Identification of anti-herpes simplex virus antibody-producing B cells in a patient with an atypical RAG1 immunodeficiency

Blood. 2001 Sep 1;98(5):1464-8. doi: 10.1182/blood.v98.5.1464.

Abstract

Mutations of the RAG1 or RAG2 protein that eliminate their recombination activity result in T-B-severe combined immunodeficiency (SCID), whereas mutations retaining partial recombination activity lead to Omenn syndrome, a peculiar SCID characterized by increased host T cells and absence of circulating B cells. The prognosis of this disease is fatal, unless hematopoietic stem cell transplantation is performed. This study reports a case of atypical SCID, carrying RAG1 mutations. The patient survived for 6 years without hematopoietic stem cell transplantation. The missense mutation, tested by in vivo recombination assay, revealed residual recombination activity. By the age of 5 years, the patient developed host B cells, but not T cells, possibly due to engrafted maternal T cells. In addition, the host B cells were able to produce antibodies, including anti-herpes simplex virus-antibodies. The fact that host B cells could produce antibodies in this patient could explain not only the mild phenotype observed but also, at least in part, how patients with Omenn syndrome produce immunoglobulin E and sometimes immunoglobulin M, as the same missense mutation of RAG1 gene has been reported in a patient with Omenn syndrome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amino Acid Substitution
  • Antibodies, Viral / biosynthesis*
  • B-Lymphocytes / immunology*
  • DNA Mutational Analysis
  • DNA Nucleotidyltransferases / metabolism
  • DNA, Complementary / genetics
  • Female
  • Homeodomain Proteins / genetics*
  • Homeodomain Proteins / physiology
  • Humans
  • Immunity, Maternally-Acquired
  • Immunoglobulin E / biosynthesis
  • Immunoglobulin M / biosynthesis
  • Infant
  • Infections / etiology
  • Lymphocyte Activation
  • Male
  • Mutagenesis, Site-Directed
  • Mutation, Missense
  • Recombination, Genetic
  • Recurrence
  • Severe Combined Immunodeficiency / genetics
  • Severe Combined Immunodeficiency / immunology*
  • Simplexvirus / immunology*
  • Syndrome
  • T-Lymphocytes / immunology
  • Transfection
  • VDJ Recombinases

Substances

  • Antibodies, Viral
  • DNA, Complementary
  • Homeodomain Proteins
  • Immunoglobulin M
  • RAG-1 protein
  • Immunoglobulin E
  • DNA Nucleotidyltransferases
  • VDJ Recombinases

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