Publication:
Adult-onset immunodeficiency in Thailand and Taiwan

Issued Date

2012-08-23

Resource Type

Article

ISSN

15334406
00284793

DOI

10.1056/NEJMoa1111160

Other identifier(s)

2-s2.0-84865300679

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

New England Journal of Medicine. Vol.367, No.8 (2012), 725-734

Suggested Citation

Sarah K. Browne, Peter D. Burbelo, Ploenchan Chetchotisakd, Yupin Suputtamongkol, Sasisopin Kiertiburanakul, Pamela A. Shaw, Jennifer L. Kirk, Kamonwan Jutivorakool, Rifat Zaman, Li Ding, Amy P. Hsu, Smita Y. Patel, Kenneth N. Olivier, Viraphong Lulitanond, Piroon Mootsikapun, Siriluck Anunnatsiri, Nasikarn Angkasekwinai, Boonmee Sathapatayavongs, Po Ren Hsueh, Chi Chang Shieh, Margaret R. Brown, Wanna Thongnoppakhun, Reginald Claypool, Elizabeth P. Sampaio, Charin Thepthai, Duangdao Waywa, Camilla Dacombe, Yona Reizes, Adrian M. Zelazny, Paul Saleeb, Lindsey B. Rosen, Allen Mo, Michael Iadarola, Steven M. Holland Adult-onset immunodeficiency in Thailand and Taiwan. New England Journal of Medicine. Vol.367, No.8 (2012), 725-734. doi:10.1056/NEJMoa1111160 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/14687

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Title

Adult-onset immunodeficiency in Thailand and Taiwan

Author(s)

Sarah K. Browne
 Peter D. Burbelo
 Ploenchan Chetchotisakd
 Yupin Suputtamongkol
 Sasisopin Kiertiburanakul
 Pamela A. Shaw
 Jennifer L. Kirk
 Kamonwan Jutivorakool
 Rifat Zaman
 Li Ding
 Amy P. Hsu
 Smita Y. Patel
 Kenneth N. Olivier
 Viraphong Lulitanond
 Piroon Mootsikapun
 Siriluck Anunnatsiri
 Nasikarn Angkasekwinai
 Boonmee Sathapatayavongs
 Po Ren Hsueh
 Chi Chang Shieh
 Margaret R. Brown
 Wanna Thongnoppakhun
 Reginald Claypool
 Elizabeth P. Sampaio
 Charin Thepthai
 Duangdao Waywa
 Camilla Dacombe
 Yona Reizes
 Adrian M. Zelazny
 Paul Saleeb
 Lindsey B. Rosen
 Allen Mo
 Michael Iadarola
 Steven M. Holland

Other Contributor(s)

National Institute of Allergy and Infectious Diseases
 National Institute of Dental and Craniofacial Research
 National Institutes of Health, Bethesda
 Systex
 Khon Kaen University
 Mahidol University
 Chulalongkorn University
 University of Oxford
 National Taiwan University
 National Cheng Kung University
 Fundacao Oswaldo Cruz
 Colgate University

Abstract

BACKGROUND: Autoantibodies against interferon-γ are associated with severe disseminated opportunistic infection, but their importance and prevalence are unknown. METHODS: We enrolled 203 persons from sites in Thailand and Taiwan in five groups: 52 patients with disseminated, rapidly or slowly growing, nontuberculous mycobacterial infection (group 1); 45 patients with another opportunistic infection, with or without nontuberculous mycobacterial infection (group 2); 9 patients with disseminated tuberculosis (group 3); 49 patients with pulmonary tuberculosis (group 4); and 48 healthy controls (group 5). Clinical histories were recorded, and blood specimens were obtained. RESULTS: Patients in groups 1 and 2 had CD4+ T-lymphocyte counts that were similar to those in patients in groups 4 and 5, and they were not infected with the human immunodeficiency virus (HIV). Washed cells obtained from patients in groups 1 and 2 had intact cytokine production and a response to cytokine stimulation. In contrast, plasma obtained from these patients inhibited the activity of interferon-γ in normal cells. High-titer anti-interferon-γ autoantibodies were detected in 81% of patients in group 1, 96% of patients in group 2, 11% of patients in group 3, 2% of patients in group 4, and 2% of controls (group 5). Forty other anticytokine autoantibodies were assayed. One patient with cryptococcal meningitis had autoantibodies only against granulocyte-macrophage colony-stimulating factor. No other anticytokine autoantibodies or genetic defects correlated with infections. There was no familial clustering. CONCLUSIONS: Neutralizing anti-interferon-γ autoantibodies were detected in 88% of Asian adults with multiple opportunistic infections and were associated with an adult-onset immunodeficiency akin to that of advanced HIV infection. (Funded by the National Institute of Allergy and Infectious Diseases and the National Institute of Dental and Craniofacial Research; ClinicalTrials.gov number, NCT00814827.) Copyright © 2012 Massachusetts Medical Society.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/14687

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