Common variable hypogammaglobulinemia (CVH) or adult-onset agammaglobulinemia is an acquired humoral immune deficiency characterized by low levels of circulating IgG, IgA, and usually IgM, frequent sinopulmonary infections and commonly, gastrointestinal tract infections. Although its place in the pathogenesis of this disease is unclear, a portion of patients with CVH have circulating suppressor T-lymphocytes capable of inhibiting immunoglobulin synthesis by B-lymphocytes of both the patient himself and normals with no humoral immune deficiency. In at least some situations, B-lymphocytes from such patients are capable of immunoglobulin synthesis when removed from the suppressor influences of their own T-cells. Although in mice surface antigens have been identified which are in varying degrees specific for suppressor cells, such cells have not yet been separated in humans. Although human T-lymphocytes with IgM Fc receptors have been characterized as helpers, while those with IgG Fc receptors as suppressors, there are experimental circumstances in which this division breaks down. We here describe a patient with common variable hypogammaglobulinemia with circulating suppressor cells whose unique surface characteristics enabled their physical separation.
ASJC Scopus subject areas
- Immunology and Allergy