Unlocking The Secrets Of A Rare Immune Disease

by Adrian Liston and Josselyn Garcia-Perez 

Primary immunodeficiencies (PID) are a heterogeneous group of disorders that disturb the host’s immunity, creating susceptibility to infections. PIDs are genetically diverse, with mutations in many different genes capable of causing immunodeficiency. The clinical symptoms of PIDs include, but are not limited to, susceptibility to infections, inflammation, and autoimmunity, although each gene mutated, and indeed each individual mutation, can lead to different manifestations.

Central to understanding PIDs is to understand which immune cell type is rendered defective by the mutation the patient carries. The type of infections the patient develops is often a key indicator of the underlying immunodeficiency; for example, pulmonary infections and bacterial septicemia are associated with B cell defect, whereas fungal susceptibility is associated with defects in certain types of T cells. Candidate pathways can be investigated using genetics and immune screening, and successful identification of the underlying causes allows a treatment program to be tailored to the patient.

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