[CIS PIDD] [cis-pidd] Memory B-cells & switched memory B-cells in Antibody deficiency patients

[Church, Joseph]

Stan:
We use the panel you described: memory and switched memory.  We do not routinely look at switched memory CD21+ cells.
I agree with Charlotte that this does not replace specific antibody responses, but as you suggest there may be some prognostic value in measuring B-cell subsets.
Additionally, sometimes we need all the evidence we can gather to convince an insurance company to pay for Ig replacement.
Joe Church
Children's Hospital Los Angeles


From: Stan Ress [mailto:Stan.Ress at uct.ac.za]
Sent: Thursday, November 29, 2012 5:59 AM
To: CIS-PIDD
Subject: [cis-pidd] Memory B-cells & switched memory B-cells in Antibody deficiency patients

Dear colleagues,

Aside from their value in classifying CVH patients, there are references to measuring memory B-cells in other patients with diverse antibody deficiencies, as being a better prognostic indicator of susceptibility to infections than absolute Ig levels. Do people routinely make use of these B-cell markers to monitor patients and/or decide on IVIG where the indication may not be so clear cut, & if so, what B-cell subsets are being requested:
Memory B-cells (CD27+ IgM+ IgD-) &  Isotype switched memory B-cells (CD27+IgM-IgD-)? Would you also routinely request the % of switched memory B-cells according to CD21 expression, for example in a patient with isolated, mildly reduced IgG ? Or would you reserve the latter only for CVH patients?

As I'm trying to set up this B-cell panel for use in managing my patients, I'd value comments & suggestions.

Thanks,

Stan




--
Stanley Ress
Associate Professor of Medicine
Head: Division of Clinical Immunology
Department of Medicine
H47 Old Main Building-room 26
Groote Schuur Hospital and UCT
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