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Abolhassani H, Avcin T, Bahceciler N, Balashov D, Bata Z, Bataneant M, Belevtsev M, Bernatowska E, Bidló J, Blazsó P, Boisson B, Bolkov M, Bondarenko A, Boyarchuk O, Bundschu A, Casanova JL, Chernishova L, Ciznar P, Csürke I, Erdős M, Farkas H, Fomina DS, Galal N, Goda V, Guner SN, Hauser P, Ilyina NI, Iremadze T, Iritsyan S, Ismaili-Jaha V, Jesenak M, Kelecic J, Keles S, Kindle G, Kondratenko IV, Kostyuchenko L, Kovzel E, Kriván G, Kuli-Lito G, Kumánovics G, Kurjane N, Latysheva EA, Latysheva TV, Lázár I, Markelj G, Markovic M, Maródi L, Mammadova V, Medvecz M, Miltner N, Mironska K, Modell F, Modell V, Mosdósi B, Mukhina AA, Murdjeva M, Műzes G, Nabieva U, Nasrullayeva G, Naumova E, Nagy K, Onozó B, Orozbekova B, Pac M, Pagava K, Pampura AN, Pasic S, Petrosyan M, Petrovic G, Pocek L, Prodeus AP, Reisli I, Ress K, Rezaei N, Rodina YA, Rumyantsev AG, Sciuca S, Sediva A, Serban M, Sharapova S, Shcherbina A, Sitkauskiene B, Snimshchikova I, Spahiu-Konjusha S, Szolnoky M, Szűcs G, Toplak N, Tóth B, Tsyvkina G, Tuzankina I, Vlasova E, Volokha A. Care of patients with inborn errors of immunity in thirty J Project countries between 2004 and 2021. Front Immunol 2022; 13:1032358. [PMID: 36605210 PMCID: PMC9809467 DOI: 10.3389/fimmu.2022.1032358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The J Project (JP) physician education and clinical research collaboration program was started in 2004 and includes by now 32 countries mostly in Eastern and Central Europe (ECE). Until the end of 2021, 344 inborn errors of immunity (IEI)-focused meetings were organized by the JP to raise awareness and facilitate the diagnosis and treatment of patients with IEI. Results In this study, meeting profiles and major diagnostic and treatment parameters were studied. JP center leaders reported patients' data from 30 countries representing a total population of 506 567 565. Two countries reported patients from JP centers (Konya, Turkey and Cairo University, Egypt). Diagnostic criteria were based on the 2020 update of classification by the IUIS Expert Committee on IEI. The number of JP meetings increased from 6 per year in 2004 and 2005 to 44 and 63 in 2020 and 2021, respectively. The cumulative number of meetings per country varied from 1 to 59 in various countries reflecting partly but not entirely the population of the respective countries. Altogether, 24,879 patients were reported giving an average prevalence of 4.9. Most of the patients had predominantly antibody deficiency (46,32%) followed by patients with combined immunodeficiencies (14.3%). The percentages of patients with bone marrow failure and phenocopies of IEI were less than 1 each. The number of patients was remarkably higher that those reported to the ESID Registry in 13 countries. Immunoglobulin (IgG) substitution was provided to 7,572 patients (5,693 intravenously) and 1,480 patients received hematopoietic stem cell therapy (HSCT). Searching for basic diagnostic parameters revealed the availability of immunochemistry and flow cytometry in 27 and 28 countries, respectively, and targeted gene sequencing and new generation sequencing was available in 21 and 18 countries. The number of IEI centers and experts in the field were 260 and 690, respectively. We found high correlation between the number of IEI centers and patients treated with intravenous IgG (IVIG) (correlation coefficient, cc, 0,916) and with those who were treated with HSCT (cc, 0,905). Similar correlation was found when the number of experts was compared with those treated with HSCT. However, the number of patients treated with subcutaneous Ig (SCIG) only slightly correlated with the number of experts (cc, 0,489) and no correlation was found between the number of centers and patients on SCIG (cc, 0,174). Conclusions 1) this is the first study describing major diagnostic and treatment parameters of IEI care in countries of the JP; 2) the data suggest that the JP had tremendous impact on the development of IEI care in ECE; 3) our data help to define major future targets of JP activity in various countries; 4) we suggest that the number of IEI centers and IEI experts closely correlate to the most important treatment parameters; 5) we propose that specialist education among medical professionals plays pivotal role in increasing levels of diagnostics and adequate care of this vulnerable and still highly neglected patient population; 6) this study also provides the basis for further analysis of more specific aspects of IEI care including genetic diagnostics, disease specific prevalence, newborn screening and professional collaboration in JP countries.
