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RT Perri and DJ Weisdorf
Common variable hypogammaglobulinemia (CVH) is a clinical syndrome that
includes a diverse group of patients with heterogeneous defects resulting
in impaired B cell proliferation and terminal differentiation into mature
plasma cells capable of normal immunoglobulin synthesis and secretion. In
this study, we report our identification of a previously undescribed
intrinsic B cell defect in a patient with CVH. This patient's B cells
showed a marked impairment in hemolytic plaque- forming cell (HePFC)
formation compared with control B cells (15 v 80 HePFCs per culture,
respectively). In addition, this patient's B cells displayed decreased B
cell colony formation compared with control B cells (5 +/- 2 v 93 +/- 8,
respectively). When examined for their responsiveness to
phytohemagglutinin-T cell conditioned media (PHA- TCM), the patient's B
cells displayed impaired B cell proliferation compared with control B cells
(stimulation index [SI] 1.3 +/- 0.20 v 26 +/- 1.4 with 20% control PHA-TCM
[vol/vol]). Impaired proliferation by the patient's B cells persisted with
increasing concentrations of B cell growth factor (BCGF). Additionally,
PHA-TCM prepared from the patient's T cells when compared with control
PHA-TCM consistently showed less support for control B cell proliferation
(SI 1.27 +/- 0.21 v 26 +/- 1.4, respectively). In coculture studies of B
cell proliferation and immunoglobulin synthesis, patient's T cells showed
no evidence of an enhanced suppressive effect or decreased helper effect.
This patient's immune defects involve, first, an intrinsic B cell defect
characterized by an impaired responsiveness to BCGF's proliferation signal
and, second, impaired production of BCGF by the patient's T cells.
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| Copyright © 1985 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||