Anti-Interleukin-23 Autoantibodies in Adult-Onset Immunodeficiency

Area of Science:

• Immunology
• Infectious Diseases

Background:

• Autoantibodies against interleukin-12 (anti-interleukin-12) are common in thymoma patients.
• Opportunistic infections occur in only a subset of these patients.
• Interleukin-12 and interleukin-23 share a common subunit (p40).

Purpose of the Study:

• Investigate the role of autoantibodies against interleukin-23 (anti-interleukin-23) in patients with thymoma and opportunistic infections.
• Determine if anti-interleukin-23 is associated with infection severity and type.

Main Methods:

• Screened patients with anti-interleukin-12 for anti-interleukin-23.
• Tested a validation cohort of thymoma patients and patients with unusual infections.
• Assessed the neutralizing activity of autoantibodies and correlated with infection status.

Main Results:

• 50% of patients with anti-interleukin-12 and severe infections also had neutralizing anti-interleukin-23.
• Anti-interleukin-23 presence was associated with infection status in 81% of thymoma patients.
• Neutralizing anti-interleukin-23 was detected in 26% of thymoma patients and 83% of those with disseminated infections.

Conclusions:

• Neutralizing anti-interleukin-23 is associated with severe, persistent opportunistic infections.
• This finding suggests a critical role for interleukin-23 in defense against certain pathogens.
• Further research is warranted to understand the clinical implications of anti-interleukin-23 in immunocompromised individuals.