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بسم الله الرحمن الرحيم
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Primary immunodeficiency diseases ,[object Object],[object Object],[object Object]
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Lines of treatment of PIDs The four principal general categories of therapy include: 1-Bone marrow and hematopoietic stem cell transplantation  :   hematopoietic stem cell transplantation (HSCT) is a very effective treatment for many of PIDs . The initial successful application of stem cell transplantation in 1968  in two patients with Sever combined immuno-deficiency (SCID )gave evidence that a new donor derived immune system can reverse the poor prognosis in many PIDs .  2-Gene therapy: The first true success of human gene therapy was reported with the correction of several patients with X-linked SCID by ex vivo transduction and reinfusion of stem cells with a functional copy of the gamma chain gene by using a retroviral vector (Bonilla and Geha .,2003). Now, all gene therapy using retroviral vectors for immunodeficiency are freezed after the occurrence of T cell leukemia in two of the 10 children administered gene therapy for SCID with  IL2RG  gene mutation. It was found that the retroviral gene construct of the  IL2RG  gene inserted itself on the oncogene  LMO2  that is aberrantly expressed in acute lymphocytic leukemia of childhood. Thus, insertional oncogenesis was the probable cause of the T-cell leukemia in these two cases .
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Primary hypogammaglobulinemia ,[object Object],[object Object],[object Object],[object Object]
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Common primary hypogammaglobulinemias A – B cell or humoral immunodeficiency: ,[object Object],[object Object],[object Object]
Common primary hypogammaglobulinemias A – B cell or humoral immunodeficiency: ,[object Object],[object Object],[object Object],[object Object],[object Object]
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The pattern of B lymphocytes and immunoglobulin level in various types of primary hypogammaglobulinemia (Eley , 2008). Raised IgM ,Low IgG and IgA. Normal 6-HIGM Normal Normal 5-Specific antibody Deficiency. Normal Normal 4-Isolated IgG Deficiency. Low IgG, IgA , and IgM. Absent/low 3-X-linked and autosomal recessive agammaglobulinemias  Low IgG and IgA, Normal/low IgM. low 2-CVID Low IgA ,Normal IgG, IgM. Normal 1-Selective IgA. Immunoglobulins B cells Disease
Common primary hypogammaglobulinemias B- The combined immunodeficiencies: ,[object Object],[object Object],[object Object]
Common primary hypogammaglobulinemias C- Specific syndromes accompanied by antibody deficiency: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory testing of hypogammaglobulinemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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Classification of CVID ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of CVID ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],EURO Class classification >1% B cells (group B+) ≤ 1% B cells   (group B-) (smB+) group with >2% switched memory B cells ( smB-) group with less than or equal to 2% switched memory B cells
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The role of Innate immunity defects in CVID
The role of acquired immunity defects in CVID ,[object Object],[object Object],[object Object]
The stages of B cells development and the defect in CVID and IgAD which occurs in late stages during activation and differentiation of B  cells into plasma cells ( Kokron et a.,2004).
The role of acquired immunity defects in CVID ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Known Genetic abnormalities in CVID : ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Presentation of CVID patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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الحمد لله رب العالمين   و شكرا لأساتذتي و السادة الحضور
الحمد لله رب العالمين   و شكرا لأساتذتي و السادة الحضور

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  • 10. Lines of treatment of PIDs The four principal general categories of therapy include: 1-Bone marrow and hematopoietic stem cell transplantation : hematopoietic stem cell transplantation (HSCT) is a very effective treatment for many of PIDs . The initial successful application of stem cell transplantation in 1968 in two patients with Sever combined immuno-deficiency (SCID )gave evidence that a new donor derived immune system can reverse the poor prognosis in many PIDs . 2-Gene therapy: The first true success of human gene therapy was reported with the correction of several patients with X-linked SCID by ex vivo transduction and reinfusion of stem cells with a functional copy of the gamma chain gene by using a retroviral vector (Bonilla and Geha .,2003). Now, all gene therapy using retroviral vectors for immunodeficiency are freezed after the occurrence of T cell leukemia in two of the 10 children administered gene therapy for SCID with IL2RG gene mutation. It was found that the retroviral gene construct of the IL2RG gene inserted itself on the oncogene LMO2 that is aberrantly expressed in acute lymphocytic leukemia of childhood. Thus, insertional oncogenesis was the probable cause of the T-cell leukemia in these two cases .
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  • 20. The pattern of B lymphocytes and immunoglobulin level in various types of primary hypogammaglobulinemia (Eley , 2008). Raised IgM ,Low IgG and IgA. Normal 6-HIGM Normal Normal 5-Specific antibody Deficiency. Normal Normal 4-Isolated IgG Deficiency. Low IgG, IgA , and IgM. Absent/low 3-X-linked and autosomal recessive agammaglobulinemias Low IgG and IgA, Normal/low IgM. low 2-CVID Low IgA ,Normal IgG, IgM. Normal 1-Selective IgA. Immunoglobulins B cells Disease
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  • 33. The stages of B cells development and the defect in CVID and IgAD which occurs in late stages during activation and differentiation of B cells into plasma cells ( Kokron et a.,2004).
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  • 41. الحمد لله رب العالمين و شكرا لأساتذتي و السادة الحضور
  • 42. الحمد لله رب العالمين و شكرا لأساتذتي و السادة الحضور