Abstract
Functional hyposplenism is a condition accompanying many diseases including autoimmune disorders and lymphomas. Hyposplenism is also commonly found in adult coeliac disease (up to 20% of non-complicated and up to 80% of complicated disease).
Hyposplenism is associated with an increased risk of severe infections (Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae). The aim of this prospective study was to investigate memory B lymphocytes as an indirect biomarker of functional hyposplenism.
A total of 42 patients with coeliac disease (11 men, 31 women; mean age 49 +- 14 years) and 10 healthy controls, blood donors (2 men, 8 women; mean age 39 +- 7 years) were enrolled into the study. None of the patients had a history of splenectomy and none of them suffered. from immunodeficiency.
The DuraClone IM panel was used to identify B lymphocytes subpopulations in peripheral blood samples by flow cytometry Navios (Beckman Coulter) with software analysis using Kaluza version 1.2. Patients with coeliac disease and controls did not differ in basic parameters of leukocyte and total lymphocyte blood count.
Switched memory B lymphocytes (CD19+CD27+IgD-), non-switched memory/marginal-zone-like B lymphocytes (CD19+CD27+IgD+) and immunoglobulin (Ig) M memory B lymphocytes (CD19+CD27+IgM++) were significantly lower in patients with coeliac compared to controls. Follicular (naïve) B lymphocytes were not significantly different between coeliac disease and controls.
In conclusion, dysfunction of memory B lymphocytes can be responsible for an increased risk of severe bacterial infections in coeliac disease. Patients with coeliac disease with dysfunction of memory B lymphocytes are clearly indicated for pneumococcal vaccination.