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Affiliation(s)
- Hassan Abolhassani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Tadej Avcin
- Children’s Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Nerin Bahceciler
- Division of Pediatric Allergy and Immunology, Near East University, Nicosia, Cyprus
| | - Dmitry Balashov
- Department of Hematopoietic Stem Cell Transplantation, Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Zsuzsanna Bata
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Mihaela Bataneant
- Department of Immunology, Clinical Emergency Paediatric Hospital Louis Turcanu, Timisoara, Romania
| | - Mikhail Belevtsev
- Immunology Department, Belarussian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - Ewa Bernatowska
- Department of Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Judit Bidló
- National Health Insurance Fund Administration, Budapest, Hungary
| | - Péter Blazsó
- Department of Pediatrics, University of Szeged, Szeged, Hungary
| | - Bertrand Boisson
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France,Paris Cité University, Imagine Institute, Paris, France,Department of Pediatrics, Necker Hospital for Sick Children, Paris, France,Howard Hughes Medical Institute, New York, NY, United States
| | - Mikhail Bolkov
- Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russia
| | - Anastasia Bondarenko
- Pediatric Infectious Disease and Pediatric Immunology Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Oksana Boyarchuk
- Department of Children’s Diseases and Pediatric Surgery, I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Anna Bundschu
- National Health Insurance Fund Administration, Budapest, Hungary
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France,Paris Cité University, Imagine Institute, Paris, France,Department of Pediatrics, Necker Hospital for Sick Children, Paris, France,Howard Hughes Medical Institute, New York, NY, United States
| | - Liudmyla Chernishova
- Pediatric Infectious Disease and Pediatric Immunology Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Peter Ciznar
- Department of Pediatrics, University of Bratislava, Bratislava, Slovakia
| | - Ildikó Csürke
- Department of Pediatrics, Jósa András County Hospital and University Teaching Hospital, Nyíregyháza, Hungary
| | - Melinda Erdős
- Primary Immunodeficiency Clinical Unit and Laboratory, Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Henriette Farkas
- Center for Hereditary Angioedema, Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Daria S. Fomina
- Department of Clinical Immunology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Nermeen Galal
- Pediatrics Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Vera Goda
- Department of Pediatric Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest, Budapest, Hungary
| | - Sukru Nail Guner
- Department of Pediatric Immunology, Necmettin Erbakan University, Konya, Turkey
| | - Péter Hauser
- Velkey László Child’s Health Center, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Natalya I. Ilyina
- Department of Pulmonology, National Research Center Institute of Immunology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - Teona Iremadze
- Department of Pulmonology, Iashvili Children’s Central Hospital, Tbilisi, Georgia
| | - Sevan Iritsyan
- Department of Hematology and Transfusion Medicine, National Institute of Health, Yerevan, Armenia
| | - Vlora Ismaili-Jaha
- Pediatric Clinic, Department of Gastroenterology, University Clinical Center of Kosovo Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Pristina, Kosovo
| | - Milos Jesenak
- Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - Jadranka Kelecic
- Department of Pediatrics, Division of Clinical Immunology, Allergology, Respiratory Diseases and Rheumatology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Sevgi Keles
- Department of Pediatric Immunology, Necmettin Erbakan University, Konya, Turkey
| | - Gerhard Kindle
- Institute for Immunodeficiency, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Irina V. Kondratenko
- Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - Larysa Kostyuchenko
- Department of Pediatric Immunology and Reumatology, Western-Ukrainian Specialized Children’s Medical Centre, Lviv, Ukraine
| | - Elena Kovzel
- Program of Clinical Immunology, Allergology and Pulmonology, University Medical Center, Nazarbaev University, Nur-Sultan, Kazakhstan
| | - Gergely Kriván
- Department of Pediatric Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest, Budapest, Hungary
| | - Georgina Kuli-Lito
- Department of Pediatrics, University Hospital Centre Mother Theresa, Tirana, Albania
| | - Gábor Kumánovics
- Department of Rheumatology and Immunology, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - Natalja Kurjane
- Department of Biology and Microbiology, Rīga Stradiņš University, Riga, Latvia
| | - Elena A. Latysheva
- Department of Pulmonology, National Research Center Institute of Immunology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - Tatiana V. Latysheva
- Department of Pulmonology, National Research Center Institute of Immunology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - István Lázár
- Department of Meteorology, University of Debrecen, Debrecen, Hungary
| | - Gasper Markelj
- Children’s Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Maja Markovic
