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Letter
High oligoclonality of immunoglobulins in SARS-CoV2 positive patients
  1. Marie Kolopp-Sarda1,
  2. Pierre Miossec2
  1. 1 Immunology, University of Lyon, Lyon, France
  2. 2 Immunology and Rheumatology, University of Lyon, Lyon, France
  1. Correspondence to Prof Pierre Miossec, Immunology and rheumatology, University of Lyon, Lyon 69007, France; miossec{at}univ-lyon1.fr

https://doi.org/10.1136/annrheumdis-2020-218316

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    SARS-CoV2 virus affects the immune system at multiple sites.1 Severe cases with a cytokine storm show massive defects of all T cell subsets with lymphopenia. B cells are rather hyper-reactive, suggesting defective regulation from T cells and patients with severe forms produce higher levels of antivirus antibodies.2 However, the production of high affinity and protective antibodies requires a fine tuning of the interactions between viral-specific T and B cells. Defects of such regulation can lead to changes in immunoglobulin (Ig) production, with reduction of their protective properties, and induction of autoreactive and possibly pathogenic antibodies through tolerance loss. Serum protein electrophoresis is a simple way to look at Ig heterogeneity. Profiles can show polyclonal hypergammaglobulinaemia, oligoclonality with several small spikes or monoclonality with single M-spike.

    From 3 March to 30 April 2020, 136 patients tested PCR-positive …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors MK-S: analysis of results and writing. PM: concept, writing and submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval The protocol was approved by the Ethics Committee of the Hospitals of Lyon for the protection of individuals participating in biomedical research under the number AC-2016-2729.

    • Provenance and peer review Not commissioned; externally peer reviewed.