Histopathological changes in the nasal mucosa were studied in biopsies from the inferior turbinate in 22 patients with common variable immunodeficiency (CVID) and 16 patients with selective IgA deficiency. Most patients with CVID had fewer goblet cells than the healthy controls (p < 0.001), whereas patients with selective IgA deficiency often had manyfold increased numbers (p < 0.001). The number of goblet cells showed a significant (p < 0.001) relationship to the cell-mediated immune function. Patients with lowered cell-mediated immune function, as measured by in vivo and in vitro tests, showed reduced numbers or lack of goblet cells. These patients had an increased number of subepithelial, seromucous gland acini compared with healthy controls (p < 0.01) and patients with selective IgA deficiency (p < 0.05). The production of mucus may be a compensatory mechanism, participating in the protection of the mucosal surface of the antibody-deficient patient. The increase in the number of goblet cells, but not of subepithelial, seromucous gland acini seems dependent on the cell-mediated immune system.
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