CC BY-NC-ND 4.0 · Laryngorhinootologie 2019; 98(S 02): S362
DOI: 10.1055/s-0039-1686718
Poster
Rhinology

Alterations of the adaptive immunity in Herditary Hemorrhagic Telangiectasia (HHT) are associated with anemia severity

F Dröge
1   HNO Klinik, Universitätsklinik Essen, Essen
,
E Pylaeva
2   Translationale Onkologie, Universitätsklinik Essen, Essen
,
S Bordbari
2   Translationale Onkologie, Universitätsklinik Essen, Essen
,
I Spyra
2   Translationale Onkologie, Universitätsklinik Essen, Essen
,
K Thangavelu
1   HNO Klinik, Universitätsklinik Essen, Essen
,
C Lueb
1   HNO Klinik, Universitätsklinik Essen, Essen
,
S Lang
1   HNO Klinik, Universitätsklinik Essen, Essen
,
U Geisthoff
3   HNO Klinik, Universitätsklinik Marburg, Marburg
,
J Jablonska-Koch
2   Translationale Onkologie, Universitätsklinik Essen, Essen
› Author Affiliations
 

Objectives:

Hereditary hemorrhagic telangiectasia (HHT) is associated with an increased risk of bacterial infections. Experimental evidence on the immune response in these patients is sparse. Therefore, we aimed to assess the immunological changes in HHT patients and to reveal the factors predisposing to the immunological decline.

Methods:

In a prospective study clinical data and the Epistaxis Severity Score (ESS) were documented. The phenotypic characterization of lymphocyte subsets was performed using whole blood and standard immunofluorescence and flow cytometry technology.

Results:

Clinical data and parameters of cellular immunity of 72 HHT patients and 40 controls were analyzed. We observed prominent decrease in peripheral T-lymphocyte absolute numbers with relative predominance of other cell populations (percentage of NK, B cells, neutrophils, monocytes) in HHT vs. healthy of comparable age (p < 0.05). Moreover, PD1+ cell numbers and memory/naïve T cells ratio were increased in this group. Blood loss and iron-deficient anemia correlated with severity of lymphopenia (ESS: R =-0.39; p < 0.05; Hb:R =-0.42; p < 0.05). Lymphopenia was associated with higher prevalence of abscesses/strokes and chronic inflammatory diseases (CID)/autoimmune diseases (AD) (abscesses/stroke: OR = 3.70,95%CI: 0.72 – 18.84, p = 0.11; CID/AD: OR = 3.02,95%CI: 0.84 – 10.86, p = 0.09). In a logistic regression especially the hemoglobin level and the ESS which increases with age were associated with decreased T-cells and a lymphopenia.

Conclusions:

Severe nasal bleedings and resulting anemia, especially in aged patients with HHT, were associated with prominent decline in adaptive immunity. These patients seem to be more prone to bacterial infections which might be relevant for further research and clinical management.



Publication History

Publication Date:
23 April 2019 (online)

© 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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