COVID-19 and X-linked agammaglobulinemia (XLA) - insights from a monogenic antibody deficiency.
Journal
Current opinion in allergy and clinical immunology
ISSN: 1473-6322
Titre abrégé: Curr Opin Allergy Clin Immunol
Pays: United States
ID NLM: 100936359
Informations de publication
Date de publication:
01 12 2021
01 12 2021
Historique:
pubmed:
2
10
2021
medline:
10
11
2021
entrez:
1
10
2021
Statut:
ppublish
Résumé
The clinical outcomes from COVID-19 in monogenic causes of predominant antibody deficiency have pivotal implications for our understanding of the antiviral contribution of humoral immunity. This review summarizes the lessons learned from COVID-19 infection in X-linked agammaglobulinemia (XLA) due to genetic defects in Bruton's tyrosine kinase (BTK). Key molecular pathways underlying the development of severe COVID-19 are emerging, highlighting the possible contribution of BTK to hyperinflammation. SARS-CoV-2 specific T-cell responses and complement activation appear insufficient to achieve viral clearance in some B-cell deficient individuals. Whilst appearing efficacious in this group, use of convalescent plasma has been recently associated with the evolution of viral escape variants. Early data suggests individuals with XLA can mount a viral-specific T-cell vaccine response, however, the clinical significance of this is still emerging. In contrast to reports made early in the pandemic, we show XLA patients remain susceptible to severe disease. Persistent infection was common and is likely to carry a significant symptom burden and risk of novel variant evolution. COVID-19 infection in this vulnerable, antibody deficient group due to genetic, therapeutic or disease causes may require prompt and specific intervention for both patient and societal benefit.
Identifiants
pubmed: 34596095
doi: 10.1097/ACI.0000000000000792
pii: 00130832-202112000-00003
doi:
Substances chimiques
Agammaglobulinaemia Tyrosine Kinase
EC 2.7.10.2
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
525-534Subventions
Organisme : Wellcome Trust
ID : 207503/Z/17/Z
Pays : United Kingdom
Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
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