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Interleukin-23 (IL-23) is involved in susceptibility to mycobacterial and fungal diseases and shares a subunit with IL-12. Anti–IL-12 antibodies (Abs) — but not opportunistic infections — are common in patients with thymoma. The identification of a disseminated infection with Burkholderia gladioli in a woman with anti–IL-12 Abs that cross-reacted with IL-23 led investigators to evaluate the association of anti–IL-23 Abs with severe infections in adults.
In the discovery cohort (30 patients with anti–IL-12 Abs), 80% had thymoma and 67% had persistent or recurrent fungal, mycobacterial, or bacterial infections. The presence of anti–IL-12 Abs did not correlate with infections, but anti–IL-23 Abs did — and disease severity was linked to neutrali…