Division of Allergy and Clinical Immunology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029-6574, United States.
Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029-6574, United States.
Clin Immunol. 2020 Mar;212:108362. doi: 10.1016/j.clim.2020.108362. Epub 2020 Feb 11.
A number of gastrointestinal complications occur in common variable immunodeficiency (CVID). Infections are one cause, but various forms of severe non-infectious enteropathy also lead to substantial morbidity. The presence of T cell lymphocytic infiltrates in the mucosa have suggested that vedolizumab, a humanized monoclonal antibody which binds to alpha4 beta7 integrin and inhibits the migration of effector T-lymphocytes into gastrointestinal tissues, would be an effective treatment. A previous report of 3 CVID cases suggested benefit in 2 subjects. In this study 7 CVID patients with severe enteropathy were treated with vedolizumab. Four of the 7 completed vedolizumab induction therapy but 3 subjects had acute decompensation during induction and treatment was stopped. While one subject showed improvement, 6 of the 7 patients were withdrawn from therapy. While vedolizumab may be of use in some CVID subjects, it was not ultimately found helpful in most of these patients.
许多胃肠道并发症在普通可变免疫缺陷（CVID）中共同发生。感染是一个原因，但各种形式的严重非传染性肠炎也会导致相当大的发病率。黏膜中 T 细胞淋巴细胞浸润表明，vedolizumab（一种与人源化单克隆抗体结合的 alpha4 beta7 整合素，抑制效应 T 淋巴细胞向胃肠道组织迁移）将是一种有效的治疗方法。先前有 3 例 CVID 病例的报告表明 2 例患者受益。在这项研究中，7 例 CVID 严重肠炎患者接受了 vedolizumab 治疗。7 例患者中有 4 例完成了 vedolizumab 诱导治疗，但 3 例在诱导过程中出现急性失代偿，治疗停止。虽然有 1 例患者显示出改善，但 7 例患者中有 6 例停止了治疗。虽然 vedolizumab 可能对某些 CVID 患者有用，但最终发现它对大多数患者没有帮助。
