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Master Thesis

Phénotype clinique et réponses humorales intestinales de patients déficitaires en IgA

Abstract : Selective IgA deficiency (sIgAd) and common variable immunodeficiency (CVID) lead to lack of seric IgA in all cases for the former and half cases for the latter. Complications associated with these conditions are mucosal infections, auto-immunity and unexplained entheropathy. IgA responses are mainly triggered in intestinal mucosal associated lymphoïd tissues and contribute to host/intestinal flora (gut microbiota) homeostasis. Symbiosis disruption, also called dysbiosis, can induce inflammatory bowel disease, inappropriate local and systemic humoral responses, and metabolic troubles. The aim of this study is to describe clinical phenotype of patients lacking seric IgA (sIgAd and CVID, n=26) and to study their intestinal humoral responses. Our results showed that 100% CVID and 85% sIgAd patients had recurrent respiratory tract and/or digestive and/or vaginal infections, leading to antibiotics abuse. Moreover, 63% sIgAd patients had at least one autoimmune condition and 33% CVID patients had an autoimmune cytopenia; Polyclonal lymphoproliferation was found in 66% CVID patients. Interestingly, 46% dIgAs patients and 75% CVID patients had a chronic diarrhea with inflammatory histological features in all cases. Intestinal humoral responses were altered since IgA responses were indeed abolished. In cases of sIgAd, intestinal IgM responses were systematically observed. Our results suggest that all patients have at least one complication, and half of them present with gastrointestinal troubles, suggesting intestinal dysbiosis possibly related to secretory IgA deficiency and despite IgM secretion.
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Master Thesis
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  • HAL Id : dumas-01121758, version 1

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Jehane Fadlallah. Phénotype clinique et réponses humorales intestinales de patients déficitaires en IgA. Médecine humaine et pathologie. 2014. ⟨dumas-01121758⟩

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