van Schewick, CM;
Lowe, DM;
Burns, SO;
Workman, S;
Symes, A;
Guzman, D;
Moreira, F;
... Grimbacher, B; + view all
(2021)
Bowel Histology of CVID Patients Reveals Distinct Patterns of Mucosal Inflammation.
Journal of Clinical Immunology
10.1007/s10875-021-01104-5.
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Abstract
Diarrhea is the commonest gastrointestinal symptom in patients with common variable immunodeficiency (CVID). Different pathologies in patients’ bowel biopsies have been described and links with infections have been demonstrated. The aim of this study was to analyze the bowel histology of CVID patients in the Royal-Free-Hospital (RFH) London CVID cohort. Ninety-five bowel histology samples from 44 adult CVID patients were reviewed and grouped by histological patterns. Reasons for endoscopy and possible causative infections were recorded. Lymphocyte phenotyping results were compared between patients with different histological features. There was no distinctive feature that occurred in most diarrhea patients. Out of 44 patients (95 biopsies), 38 lacked plasma cells. In 14 of 21 patients with nodular lymphoid hyperplasia (NLH), this was the only visible pathology. In two patients, an infection with Giardia lamblia was associated with NLH. An IBD-like picture was seen in two patients. A coeliac-like picture was found in six patients, four of these had norovirus. NLH as well as inflammation often occurred as single features. There was no difference in blood lymphocyte phenotyping results comparing groups of histological features. We suggest that bowel histology in CVID patients with abdominal symptoms falls into three major histological patterns: (i) a coeliac-like histology, (ii) IBD-like changes, and (iii) NLH. Most patients, but remarkably not all, lacked plasma cells. CVID patients with diarrhea may have an altered bowel histology due to poorly understood and likely diverse immune-mediated mechanisms, occasionally driven by infections.
| Type: | Article |
|---|---|
| Title: | Bowel Histology of CVID Patients Reveals Distinct Patterns of Mucosal Inflammation |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s10875-021-01104-5 |
| Publisher version: | https://doi.org/10.1007/s10875-021-01104-5 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Immunology, CVID, diarrhea, norovirus, lymphocytes, histology, bowel, COMMON VARIABLE IMMUNODEFICIENCY, NODULAR LYMPHOID HYPERPLASIA, GASTROINTESTINAL-TRACT, EOSINOPHILIC GASTROENTERITIS, CYTOMEGALOVIRUS ILEITIS, IMMUNOLOGICAL FEATURES, NOROVIRUS INFECTION, DISEASE, CELLS, PATHOLOGY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10136785 |
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