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Duodenal inflammation in common variable immunodeficiency has altered transcriptional response to viruses - 03/03/23

Doi : 10.1016/j.jaci.2022.09.029 
Mari Kaarbø, PhD a, Mingyi Yang, PhD a, b, Johannes R. Hov, MD, PhD c, d, e, f, Kristian Holm, Cand Scient c, d, e, Mirta Mittelstedt Leal de Sousa, PhD g, h, Magnhild E. Macpherson, MD, PhD e, i, j, Henrik M. Reims, MD, PhD k, Anne-Marte Bakken Kran, MD, PhD a, Bente Halvorsen, PhD d, e, Tom H. Karlsen, MD, PhD c, d, e, f, Pål Aukrust, MD, PhD d, e, i, Knut E.A. Lundin, MD, PhD f, l, Børre Fevang, MD, Ph e, i, Magnar Bjørås, Cand Scient a, g, Silje Fjellgård Jørgensen, MD, PhD e, i,
a Department of Microbiology, Oslo University Hospital and University of Oslo, Oslo, Norway 
b Department of Medical Biochemistry, Oslo University Hospital and University of Oslo, Oslo, Norway 
c Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway 
d Institute of Clinical Medicine, University of Oslo, Oslo, Norway 
e Research Institute of Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway 
f Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway 
g Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim, Norway 
h Proteomics and Modomics Experimental Core Facility (PROMEC) at Norwegian University of Science and Technology, Trondheim, Norway 
i Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway 
j Department of Infectious Diseases, Oslo University Hospital, Ullevål, Oslo, Norway 
k Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway 
l K. G. Jebsen Celiac Disease Research Centre, Faculty of Medicine, University of Oslo, Oslo, Norway 

Corresponding author: Silje Fjellgård Jørgensen, MD, PhD, Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, 0424 Oslo, Norway.Section of Clinical Immunology and Infectious DiseasesOslo University HospitalRikshospitaletOslo0424Norway

Abstract

Background

A substantial proportion of common variable immunodeficiency (CVID) patients has duodenal inflammation of largely unknown etiology. However, because of its histologic similarities with celiac disease, gluten sensitivity has been proposed as a potential mechanism.

Objective

We aimed to elucidate the role of the duodenal microenvironment in the pathogenesis of duodenal inflammation in CVID by investigating the transcriptional, proteomic, and microbial signatures of duodenal biopsy samples in CVID.

Methods

DNA, total RNA, and protein were isolated from snap-frozen pieces of duodenal biopsy samples from CVID (with and without duodenal inflammation), healthy controls, and patients with celiac disease (untreated). RNA sequencing, mass spectrometry–based proteomics, and 16S ribosomal DNA sequencing (bacteria) were then performed.

Results

CVID separated from controls in regulation of transcriptional response to lipopolysaccharide and cellular immune responses. These differences were independent of mucosal inflammation. Instead, CVID patients with duodenal inflammation displayed alterations in transcription of genes involved in response to viral infections. Four proteins were differently regulated between CVID patients and healthy controls—DBNL, TRMT11, GCHFR, and IGHA2—independent of duodenal inflammation. Despite similar histology, there were major differences in CVID with duodenal inflammation and celiac disease both at the RNA and protein level. No significant difference was observed in the bacterial gut microbial signature between CVID, celiac, and healthy controls.

Conclusion

Our findings suggest the existence of altered functions of the duodenal epithelium, particularly in response to lipopolysaccharide and viruses. The latter finding was related to duodenal inflammation, suggesting that viruses, not gluten sensitivity, could be related to duodenal inflammation in CVID.

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Key words : CVID, RNA sequencing, proteomics, microbiome, gut microbiota, microbiota, gastrointestinal tract, duodenum, celiac disease, Primary immunodeficiency, IgA

Abbreviations used : CVID, CVID_all, CVID_IEL, CVID_N, DEG, DEP, GI, GO, IEL, LPS, MS, RNA-Seq, rRNA


Plan


 The first 2 authors contributed equally to this article, and both should be considered first author.
 S.F.J. (project 2019089), M.B. (project 2021076), and M.E.M. (project 2012/521) were funded by grants from the South-Eastern Norway Regional Health Authority. In addition, funding from “Anders Jahres fond til vitenskapens fremme” and Unifor Frimed covered various analyses.
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


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Vol 151 - N° 3

P. 767-777 - mars 2023 Retour au numéro
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