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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/17745

Title: Cytokine Production Assays Reveal Discriminatory Immune Defects in Adults with Recurrent Infections and Noninfectious Inflammation
Authors: ten Oever, Jaap
van de Veerdonk, Frank L.
Joosten, Leo A. B.
Simon, Anna
van Crevel, Reinout
Kullberg, Bart-Jan
van der Meer, Jos W. M.
van Deuren, Marcel
Netea, Mihai G.
Issue Date: 2014
Citation: CLINICAL AND VACCINE IMMUNOLOGY, 21 (8), p. 1061-1069
Abstract: Cytokine production assays have been primarily used in research settings studying novel immunodeficiencies. We sought to determine the diagnostic value of cytokine production assays in patients with recurrent and/or severe infectious diseases (IDs) without known immunodeficiencies and unclassified noninfectious inflammatory disorders (NIIDs). We retrospectively examined cytokine production in whole-blood and peripheral blood mononuclear cell samples from 157 adult patients. A cytokine production rate of <5% of that of healthy controls was considered defective. While monocyte-derived cytokine (tumor necrosis factor alpha [TNF-alpha], interleukin-1 beta [IL-1 beta], and IL-6) production was rarely affected, 30% of all included patients had deficient production of interferon gamma (IFN-gamma), IL-17A, or IL-22. Twenty-five percent of the NIID patients displayed defective IFN-gamma production, whereas IL-17A production was generally unaffected. In the group of ID patients, defective IFN-gamma production was found in 19% and 14% of the patients with viral and bacterial infections, respectively, and in 38%, 24%, and 50% of patients with mycobacterial, mucocutaneous, and invasive fungal infections, respectively. Defective IL-17A and IL-22 production was mainly confined to ID patients with mucocutaneous fungal infections. In conclusion, cytokine production assays frequently detect defective Th1 responses in patients with mycobacterial or fungal infections, in contrast to patients with respiratory tract infections or isolated bacterial infections. Defective IL-17A and IL-22 production was primarily found in patients with fungal infections, while monocyte-derived cytokine production was unaffected. Thus, lymphocyte-derived cytokine production assays are helpful in the diagnostic workup of patients with recurrent infections and suspected immunodeficiencies and have the potential to reveal immune defects that might guide adjunctive immunomodulatory therapy.
Notes: [ten Oever, Jaap; van de Veerdonk, Frank L.; Joosten, Leo A. B.; Simon, Anna; van Crevel, Reinout; Kullberg, Bart-Jan; Gyssens, Inge C.; van der Meer, Jos W. M.; van Deuren, Marcel; Netea, Mihai G.] Radboud Univ Nijmegen, Med Ctr, Dept Internal Med, NL-6525 ED Nijmegen, Netherlands. [Gyssens, Inge C.] Canisius Wilhelmina Ziekenhuis, Dept Med Microbiol & Infect Dis, Nijmegen, Netherlands. [Gyssens, Inge C.] Hasselt Univ, Diepenbeek, Belgium.
URI: http://hdl.handle.net/1942/17745
DOI: 10.1128/CVI.00152-14
ISI #: 000341624000005
ISSN: 1556-6811
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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