Mahlaoui Nizar, Warnatz Klaus, Jones Alison, Workman Sarita, Cant Andrew
French National Reference Center for Primary Immune Deficiencies (CEREDIH), Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Pediatric Immuno-Haematology and Rheumatology Unit, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
J Clin Immunol. 2017 Jul;37(5):452-460. doi: 10.1007/s10875-017-0401-y. Epub 2017 May 18.
Primary immunodeficiencies (PIDs) are a widely heterogeneous group of inherited defects of the immune system consisting of many clinical phenotypes with at least 300 underlying genetic deficits currently known. Patients with PIDs can present with, or develop during the course of their life, a susceptibility to recurrent and chronic infection along with autoimmune, allergic, inflammatory, and/or proliferative disorders, all potentially leading to end-organ damage. In recent years, a combination of basic and clinical research has greatly improved understanding of the underlying immunological and genetic defects in PIDs, leading to improved diagnosis, classification, and treatment approaches. In this review, we consider some of the key understandings that should direct diagnostic and treatment approaches in PID and offer insights into current and emerging management approaches and the lifelong care of patients from childhood through to adulthood.
原发性免疫缺陷病(PIDs)是一组广泛的、异质性的遗传性免疫系统缺陷,由许多临床表型组成,目前已知至少有300种潜在的基因缺陷。患有原发性免疫缺陷病的患者在其一生中可能会出现或发展为易患反复和慢性感染,以及自身免疫性、过敏性、炎症性和/或增殖性疾病,所有这些都可能导致终末器官损害。近年来,基础研究和临床研究相结合,极大地增进了对原发性免疫缺陷病潜在免疫和基因缺陷的理解,从而改进了诊断、分类和治疗方法。在这篇综述中,我们探讨了一些关键认识,这些认识应指导原发性免疫缺陷病的诊断和治疗方法,并深入了解当前和新兴的管理方法以及从儿童到成人患者的终身护理。