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Lymphocyte Subgroups and KREC Numbers in Common Variable Immunodeficiency: A Single Center Study

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Common variable immunodeficiency (CVID) results in defective B cell differentiation and impaired antibody production and is the most common symptomatic primary immunodeficiency. Our aim was to evaluate the correlation among B cell subgroups, κ-deleting recombination excision circle (KREC) copy numbers, and clinical and immunological data of the patients with CVID, and evaluate the patients according to classifications currently available to define the role of KREC copy numbers in the diagnosis of CVID. KREC analysis was performed using a quantitative real-time polymerase chain reaction assay, and B cell subgroups were measured by flow cytometry. The median age of the patients (n = 30) was 25 (6–69) years. Parental consanguinity ratio was 33%. The median age at diagnosis was 15 (4–59), and follow-up period was 6 (1–37) years. CD19+ and CD4+ cell counts at the time of diagnosis were low in 66.7% and 46.7% of the patients, respectively. CD19+ cell counts were positively correlated with KREC copy numbers in patients and healthy controls. CD19+ cell counts and KREC copy numbers were significantly reduced in CVID patients compared to healthy controls as expected. KRECs are quantitative markers for B cell defects. We found low CD4+ cell numbers, recent thymic emigrants, and lymphopenia in some of the patients at diagnosis, which reminds the heterogeneity of CVID’s etiology. In this study, a positive correlation was shown between CD19+ cell counts and KREC copy numbers. Low KREC copy numbers indicated B cell deficiency; however, high KREC copy numbers were not sufficient to rule out CVID.

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We appreciate Dr. Luisa Imberti and Dr. Alessandra Sottini from Laboratorio CREA, Spedali Civili di Brescia, Italy, for kindly supplying the TREC-KREC-TCRAC plasmid to our laboratory. The authors thank to the patients and their families for their collaboration and participation. This project was supported by Scientific and Technological Research Council of Turkey (Project Number: 315S125) and also by Hacettepe University Scientific Research Projects Coordination Unit (Project number: N17128).

Author information

Ismail Yaz, MSc, performed experiments, collected the data, contributed data or analysis tools, interpreted the data, and wrote the paper.

Begum Ozbek, MSc, performed experiments, contributed data collection, and interpreted the data.

Yuk Yin NG, PhD, contributed experiments and analysis tools.

Pinar Gur Cetinkaya, MD, contributed data collection.

Sevil Oskay Halacli, PhD, contributed data collection.

Cagman Tan, MD, contributed data collection and interpreted the data.

Merve Kasikci, MSc, analyzed the data.

Can Kosukcu, MSc, analyzed the data.

Ilhan Tezcan, MD, PhD, supervised the study.

Deniz Cagdas Ayvaz, MD, PhD, conceived, designed, and supervised the study.

Correspondence to Deniz Cagdas.

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Yaz, I., Ozbek, B., Ng, Y.Y. et al. Lymphocyte Subgroups and KREC Numbers in Common Variable Immunodeficiency: A Single Center Study. J Clin Immunol (2020). https://doi.org/10.1007/s10875-020-00761-2

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  • CVID
  • KRECs
  • B cells
  • qRT-PCR
  • Flow cytometry