Functional impairment of bacteria-specific CD4 T cells in CVID patients. CD4 T cells from healthy subjects (HS) or CVID patients were stimulated with S. pneumoniae and K. pneumoniae bacteria antigen preparations and expression of IL-17A, IL-2, TNF, and IFN-γ were measured by flow cytometry. CD4 T cell responses to α-CD3/α-CD28 (polyclonal stimulation) or unstimulated (negative control) are also shown (n = 30 healthy individuals and 12 CVID patients). (A and B) Representative flow plots from one healthy subject (#882; A) and one representative CVID patient (CVID-11; B) are shown. (C) Frequencies of bacteria-specific and virus-specific CD4 T cells producing IFN-γ, IL-2, TNF, or IL-17A were calculated. (D) CD4 T cells from healthy subjects (n = 10) and CVID patients (n = 12) were stimulated with S. pneumoniae and K. pneumoniae and proliferation was measured by CFSE dilution. Unstimulated cell cultures (negative control) and cell cultures stimulated with SEB (positive control) are also shown. (E) Percentage of bacteria- and virus-specific CD4 T cell proliferation. P-values were calculated using Student’s t test. *, P < 0.05; **, P < 0.001; ***, P < 0.0001.