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Abatacept is effective in Chinese patients with LRBA and CTLA4 deficiency

Abatacept is effective in Chinese patients with LRBA and CTLA4 deficiency

Lu Yang
Xiuhong Xue
Xuemei Chen
Junfeng Wu
Xi Yang
Li Xu
Xuemei Tang
Mo Wang
Huawei Mao
Xiaodong Zhao
Genes & Diseases第8卷, 第5期pp.662-668纸质出版 2021-09-01在线发表 2020-03-12
124900

CTLA4 deficiency and LRBA deficiency are a group disorders of immune dysregulation that affect CTLA4 pathway. The patients mainly present with autoimmunity, antibody deficiency and recurrent infections. Here we reported three Chinese patients with LRBA and CTLA4 mutations. They all presented with chronic diarrhea, hypokalemia, organomegaly, recurrent infections, and hypogammaglobulinemia. Reduced Treg cells and increased percentage of circulating follicular helper T (cTfh) cells were revealed in these patients. Although steroid and immunoglobulin therapy were given, the enteropathy was persistent. Therefore, abatacept treatment was provided to these patients. They showed a marked improvement of enteropathy and gastrointestinal endoscopy showed alleviated inflammatory lesion and follicular hyperplasia. Furthermore, the frequency of cTfh cells was reduced after abatacept therapy. Taken together, targeted therapy with abatacept is a promising treatment modality for patients with LRBA and CTLA4 deficiency. The findings also suggest that the frequency of cTfh cells could serve as a marker for tracking disease activity and the response to abatacept therapy.

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LRBA deficiencyCTLA4 deficiencyTarget therapyAbataceptEfficacy