Exhaustion of bacteria-specific CD4 T cells and microbial translocation in common variable immunodeficiency disorders

M Perreau, S Vigano, F Bellanger, C Pellaton… - Journal of Experimental …, 2014 - rupress.org
M Perreau, S Vigano, F Bellanger, C Pellaton, G Buss, D Comte, T Roger, C Lacabaratz…
Journal of Experimental Medicine, 2014rupress.org
In the present study, we have investigated the functional profile of CD4 T cells from patients
with common variable immunodeficiency (CVID), including production of cytokines and
proliferation in response to bacteria and virus-derived antigens. We show that the functional
impairment of CD4 T cells, including the reduced capacity to proliferate and to produce IFN-γ
and IL-2, was restricted to bacteria-specific and not virus-specific CD4 T cells. High levels of
endotoxins were found in the plasma of patients with CVID, suggesting that CD4 T cell …
In the present study, we have investigated the functional profile of CD4 T cells from patients with common variable immunodeficiency (CVID), including production of cytokines and proliferation in response to bacteria and virus-derived antigens. We show that the functional impairment of CD4 T cells, including the reduced capacity to proliferate and to produce IFN-γ and IL-2, was restricted to bacteria-specific and not virus-specific CD4 T cells. High levels of endotoxins were found in the plasma of patients with CVID, suggesting that CD4 T cell dysfunction might be caused by bacterial translocation. Of note, endotoxemia was associated with significantly higher expression of programmed death 1 (PD-1) on CD4 T cells. The blockade of the PD-1–PD-L1/2 axis in vitro restored CD4 T cell proliferation capacity, thus indicating that PD-1 signaling negatively regulates CD4 T cell functions. Finally, we showed that intravenous immunoglobulin G (IVIG) treatment significantly reduced endotoxemia and the percentage of PD-1+ CD4 T cells, and restored bacteria-specific CD4 T cell cytokine production and proliferation. In conclusion, the present study demonstrates that the CD4 T cell exhaustion and functional impairment observed in CVID patients is associated with bacterial translocation and that IVIG treatment resolves bacterial translocation and restores CD4 T cell functions.
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