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Mullen KR, Felippe MJB. The Horse with Recurrent Fevers and Infections: Approach to Common Variable Immunodeficiency. Vet Clin North Am Equine Pract 2024:S0749-0739(24)00031-2. [PMID: 38789347 DOI: 10.1016/j.cveq.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024] Open
Abstract
Equine common variable immunodeficiency (CVID) is a rare, late-onset, nonfamilial humoral deficiency characterized by B-cell depletion and/or dysfunction resulting in inadequate antibody production and predisposition to recurrent infections. Serum immunoglobulin concentration and peripheral blood lymphocyte immunophenotyping are required to diagnose and characterize CVID in horses. Early recognition of the disease by the equine practitioner is paramount to managing the quality of life for these patients, for whom specific treatment is not yet available and long-term prognosis remains poor. An approach to the diagnosis, identification of complicating factors, and management of horses with CVID are discussed.
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Affiliation(s)
- Kathleen Rory Mullen
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 North Revere Court, Mailstop F600, Aurora, CO 80045, USA
| | - Maria Julia Bevilaqua Felippe
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Box 34, Ithaca, NY 14853, USA.
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Pecoraro HL, Felippe MJB, Miller AD, Divers TJ, Simpson KW, Guyer KM, Duhamel GE. Neuroborreliosis in a horse with common variable immunodeficiency. J Vet Diagn Invest 2019; 31:241-245. [PMID: 30661472 DOI: 10.1177/1040638718824146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Common variable immunodeficiency (CVID) is a rare condition in adult horses characterized by hypogammaglobulinemia and increased susceptibility to parasitic and bacterial infections, including recurrent respiratory diseases, septicemia, and meningitis. Lyme disease is often included as a differential diagnosis in CVID horses with signs of meningitis; however, the Borrelia burgdorferi organism has not been demonstrated previously within central nervous system tissues of CVID horses with neurologic disease, to our knowledge. We report herein a case of neuroborreliosis in a CVID horse, confirmed by combined immunologic testing, histopathology, real-time PCR assay, fluorescent in situ hybridization, and immunohistochemical staining. Implications of these findings include heightened monitoring of CVID horses for Lyme disease in endemic areas and appropriate therapy in the case of neurologic disease.
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Affiliation(s)
- Heidi L Pecoraro
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - M Julia B Felippe
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Andrew D Miller
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Thomas J Divers
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Kenneth W Simpson
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Kimberly M Guyer
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Gerald E Duhamel
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
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Expression of essential B cell development genes in horses with common variable immunodeficiency. Mol Immunol 2012; 51:169-76. [PMID: 22464097 DOI: 10.1016/j.molimm.2012.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 02/27/2012] [Accepted: 03/03/2012] [Indexed: 11/22/2022]
Abstract
Common variable immunodeficiency (CVID) is a heterogeneous disorder of B cell differentiation or function with inadequate antibody production. Our laboratory studies a natural form of CVID in horses characterized by late-onset B cell lymphopenia due to impaired B cell production in the bone marrow. This study was undertaken to assess the status of B cell differentiation in the bone marrow of CVID-affected horses by measuring the expression of genes essential for early B cell commitment and development. Standard RT-PCR revealed that most of the transcription factors and key signaling molecules that directly regulate B cell differentiation in the bone marrow and precede PAX5 are expressed in the affected horses. Yet, the expression of PAX5 and relevant target genes was variable. Quantitative RT-PCR analysis confirmed that the mRNA expression of E2A, PAX5, CD19, and IGHD was significantly reduced in equine CVID patients when compared to healthy horses (p<0.05). In addition, the PAX5/EBF1 and PAX5/B220 ratios were significantly reduced in CVID patients (p<0.01). Immunohistochemical analysis confirmed the absence of PAX5-BSAP expression in the bone marrow of affected horses. Our data suggest that B cell development seems to be impaired at the transition between pre-pro-B cells and pro-B cells in equine CVID patients.
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