AB0021 FEATURES OF IMMUNOLOGICAL MANIFESTATIONS OF СOMMON VARIABLE IMMUNODEFICIENCY COMBINED WITH RHEUMATOID ARTHRITIS

Abstract

BackgroundThe prevalence rate of сommon variable immunodeficiency (CVID), the most common symptomatic form of primary immunodeficiency disease (PID), is growing every year. In the Republican Register of PID in the Chuvash Republic (Russia) there are 32 patients with CVID, 5 (15.6%) of whom have CVID combined with an autoimmune disease - rheumatoid arthritis (RA). The immunological studies occupy a large place in the diagnosis of PID and autoimmune diseases.ObjectivesThe aim of the study was to search for immunological criteria for the differentiation of RA from CVID combined with RA.MethodsThe object of the study were 2 groups of patients. Group 1 consisted of 20 RA patients; group 2 consisted of 5 patients with CVID in combination with RA. Patients with CVID, who had the results of an immunological study conducted before the appointment of immunoglobulin replacement therapy, were selected for this study. The control group consisted of 20 practically healthy people.ResultsThe significant changes were revealed in the concentration of serum immunoglobulins in the studied groups of patients, in particular, a sharp decrease in IgG levels in group 2 (1.9±0.3 g/l vs. 15.2±2.3 in group 1, p<0.001), IgA (0.1±0.02 g/l vs. 3.1±0.7 g/l in group 1, p<0.001), IgM (0.2±0.03 g/l vs. 1.7±0.2 g/l in group 1, p<0.001). Immunoglobulin levels in both groups of patients were lower (p<0.001) compared to the control group. In both groups, the number of regulatory cells – Treg (CD4+CD25+FoxP3) was reduced: in group 1 - to 2.5±0.03%; in group 2 - to 2.3± 0.02%, while in the control group it was 4.2± 0.5%, p<0.001. The result of our study confirms that the development of RA and CVID is associated with the decrease in the number of Treg cells responsible for ensuring peripheral tolerance and preventing the development of autoimmune diseases.ConclusionCVID and RA have a common immunopathological sign - a decrease in the content of Treg cells in the blood. In the differential diagnosis between RA and CVID, combined with RA, it is necessary to rely on the results of the determination of immunoglobulins in the blood serum.Disclosure of InterestsNone declared