Michael C. Sneller, MD; Warren Strober, MD; Eli Eisenstein, MD; Jonathan S. Jaffe, MD; Charlotte Cunningham-Rundles, MD, PhD
Common variable immunodeficiency (CVI) is a heterogenous immunodeficiency syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections, and various immunologic abnormalities. In addition to recurrent infections, patients with this syndrome also have an increased incidence of autoimmune disease and malignancy. Because the spectrum of associated diseases is broad, patients with CVI are seen by various medical specialists. This review discusses the pathogenesis, clinical manifestations, diagnosis, and treatment of CVI.
9. Total cellular RNA was isolated from phytohemagglutinin-stimulated cells at indicated time points, was slot blotted onto nitrocellulose filters, and was hybridized with cDNA probes for interleukin-2, -interferon, interleukin-2-R chain, and c-myc. The hybridization intensity was determined by scanning densitometry and was plotted graphically (normal persons expressed as mean SE). Only the 6-hour time point is shown for c-myc. All slot blots were hybridized with an actin probe to ensure that equal amounts of RNA had been loaded.
9. Peripheral blood lymphocytes from patients and normal persons were stimulated for 48 hours with phytohemagglutinin. Levels of interleukin-2 (IL-2) and -interferon (IFN-) in culture supernatants were then measured by specific enzyme-linked immunosorbent assays.
Purified CD4+ T cells from A) Patients with a CD4/CD8 ratio > 0.9; B) Patients with CD4/CD8 ratios < 0.9 (CD8 patients) and normal persons (controls) were stimulated with phytohemagglutinin. Supernatants were assayed for interleukin-2 (IL-2) using an enzyme-linked immunosorbent assay at 48 hours.
Normal tonsil B cells (2 10 ) were stimulated with -A Cowan's and interleukin-2 in the presence of varying numbers of CD8+ T cells from normal persons ( = 4) or CD8 patients ( = 5). After 7 days, supernatants were harvested and assayed for IgG using an enzyme-linked immunosorbent assay. The percent baseline IgG was calculated by dividing the amount of IgG produced in B-cell cultures containing CD8+ T cells by the amount of IgG produced in cultures containing only -A Cowan's interleukin-2-stimulated B cells. The percentages are expressed as mean SE for patient and control groups at each T cell/B cell ratio.
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Sneller MC, Strober W, Eisenstein E, Jaffe JS, Cunningham-Rundles C. New Insights into Common Variable Immunodeficiency. Ann Intern Med. ;118:720–730. doi: 10.7326/0003-4819-118-9-199305010-00011
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Published: Ann Intern Med. 1993;118(9):720-730.
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