Is there a role for microbiome-based approach in common variable immunodeficiency?

Remo Poto, Gianluca Laniro, Amato de Paulis, Giuseppe Spadaro, Gianni Marone, Antonio Gasbarrini, Gilda Varricchi

Journal: Clinical and experimental medicine 2023;23(6):1981-1998

PMID: 36737487

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Abstract

Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by low levels of serum immunoglobulins and increased susceptibility to infections, autoimmune disorders and cancer. CVID embraces a plethora of heterogeneous manifestations linked to complex immune dysregulation. While CVID is thought to be due to genetic defects, the exact cause of this immune disorder is unknown in the large majority of cases. Compelling evidences support a linkage between the gut microbiome and the CVID pathogenesis, therefore a potential for microbiome-based treatments to be a therapeutic pathway for this disorder. Here we discuss the potential of treating CVID patients by developing a gut microbiome-based personalized approach, including diet, prebiotics, probiotics, postbiotics and fecal microbiota transplantation. We also highlight the need for a better understanding of microbiota-host interactions in CVID patients to prime the development of improved preventive strategies and specific therapeutic targets.

Address: Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy.; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy.; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy.; Department of Oncology and Molecular Medicine, Istituto Superiore Di Sanità (ISS), Rome, Italy.; Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.; Department of Translational Medicine and Surgery, Catholic University of Rome, Rome, Italy.; Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, 80131, Naples, Italy.; Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy. [email protected].; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy. [email protected].; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy. [email protected].; Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, 80131, Naples, Italy. [email protected].

DOI: 10.1007/s10238-023-01006-3

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MeSH Terms: Humans, Common Variable Immunodeficiency, Microbiota, Gastrointestinal Microbiome, Autoimmune Diseases