ID 360 – Immunodeficiency in Interdisciplinary Collaboration 2022
For the second time, a two-day meeting titled "ID 360 – Immunodeficiency in Interdisciplinary Collaboration" took place, this time on March 25–26, 2022, in Prague. Several current topics were discussed during this professional event, which brings together experts who care for patients with primary or secondary immunodeficiencies. The meeting was professionally guaranteed by Prof. MUDr. Anna Šedivá, DSc., from the Institute of Immunology, 2nd Faculty of Medicine, Charles University and University Hospital Motol in Prague.
Immunodeficiencies in relation to COVID-19
During the afternoon of the first day, attention was focused on immunodeficiencies in relation to COVID-19 disease. Professor Šedivá talked about the impact of SARS-CoV-2 infection on the population with immunodeficiencies and emphasized that the immune system's response to viral infection is complex. In people with primary immunodeficiency (PID), the observed risk factors were comparable to the general population, with a worse response to infection being demonstrated, for example, in the population with common variable immunodeficiency (CVID).
Doc. MUDr. Pavlína Králíčková, Ph.D., from the Institute of Clinical Immunology and Allergology, Charles University Faculty of Medicine and University Hospital Hradec Králové, summarized the issue of COVID-19 vaccination in patients with immune disorders from the perspective of immunogenicity and efficacy. According to her, vaccination is meaningful for both primary and secondary immunodeficiencies (SID), with the third dose also being significant for these patients. From the perspective of autoimmune diseases, vaccination should be considered on an individual basis.
MUDr. Helena Schneiderová from the Department of Pediatrics, Masaryk University Faculty of Medicine and University Hospital Brno, discussed in detail the issue of PIMS (pediatric inflammatory multiorgan syndrome temporarily related to SARS-CoV-2) in the pediatric population. A number of children with various manifestations of this new phenomenon were treated in the Czech Republic, with some cases being life-threatening and requiring intensive support. Most children were treated with immunomodulation – administering high-dose intravenous immunoglobulins or corticosteroids, and antithrombotic therapy was also indicated for a large number of children.
Data from the national register and the introduction of newborn screening
The first block of Saturday morning, titled "News in the Field of Immunodeficiencies," presented two current topics.
MUDr. Zita Chovancová, Ph.D., from the Institute of Clinical Immunology and Allergology, Masaryk University Faculty of Medicine and University Hospital Brno, shared data from the National Register of Primary Immunodeficiencies on the distribution of patients in specialized centers and their treatment, particularly immunoglobulin substitution for antibody deficiencies.
Prof. Šedivá then informed about a very important initiative – the introduction of screening for severe combined immunodeficiency (SCID) in the Czech Republic. SCID represents the most severe form of congenital immunodeficiencies, which has various manifestations, and its early detection is crucial for the possibility of intervention. This pilot newborn screening project was significantly contributed to by the immunodeficiency group of the Czech Society of Allergology and Clinical Immunology ČLS JEP (ČSAKI). As of January 1, 2022, according to the methodological instruction of the Ministry of Health of the Czech Republic, a pilot screening program for detecting spinal muscular atrophy and SCID has been added in the Czech Republic.
Secondary immunodeficiencies in hemato-oncological and rheumatological patients
The final block of the meeting discussed secondary immunodeficiencies in hemato-oncological patients. The etiology involves both the underlying hemato-oncological diseases and their treatments, particularly B-cell ablative therapy. With the introduction of regular substitution treatment of immunodeficiencies, there has been a decrease in the occurrence of infectious complications, an improvement in the quality of life for many patients, and a reduction in their morbidity and mortality. This was documented, among other things, by case studies presented by MUDr. Alexandra Jungová, Ph.D., from the Department of Hematology and Oncology, University Hospital Plzeň and Prof. MUDr. Pavel Žák, Ph.D., from the 4th Internal Clinic, Charles University Faculty of Medicine and University Hospital Hradec Králové. In the final contribution, MUDr. Olga Kryštůfková, Ph.D., from the Institute of Rheumatology in Prague, presented case studies of rheumatological patients with secondary immunodeficiencies and informed the audience about the latest recommendations for the treatment of patients with autoimmune rheumatoid diseases and secondary hypogammaglobulinemia following B-cell targeted therapy.
Conclusion
This meeting contributed to updating the issues of primary and secondary immunodeficiencies, sharing important data from the National Register of Primary Immunodeficiencies, and the latest experiences with the impact of COVID-19 infection on the population of patients with immunodeficiencies.
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C-ANPROM/CZ/PO/0006 March 2022
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