Immune Control in Repeated Babesia microti Infection in a Patient With B-Cell Deficiency

The immunology of human babesiosis is poorly investigated. We present a comprehensive investigation of a 75-year-old man with B-cell deficiency who experienced 3 episodes of babesiosis over a 6-year period. Slowly evolving clinical immunity was observed, as evidenced by milder clinical symptoms and...

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Bibliographic Details
Published in:	Open forum infectious diseases Vol. 11; no. 1; p. ofad568
Main Authors:	Little, Jessica S, Oakley, Miranda S, Thorner, Anna R, Johnston, Demerise, Majam, Victoria, Liakos, Alexis D, Novack, Lewis A, Zheng, Hong, Meredith, Scott, Chou, Chao-Kai, Newton, Benjamin R, Soiffer, Robert J, Krause, Peter J, Baden, Lindsey R, Kumar, Sanjai
Format:	Journal Article
Language:	English
Published:	United States Oxford University Press 01-01-2024
Subjects:	Major T memory stem cells NK cells B-cell deficient Babesia microti
Online Access:	Get full text
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Summary:	The immunology of human babesiosis is poorly investigated. We present a comprehensive investigation of a 75-year-old man with B-cell deficiency who experienced 3 episodes of babesiosis over a 6-year period. Slowly evolving clinical immunity was observed, as evidenced by milder clinical symptoms and lower peak parasite burden after each subsequent babesiosis episode. The patient exhibited several striking immunologic findings. First, the patient had exceptionally high -specific antibodies despite very few circulating B cells, which predominantly coexpressed CD27 (memory marker) and CD95 (death receptor). Second, we demonstrated the presence of long-lasting NK cells and expansion of T memory stem cells. Third, levels of the IP-10 cytokine directly correlated with parasite burden. These results raise fundamental questions on the priming, maintenance, and location of a B-cell population that produces high antibody levels in the face of severe B-cell deficiency. Our results should invoke interest among researchers to study the immunology and pathogenesis of human babesiosis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 J. S. L. and M. S. O. contributed equally to this work. P. J. K., L. R. B., and S. K. contributed equally to this work. Potential conflicts of interest. All authors: No reported conflicts.
ISSN:	2328-8957 2328-8957
DOI:	10.1093/ofid/ofad568