Little Jessica S, Oakley Miranda S, Thorner Anna R, Johnston Demerise, Majam Victoria, Liakos Alexis D, Novack Lewis A, Zheng Hong, Meredith Scott, Chou Chao-Kai, Newton Benjamin R, Soiffer Robert J, Krause Peter J, Baden Lindsey R, Kumar Sanjai
Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2023 Nov 13;11(1):ofad568. doi: 10.1093/ofid/ofad568. eCollection 2024 Jan.
The immunology of human babesiosis is poorly investigated. We present a comprehensive investigation of a 75-year-old man with B-cell deficiency who experienced 3 episodes of babesiosis over a 6-year period. Slowly evolving clinical immunity was observed, as evidenced by milder clinical symptoms and lower peak parasite burden after each subsequent babesiosis episode. The patient exhibited several striking immunologic findings. First, the patient had exceptionally high -specific antibodies despite very few circulating B cells, which predominantly coexpressed CD27 (memory marker) and CD95 (death receptor). Second, we demonstrated the presence of long-lasting NK cells and expansion of T memory stem cells. Third, levels of the IP-10 cytokine directly correlated with parasite burden. These results raise fundamental questions on the priming, maintenance, and location of a B-cell population that produces high antibody levels in the face of severe B-cell deficiency. Our results should invoke interest among researchers to study the immunology and pathogenesis of human babesiosis.
人类巴贝斯虫病的免疫学研究较少。我们对一名75岁的B细胞缺陷男性进行了全面调查，该患者在6年期间经历了3次巴贝斯虫病发作。观察到临床免疫反应是逐渐发展的，每次后续巴贝斯虫病发作后临床症状较轻且寄生虫负荷峰值较低即可证明。该患者表现出几个显著的免疫学发现。首先，尽管循环B细胞极少，但患者具有异常高的特异性抗体，这些B细胞主要共表达CD27（记忆标志物）和CD95（死亡受体）。其次，我们证明了持久自然杀伤细胞的存在以及T记忆干细胞的扩增。第三，IP-10细胞因子水平与寄生虫负荷直接相关。这些结果引发了关于在严重B细胞缺陷情况下产生高抗体水平的B细胞群体的启动、维持和定位的基本问题。我们的结果应引起研究人员对人类巴贝斯虫病免疫学和发病机制研究的兴趣。
