• Source: T cell deficiency

T cell deficiency is a deficiency of T cells, caused by decreased function of individual T cells, it causes an immunodeficiency of cell-mediated immunity. T cells normal function is to help with the human body's immunity, they are one of the two primary types of lymphocytes (the other being B cells).




Symptoms and signs


Presentations differ among causes, but T cell insufficiency generally manifests as unusually severe common viral infections (respiratory syncytial virus, rotavirus), diarrhea, and eczematous or erythrodermatous rashes. Failure to thrive and cachexia are later signs of a T-cell deficiency.




Mechanism


In terms of the normal mechanism of T cell we find that it is a type of white blood cell that has an important role in immunity, and is made from thymocytes. One sees in the partial disorder of T cells that happen due to cell signaling defects, are usually caused by hypomorphic gene defects. Generally, (micro)deletion of 22Q11.2 is the most often seen.




= Pathogens of concern

=

The main pathogens of concern in T cell deficiencies are intracellular pathogens, including Herpes simplex virus, Mycobacterium and Listeria. Also, intracellular fungal infections are also more common and severe in T cell deficiencies. Other intracellular pathogens of major concern in T cell deficiency are:




Diagnosis


The diagnosis of T cell deficiency can be ascertained in those individuals with this condition via the following:

Delayed hypersensitivity skin test
T cell count
Detection via culture(infection)




= Types

=



Primary or secondary


Primary (or hereditary) immunodeficiencies of T cells include some that cause complete insufficiency of T cells, such as severe combined immunodeficiency (SCID), Omenn syndrome, and Cartilage–hair hypoplasia.
Secondary causes are more common than primary ones. Secondary (or acquired) causes are mainly:
AIDS
Cancer chemotherapy
Lymphoma
Glucocorticoid therapy



= Complete or partial deficiency
=
Complete insufficiency of T cell function can result from hereditary conditions (also called primary conditions) such as severe combined immunodeficiency (SCID), Omenn syndrome, and cartilage–hair hypoplasia.
Partial insufficiencies of T cell function include acquired immune deficiency syndrome (AIDS), and hereditary conditions such as DiGeorge syndrome (DGS), chromosomal breakage syndromes (CBSs), and B-cell and T-cell combined disorders such as ataxia-telangiectasia (AT) and Wiskott–Aldrich syndrome (WAS).




Treatment



In terms of the management of T cell deficiency for those individuals with this condition the following can be applied:

Killed vaccines should be used(not live vaccines in T cell deficiency)
Bone marrow transplant
Immunoglobulin replacement
Antiviral therapy
Supplemental nutrition




Epidemiology


In the U.S. this defect occurs in about 1 in 70,000, with the majority of cases presenting in early life.
Furthermore, SCID has an incidence of approximately 1 in 66,000 in California.




See also


B cell deficiency




References






Further reading


Verbsky, James W.; Chatila, Talal A. (2017-05-12). "T Regulatory Cells in Primary Immune Deficiencies". Current Opinion in Allergy and Clinical Immunology. 11 (6): 539–544. doi:10.1097/ACI.0b013e32834cb8fa. ISSN 1528-4050. PMC 3718260. PMID 21986549.




External links


Pubmed

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