Serumski nivoi B ćelijskog aktivacionog faktora i interleukina 10 u običnoj promenljivoj imunodeficijenciji: povezanost sa kliničkim nalazima
Abstract
Apstrakt
Uvod/Cilj. Obična promenljiva imunodeficijencija (CVID) je imunološko i kliničko heterogeno oboljenje. Poremećena citokinska produkcija utiče na disfunkcionalan imunski odgovor. Cilj rada bio je da se ispitaju nivoi faktora aktivacije B-limfocita (BAFF) i interleukina (IL)-10 u serumu kod bolesnika sa CVID. Metode. Studijom je bilo obuhvaćeno 28 bolesnika sa CVID-om koji su dijagnostikovani i praćeni tokom 20 godina (srednje vreme praćenja iznosilo je 14,5 godina). Kontrolne grupe činila su: četiri bolesnika sa X vezanom agamaglobulinemijom (XLA) i 21. zdrava osoba. Prema kliničkim karakteristikama bolesnici sa CVID bili su podeljeni u četiri grupe koje su se delimično preklapale: hronična plućna bolest (n = 21), splenomegalija (n = 13), autoimunske bolesti (n = 9) i ponavljajuće infekcije koje su bolesnici imali uprkos redovnoj primeni intravenskih imunoglobulina (IVIg) (n = 4). Serumski nivoi BAFF i IL-10 mereni su standardnom ELISA metodom. Rezultati. Nivoi BAFF-a bili su povišeni kod svih bolesnika sa CVID u poređenju sa zdravim ispitanicima (p < 0.01). Najznačajnije razlike nađene su kod bolesnika sa plućnim bolestima i splenomegalijom (p < 0.0001). Takođe, koncentracije IL-10 u serumu bile su više kod svih bolesnika sa CVID-om u odnosu na bolesnike sa XLA (p < 0.05) i zdrave ispitanike (p < 0.01). Statistički značajna pozitivna korelacija između koncentracija BAFF i IL-10 nađena je kod bolesnika sa CVID sa autoimunskim bolestima (r = 0.86; p < 0.01). Bolesnici sa CVID sa hroničnim plućnim bolestima imali su značajno više nivoe IL-10, dok su bolesnici sa CVID sa recidivirajućim infekcijama imali povišene koncentracije BAFF u serumu, u poređenju sa ispitanicima bez navedenih komplikacija (p < 0.05). Zaključak. Uprkos malom broju bolesnika, ovo je prva studija iz Srbije koja je ispitivala nivoe BAFF I IL-10 kod bolesnika sa CVID-om. Bolesnici sa CVID su u našoj studiji imali značajan porast nivoa serumskog BAFF i IL-10 u odnosu na zdrave ispitanike. Za potvrdu naših rezultata o značajno višim serumskim nivoima BAFF kod bolesnika sa recidivirajućim infekcijama, i značajno višim serumskim nivoima IL-10 kod bolesnika sa hroničnim plućnim bolestima, potrebna su dalja ispitivanja.
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