Rather, they showed features consistent with high in vivo functionality and proliferative activity including reduced levels of the anti-inflammatory marker CD73 (1.67% of NLV+ cells were CD73 + vs 42.01% in noninflammatory patients; P = .004) and increased Ki-67 expression (37% vs 2% in noninflammatory patients; P < .0001). In vitro, the CMV-specific T cells showed high antigen-specific proliferative potential compared with cells from noninflammatory patients. By using sensitive immunohistochemistry, we detected for the first time viral antigen at the sites of inflammation, indicative of active viral replication. Conclusion: Our data strongly support a direct role for CMV and a hyperreactive CMV-specific immune response in the debilitating chronic inflammatory complications of common variable immunodeficiency. © 2011 American Academy of Allergy, Asthma and Immunology.
spellingShingle Marashi, S
Raeiszadeh, M
Workman, S
Rahbar, A
Soderberg-Naucler, C
Klenerman, P
Chee, R
Webster, A
Milne, R
Emery, VC
Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
title Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
title_full Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
title_fullStr Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
title_full_unstemmed Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
title_short Inflammation in common variable immunodeficiency is associated with a distinct CD8+ response to cytomegalovirus
title_sort inflammation in common variable immunodeficiency is associated with a distinct cd8 response to cytomegalovirus
work_keys_str_mv AT marashis inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT raeiszadehm inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT workmans inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT rahbara inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT soderbergnauclerc inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT klenermanp inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT cheer inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT webstera inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT milner inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus
AT emeryvc inflammationincommonvariableimmunodeficiencyisassociatedwithadistinctcd8responsetocytomegalovirus