Immunophenotypic profile of T cells in common variable immunodeficiency: is there an association with different clinical findings?

Background: A system based on the B-cell phenotype has recently been proposed to classify patients suffering from common variable immunodeficiency (CVID). Immunophenotypic T-cell abnormalities have also been correlated with clinical findings, although they have never been used in classification strategies. Objective: To simultaneously assess T and B-cell subset abnormalities in CVID patients and their relationship with clinical findings. To identify potential immunophenotypic T-cell abnormalities that could be further evaluated in multicenter studies. Patients and Methods: Peripheral blood lymphocytes from 21 CVID patients and 21 healthy donors were stained for T and B-cell subsets, analyzed by flow cytometry, and correlated with clinical characteristics. Results: Patients classified as MB0 (CD19/CD27+ < 11%) showed higher percentages of CD4/CD45RA- (87% vs 67%, p = 0.028) and lower percentages of CD8/CD45RA+CCR7+ (10% vs 26%, p = 0.028) and CD4/CD25+ T-cells (36% vs 62%, p = 0.034) than MB2 patients. Even though our cohort was small, we observed a higher prevalence of distinct clinical complications of CVID in patients with B and T-cell abnormalities. Nonmalignant lymphoproliferative disorders and IgG hypercatabolism were more frequently observed in MB0 patients. A higher prevalence of splenomegaly was observed among CVID patients with increased levels of CD4/CD45RA-, activated CD4/CD38+DR+, CD8/DR+, and CD8/CD38+ T-cells, as well as in those with tower percentages of CD4/CD45RA+CCR7+ and CD4/CD25+ T-cells. Lymphoproliferative disorders were more prevalent among CVID patients with higher CD4/CD45RA- percentages. Conclusion: The study of T-cell subsets warrants further evaluation as a potential tool to better identify CVID patients with distinct clinical profiles. (C) 2008 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.