DOI: 10.5061/dryad.3j9kd51fz
title: 16S rRNA sequencing data: Altered microbiota, impaired quality of life, malabsorption, infection, and inflammation in CVID patients with diarrhoea

description: Background: Diarrhoea is the commonest gastrointestinal symptom
 in patients with common variable immunodeficiency (CVID).
 Objective: The aim of this study was to describe the prevalence
 and clinical presentation of chronic and recurrent diarrhoea in the
 Royal-Free-Hospital (RFH) London CVID cohort, including symptoms,
 infections, level of inflammation, and microbial diversity.
 Methods: A cross-sectional study of adult CVID patients (139 out
 of 172 diagnosed with CVID completed the screening questionnaire). Those
 with diarrhoea ≥6 days/month had stool and blood samples analysed and
 completed the short Inflammatory Bowel Disease Questionnaire (sIBDQ). BMI,
 spleen-size, lymphocytes and gut-microbial diversity were compared. Due to
 logistical and clinical restraints, not all patients could be analysed on
 all measures. Results: 46/139 (33.1%) patients had current
 significant diarrhoea. In patients with past or present diarrhoea, BMI was
 lower (median 23.7 vs. 26, p = 0.005), malabsorption
 more common (57.97 vs. 35.71%, p = 0.011). CD4+
 lymphocytes were higher in patients with diarrhoea (p =
 0.028; n = 138), but CD4+ naïve lymphocytes were
 significantly higher in non-diarrhoea patients (p =
 0.009, N = 28). Nine patients had confirmed or probable
 current gastrointestinal infections. Calprotectin was &gt;60 μg/g in
 13/29 with significant diarrhoea including 9 without infection. SIBDQ
 revealed a low median score of 4.74. Microbial alpha diversity was
 significantly lower in CVID patients compared to healthy household
 controls. There was no significant difference in alpha diversity in
 relation to antibiotic intake during the 6 weeks prior to providing
 samples. Conclusion: Patients with CVID and significant diarrhoea
 had infections, raised calprotectin, malabsorption, a lower BMI, an
 impaired quality of life (comparable to active IBD), and they differed
 from non-diarrhoea patients in their lymphocyte phenotyping. Furthermore,
 microbial diversity was altered. These findings strongly imply that there
 may be an inflammatory nature and a systemic predisposition to diarrhoea
 in CVID, which necessitates further investigation.
description: <strong>Background:</strong> Diarrhoea is the
 commonest gastrointestinal symptom in patients with common variable
 immunodeficiency (CVID).
 <strong>Objective:</strong> The aim of this study was
 to describe the prevalence and clinical presentation of chronic and
 recurrent diarrhoea in the Royal-Free-Hospital (RFH) London CVID cohort,
 including symptoms, infections, level of inflammation, and microbial
 diversity. <strong>Methods:</strong> A
 cross-sectional study of adult CVID patients (139 out of 172 diagnosed
 with CVID completed the screening questionnaire). Those with diarrhoea ≥6
 days/month had stool and blood samples analysed and completed the short
 Inflammatory Bowel Disease Questionnaire (sIBDQ). BMI, spleen-size,
 lymphocytes and gut-microbial diversity were compared. Due to logistical
 and clinical restraints, not all patients could be analysed on all
 measures. <strong>Results:</strong> 46/139
 (33.1%) patients had current significant diarrhoea. In patients with past
 or present diarrhoea, BMI was lower (median 23.7 vs.
 26, <i>p</i> = 0.005), malabsorption more common (57.97 vs.
 35.71%, <i>p</i> = 0.011). CD4+ lymphocytes were higher in
 patients with diarrhoea (<i>p</i> =
 0.028; <i>n</i> = 138), but CD4+ naïve lymphocytes were
 significantly higher in non-diarrhoea patients (<i>p</i> =
 0.009, <i>N</i> = 28). Nine patients had confirmed or probable
 current gastrointestinal infections. Calprotectin was &gt;60 μg/g in
 13/29 with significant diarrhoea including 9 without infection. SIBDQ
 revealed a low median score of 4.74. Microbial alpha diversity was
 significantly lower in CVID patients compared to healthy household
 controls. There was no significant difference in alpha diversity in
 relation to antibiotic intake during the 6 weeks prior to providing
 samples.
 <strong>Conclusion:</strong> Patients with CVID and
 significant diarrhoea had infections, raised calprotectin, malabsorption,
 a lower BMI, an impaired quality of life (comparable to active IBD), and
 they differed from non-diarrhoea patients in their lymphocyte phenotyping.
 Furthermore, microbial diversity was altered. These findings strongly
 imply that there may be an inflammatory nature and a systemic
 predisposition to diarrhoea in CVID, which necessitates further
 investigation.