- Department of Eastern Europe, Octapharma Nordic, Stockholm, Sweden
| | - László Maródi
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, United States,Department of Pediatrics, Jósa András County Hospital and University Teaching Hospital, Nyíregyháza, Hungary,*Correspondence: László Maródi,
| | - Vafa Mammadova
- Research-Immunology Laboratory, Azerbaijan Medical University, Baku, Azerbaijan
| | - Márta Medvecz
- Department of Pediatrics, Jósa András County Hospital and University Teaching Hospital, Nyíregyháza, Hungary
| | - Noémi Miltner
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Kristina Mironska
- University Clinic for Children’s Diseases, Department of Immunology, Faculty of Medicine, University “St.Cyril and Methodius”, Skopje, North Macedonia
| | - Fred Modell
- The Jeffrey Modell Foundation, New York, NY, United States
| | - Vicki Modell
- The Jeffrey Modell Foundation, New York, NY, United States
| | - Bernadett Mosdósi
- Department of Pediatrics, Clinical Center, University of Pécs, Pécs, Hungary
| | - Anna A. Mukhina
- Department of Hematopoietic Stem Cell Transplantation, Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Marianna Murdjeva
- Department of Microbiology and Immunology, Faculty of Pharmacy, Research Institute, Medical University-Plovdiv, Plovdiv, Bulgaria
| | - Györgyi Műzes
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Umida Nabieva
- Institute of Immunology and Human Genomics, Academy of Sciences of the Republic of Uzbekistan, Tashkent, Uzbekistan
| | | | - Elissaveta Naumova
- Department of Clinical Immunology, Faculty of Medicine, Alexandrovska Hospital, Medical University, Sofia, Bulgaria
| | - Kálmán Nagy
- Velkey László Child’s Health Center, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Beáta Onozó
- Velkey László Child’s Health Center, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Bubusaira Orozbekova
- Department of Epidemiology and Immunology, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyzstan
| | - Malgorzata Pac
- Department of Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Karaman Pagava
- Department of Child and Adolescent Medicine, Tbilisi State Medical University, Tbilisi, Georgia
| | - Alexander N. Pampura
- Department of Allergology and Clinical Immunology, Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University of the Russian Ministry of Health, Moscow, Russia
| | - Srdjan Pasic
- Department of Pediatric Immunology, Mother and Child Health Institute, Belgrade, Serbia
| | - Mery Petrosyan
- Department of Hematology and Transfusion Medicine, Pediatric Cancer and Blood Disorders Center, Yerevan, Armenia
| | - Gordana Petrovic
- Department of Pediatric Immunology, Mother and Child Health Institute, Belgrade, Serbia
| | - Lidija Pocek
- Department of Allergology, Institute for Children Diseases, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Andrei P. Prodeus
- Department of Pediatrics, Speransky Children’s Municipal Clinical Hospital #9, Moscow, Russia
| | - Ismail Reisli
- Department of Pediatric Immunology, Necmettin Erbakan University, Konya, Turkey
| | - Krista Ress
- Department of Pediatrics, Center of Allergology and Immunology, East-Tallinn Central Hospital, Tallinn, Estonia
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yulia A. Rodina
- Department of Hematopoietic Stem Cell Transplantation, Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Alexander G. Rumyantsev
- Department of Hematopoietic Stem Cell Transplantation, Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Svetlana Sciuca
- Department of Pulmonology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Anna Sediva
- Department of Pulmonology, Motol University Hospital, 2nd Faculty of Medicine, Charles University, Prague, Czechia
| | - Margit Serban
- Academy of Medical Sciences-Research Unit, Clinical Emergency Paediatric Hospital Louis Turcanu, Timisoara, Romania
| | - Svetlana Sharapova
- Immunology Department, Belarussian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - Anna Shcherbina
- Department of Hematopoietic Stem Cell Transplantation, Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Brigita Sitkauskiene
- Department of Immunology and Allergology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Irina Snimshchikova
- Medical Institute, Orel State University named after I.S.Turgenev, Orel, Russia
| | - Shqipe Spahiu-Konjusha
- Pediatric Clinic, Genetics Department, University Clinical Center of Kosovo Faculty of Medicine, University of Pristina ”Hasan Prishtina”, Pristina, Kosovo
| | - Miklós Szolnoky
- Primary Immunodeficiency Clinic, Szent János Hospital, Budapest, Hungary
| | - Gabriella Szűcs
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Natasa Toplak
- Children’s Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Beáta Tóth
- Institute of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Galina Tsyvkina
- Department of Territorial Clinical Center of Specialized Types of Medical Care, State Autonomous Health Care Institution, Vladivostok, Russia
| | - Irina Tuzankina
- Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russia
| | - Elena Vlasova
- Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russia
| | - Alla Volokha
- Pediatric Infectious Disease and Pediatric Immunology Department, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
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