Impaired proliferative response to B-lymphocyte activators in common variable immunodeficiency

Common variable immune deficiency: reviews, continued puzzles, and a new registry

BACKGROUND

Common variable immune deficiency (CVID) is a clinically and immunologically heterogenous primary immune deficiency first described more than 50 years ago. The main features are hypogammaglobulinemia, recurrent infections, and other complications. While CVID is considered as a genetic immune defect, and several genes have been reported as leading to the CVID phenotype, one of the most puzzling features of CVID is the sporadic inheritance pattern and the relatively late onset. In most cases, no other family members have any immune defect. The mean age at diagnosis is between 25 and 45 years of age. These features suggest the interplay between either several or numerous genes with or without potential environmental factors.

Kaposi's sarcoma and the acquired immune deficiency syndrome. Treatment with recombinant interferon alpha and analysis of prognostic factors

Interferon alfa-2a (Roferon-A, Hoffmann-La Roche Inc., Nutley, NJ) was used to treat sequential groups of patients with Kaposi's sarcoma associated with the acquired immune deficiency syndrome (AIDS). Major antitumor effects (complete or partial responses) were observed in 38% of the patients treated initially with high-dose interferon alfa-2a and in 17% of patients in whom the dose was increased after low-dose treatment failed. A low dose of interferon alfa-2a was ineffective; one patient (3%) showed a partial response. Patients whose tumors responded to interferon treatment showed a significantly lower rate of opportunistic infection, as well as a longer survival than nonresponders. The status of pretreatment immune function was important in predicting the response to interferon treatment. The implication of these findings with respect to understanding the mechanism of action of interferon and the definition of the most appropriate patients for interferon treatment are discussed.