Chiu Shuenn-Nan, Shao Pei-Lan, Wang Jou-Kou, Hsu Hui-Wen, Lin Ming-Tai, Chang Luan-Yin, Lu Chun-Yi, Lee Ping-Ing, Huang Li-Min, Wu Mei-Hwan
Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
Department of Laboratory Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan.
Pediatr Res. 2016 Feb;79(2):271-7. doi: 10.1038/pr.2015.221. Epub 2015 Nov 2.
Patients with heterotaxy syndrome, commonly associated with complex congenital heart disease (CHD), exhibit a higher risk of severe bacterial infection (SBI). We sought to define the change of a novel immunologic marker, the immunoglobulin M (IgM) memory B-cell percentage, and its association with SBI.
We enrolled 46 (M/F 29/17) heterotaxy syndrome patients (42 right atrial isomerism (RAI) and 4 left atrial isomerism (LAI)) aged > 1 y during the period 2010-2012 in a tertiary care center. We analyzed IgM(+)CD27(+) memory B-cell percentages. Patients with simple and complex CHD served as controls.
The mean IgM memory B-cell percentages were the lowest in the heterotaxy syndrome group, compared with those in complex and simple CHD groups (1.8 ± 2.1 vs. 3.9 ± 3.2 vs. 5.1 ± 4.7, P < 0.001). In the heterotaxy syndrome group, 41.3% had low IgM memory B-cell percentages (<1% of B cells). Seven had a history of community-acquired SBI and 85.7% of these had low IgM memory B-cell percentages, which was the only significant factors related to community-acquired SBI (P = 0.028).
The memory B cell and IgM memory B-cell percentages are low in patients with heterotaxy syndrome, and the presence of IgM memory B-cell percentage < 1% correlates with community-acquired SBI.
内脏异位综合征患者通常伴有复杂先天性心脏病（CHD），其发生严重细菌感染（SBI）的风险较高。我们试图确定一种新型免疫标志物——免疫球蛋白M（IgM）记忆B细胞百分比的变化及其与SBI的关联。
2010年至2012年期间，我们在一家三级医疗中心纳入了46例（男/女29/17）年龄大于1岁的内脏异位综合征患者（42例右心房异构（RAI）和4例左心房异构（LAI））。我们分析了IgM(+)CD27(+)记忆B细胞百分比。单纯性和复杂性CHD患者作为对照。
与复杂性和单纯性CHD组相比，内脏异位综合征组的平均IgM记忆B细胞百分比最低（1.8±2.1 vs. 3.9±3.2 vs. 5.1±4.7，P<0.001）。在内脏异位综合征组中，41.3%的患者IgM记忆B细胞百分比低（<B细胞的1%）。7例有社区获得性SBI病史，其中85.7%的患者IgM记忆B细胞百分比低，这是与社区获得性SBI相关的唯一显著因素（P=0.028）。
内脏异位综合征患者的记忆B细胞和IgM记忆B细胞百分比低，IgM记忆B细胞百分比<1%与社区获得性SBI相关。
