A mycobacterial infection, similar to the ones that are common in these immune-compromised patients.
It's easy to forget just how busy our immune system normally is. But if your immune system is ever compromised, infections that we normally aren't even aware of suddenly become serious problems. The first reports of AIDS patients, for example, didn't necessarily note a massive immune failure; instead, they recorded a series of opportunistic infections and cancers that were normally only seen in people with compromised immune systems, such as patients undergoing chemotherapy.
That's why a series of cases in East Asia (mostly Thailand and Taiwan) was so confusing. The patients had made it well into adulthood without problems with infections, meaning there probably wasn't a genetic immune defect. Later in life, though, they began experiencing frequent and persistent infections, primarily caused by mycobacteria (specifically, relatives of tuberculosis). The patients did not have an HIV infection, and were not at any obvious risk of immune disorder. All of this indicated a new form of acquired immune deficiency, and some preliminary data suggested a problem with a signaling molecule used by the immune system.
Now, researchers have found strong evidence that the problem comes from signaling by interferon-γ, a key mediator of responses to surface infections. The molecule itself is produced normally; instead, the patients with immune deficiencies have developed antibodies that block its activity.
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