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Robust T cell responses to aspergillosis in chronic granulomatous disease: implications for immunotherapy.
[allergic bronchopulmonary aspergillosis]
Chronic
granulomatous
disease
(
CGD
)
patients
are
highly
susceptible
to
invasive
aspergillosis
and
might
benefit
from
aspergillus-
specific
T
cell
immunotherapy
,
which
has
shown
promise
in
treating
those
with
known
T
cell
defects
such
as
haematopoietic
stem
cell
transplant
(
HSCT
)
recipients
.
But
whether
such
T
cell
defects
contribute
to
increased
risks
for
aspergillus
infection
in
CGD
is
unclear
.
Hence
,
we
set
out
to
characterize
the
aspergillus-
specific
T
cell
response
in
CGD
.
In
murine
CGD
models
and
in
patients
with
CGD
we
showed
that
the
CD
4
(
+
)
T
cell
responses
to
aspergillus
were
unimpaired
:
aspergillus-
specific
T
cell
frequencies
were
even
elevated
in
CGD
mice
(
P
<
0
·
01
)
and
humans
(
P
=
0
·
02
)
,
compared
to
their
healthy
counterparts
.
CD
4
-
depleted
murine
models
suggested
that
the
role
of
T
cells
might
be
redundant
because
resistance
to
aspergillus
infection
was
conserved
in
CD
4
(
+
)
T
cell-depleted
mice
,
similar
to
wild-
type
animals
.
In
contrast
,
mice
depleted
of
neutrophils
alone
or
neutrophils
and
CD
4
(
+
)
T
cells
developed
clinical
and
pathological
evidence
of
pulmonary
aspergillosis
and
increased
mortality
(
P
<
0
·
05
compared
to
non-depleted
animals
)
.
Our
findings
that
T
cells
in
CGD
have
a
robust
aspergillus
CD
4
(
+
)
T
cell
response
suggest
that
CD
4
(
+
)
T
cell-based
immunotherapy
for
this
disease
is
unlikely
to
be
beneficial
.
Diseases
Validation
Diseases presenting
"type animals"
symptom
allergic bronchopulmonary aspergillosis
cystinuria
inclusion body myositis
pendred syndrome
werner syndrome
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