[Association between alterations in the expanded lymphoid profileby flow cytometry and inborn errors of immunity].

María Luz Martín, Maximiliano Ezequiel Frías, Laura Del Pino, Débora Velázquez, Victor Skrie, Beatriz María Inés Pereira, Julio César Orellana
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Abstract

Objective: To evaluate the association between the expanded lymphoid profile and inborn errors of immunity using flow cytometry.

Methods: Observational and cross-sectional, case-control study, carried out in patients with a diagnosis or clinical suspicion of inborn errors of immunity, treated at the Santísima Trinidad Children's Hospital in Córdoba, Argentina, from August 2021 to November 2022. Clinical data were collected, and peripheral blood samples were obtained for flow cytometry analysis, using the PIDOT tube, to identify lymphocyte subpopulations. For statistical analysis, Fisher's exact test, odds ratio and binary logistic regression model were used.

Results: 40 cases and 20 controls were analyzed. The most frequently altered lymphocyte subpopulations were: CD4+ n (63%), Mem c/s (60%) and Mem s/s (55%). A statistically significant association was found between several lymphocyte subpopulations and health-disease status. Binary logistic regression reported Mem s/s and CD4+n as altered lymphocyte subpopulations with a greater probability to have inborn errors of immunity.

Conclusions: This study contributes to improving the understanding of inborn errors of immunity and demonstrates a strong association with altered lymphocyte subpopulation profiles. Mem s/s and CD4+n emerge as relevant biomarkers for diagnosis. Heterogeneity in different diseases and in flow cytometry underlines the importance of evaluating each patient individually, to improve diagnosis and treatment.

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[流式细胞术扩大淋巴样改变与先天性免疫错误的关系]。
目的:利用流式细胞术探讨淋巴细胞扩张与先天性免疫缺陷的关系。方法:观察性和横断面病例对照研究,对2021年8月至2022年11月在阿根廷Córdoba的Santísima特立尼达儿童医院接受治疗的诊断或临床怀疑先天性免疫缺陷的患者进行研究。收集临床资料,采集外周血样本进行流式细胞术分析,使用PIDOT管鉴定淋巴细胞亚群。统计分析采用Fisher精确检验、比值比和二元logistic回归模型。结果:对40例病例和20例对照组进行分析。最常改变的淋巴细胞亚群是:CD4+ n (63%), Mem c/s(60%)和Mem s/s(55%)。在一些淋巴细胞亚群和健康-疾病状态之间发现了统计学上显著的关联。二元logistic回归报告Mem s/s和CD4+n是改变的淋巴细胞亚群,更有可能发生先天性免疫错误。结论:本研究有助于提高对先天免疫缺陷的理解,并证明先天免疫缺陷与改变的淋巴细胞亚群谱密切相关。Mem s/s和CD4+n成为诊断的相关生物标志物。不同疾病和流式细胞术的异质性强调了单独评估每个患者的重要性,以改善诊断和治疗。
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