Idiopathic CD4 T Cell Lymphocytopenia: A Case of Overexpression of PD-1/PDL-1 and CTLA-4
, Heidy Schmid-Antomarchi 2, Annie Schmid-Alliana 2, Michel Ticchioni 2 and Pierre-Marie Roger 2,3,4,5Round 1
Reviewer 1 Report
This is a valuable case report. I would like the author to modify or comment on the manuscript regarding the following points.
1) There seems to be a follow-up period of several years. In the meantime, it looks like a graph of the actual number of T cells of CD4 + and CD8 + as well as other lymphocytes and WBC (non-lymphocyte such as monocyte, neutrophils, eosinophils and basophils), and ICL seems to be clearly visible to the author.
2) The authors defined that the expression of some surface markers was significant whether there was a 3-fold difference between this case and the two groups of 5 healthy subjects. However, in the case of Fas, for example, if 39.4% of healthy people, it is impossible to triple (more than 100%). In this case, is it safe to assume that Fas has not increased significantly?
3) Is there any good way to solve the above 2)?
4) Regarding Treg, it is increasing relatively, and it is fully stated in the discussion.
5) Cytokines can be measured with serum (or plasma), and I think that a lot of information can be obtained, and it will be possible to follow up over time. Why didn't you measure it?
Author Response
Please see the attachment
Author Response File: 
Author Response.docx
Reviewer 2 Report
Kumar et al presents a case report in which they detect contradictory high levels of PD1/CTLA4. As a case report, the claims are not expected to be high
I don't find this paper overly exciting but this is made up for by the clear style of writing and succinct methods description. The paper does not provide any elevated insight on the topic and, as the authors suggest, more cases like these need to be reported and systematically characterized for the field to progress
MINOR/suggestions:
* 2.4 antibodies - please provide clone# as there may be multiple also from the company (if not now then in the future)
* Please provide raw FACS data somewhere if possible
* Since the data need not be normally distributed, consider in addition to also provide the % of all HC rather than just the mean+sd
Author Response
Please see the attachment
Author Response File: Author Response.docx
