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Immunodeficiency secondary to anticytokine autoantibodies.
PURPOSE OF REVIEWAnticytokine autoantibodies are an important and emerging mechanism of disease pathogenesis. We will review the clinical and laboratory features of syndromes in which immunodeficiency is caused by or associated with neutralizing anticytokine autoantibodies.
RECENT FINDINGSA growing number of patients have been described who demonstrate unique infectious phenotypes associated with neutralizing autoantibodies that target a particular cytokine known to participate in host defense against the offending organism. Examples include antigranulocyte macrophage-colony stimulating factor (GM-CSF) autoantibodies and pulmonary alveolar proteinosis; anti-interferon (IFN)-γ autoantibodies and disseminated nontuberculous mycobacteria (NTM); anti-interleukin-(IL)-6 autoantibodies and severe staphylococcal skin infection; anti-IL-17A, anti-IL-17F, or anti-IL-22 autoantibodies in patients with mucocutaneous candidiasis in the setting of both the autoimmune polyendocrinopathy, candidiasis, ectodermal dystrophy (APECED) syndrome and in cases of thymoma.
SUMMARYAnticytokine autoantibodies have manifestations that are diverse, ranging from asymptomatic to life-threatening. These emerging and fascinating causes of acquired immunodeficiency may explain some previously idiopathic syndromes.
Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA. firstname.lastname@example.org
Current opinion in allergy and clinical immunology 10:6 2010 Dec pg 534-41
Candidiasis, Chronic Mucocutaneous
Granulocyte-Macrophage Colony-Stimulating Factor
Mycobacterium Infections, Nontuberculous
Pulmonary Alveolar Proteinosis
Staphylococcal Skin Infections
Pub Type(s)Journal Article
Research Support, N.I.H., Intramural