Clinical Report: Distinctive Fungal Dysbiosis in Common Variable Immunodeficiency

Overview

This study identifies significant alterations in the mycobiome of patients with Common Variable Immunodeficiency (CVID), particularly a marked enrichment of Candida albicans. The findings suggest that fungal dysbiosis may play a role in the pathogenesis of CVID and highlight the potential of fungal profiles as non-invasive biomarkers.

Background

Common Variable Immunodeficiency (CVID) is the most prevalent symptomatic inborn error of immunity, leading to increased morbidity and mortality due to both infectious and non-infectious complications. While bacterial dysbiosis has been documented in CVID, the role of the fungal microbiome remains underexplored. Understanding mycobiome alterations could provide insights into immune dysregulation and potential therapeutic targets.

Data Highlights

Key Findings

• Mycobiome composition significantly differed between CVID patients and healthy controls.
• Fungal richness and evenness were notably reduced in CVID, especially in respiratory and oral samples.
• Candida albicans was enriched in sputum, stool, and saliva of CVID patients.
• Environmental or commensal fungal taxa were consistently depleted in CVID patients.
• Random forest models based on fungal profiles achieved high accuracy in distinguishing CVID from controls.
• Classification of immune dysregulation phenotypes (dCVID vs. iCVID) was less effective.

Clinical Implications

The findings suggest that monitoring fungal profiles may provide valuable insights into the pathophysiology of CVID and could serve as non-invasive biomarkers for disease stratification. Clinicians should consider the potential role of fungal dysbiosis in managing CVID and its complications.

Conclusion

This study underscores the importance of the mycobiome in CVID and suggests that alterations in fungal communities may contribute to disease pathology. Further research is warranted to explore therapeutic implications of these findings.

Related Resources & Content

1. Frontiers | Multiniche mycobiome profiling identifies distinctive fungal dysbiosis in Common Variable Immunodeficiency
2. Common Variable Immunodeficiency - StatPearls - NCBI Bookshelf
3. The Impact of Immune Dysregulation on Clinical Outcomes in Common Variable Immunodeficiency: A Systematic Literature Review | Journal of Human Immunity | Rockefeller University Press
4. Journal of Gastroenterology — Endoscopic Brush Sample Analysis Reveals Mucosal Dysbiosis in Patients with Inflammatory Bowel Disease
5. Journal of Crohn's and Colitis — Specific Bacterial Co-abundance Groups Are Associated With Inflammatory Status in Patients With Ulcerative Colitis
6. Journal of Gastroenterology — The Role of the Gut Mycobiome in Chronic Liver Disease
7. Journal of Gastroenterology — Modifying Gut Microbiota to Improve Immune Regulation in the Treatment of Inflammatory Bowel Diseases
8. Common Variable Immunodeficiency - StatPearls - NCBI Bookshelf
9. The Impact of Immune Dysregulation on Clinical Outcomes in Common Variable Immunodeficiency: A Systematic Literature Review | Journal of Human Immunity | Rockefeller University Press
10. Frontiers | Multiniche mycobiome profiling identifies distinctive fungal dysbiosis in Common Variable Immunodeficiency