Primary B cell immunodeficiencies: comparisons and contrasts.


Conley M. E. , Dobbs A. K. , Farmer D. M. , Kilic S. Ş. , Paris K., Grigoriadou S., ...More

Annual review of immunology, vol.27, pp.199-227, 2009 (Journal Indexed in SCI Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 27
  • Publication Date: 2009
  • Doi Number: 10.1146/annurev.immunol.021908.132649
  • Title of Journal : Annual review of immunology
  • Page Numbers: pp.199-227
  • Keywords: X-linked agammaglobulinemia, hyper-IgM syndrome, common variable immunodeficiency, Btk, TACI, COMMON VARIABLE IMMUNODEFICIENCY, X-LINKED AGAMMAGLOBULINEMIA, BRUTONS TYROSINE KINASE, HYPER-IGM SYNDROME, CLASS-SWITCH RECOMBINATION, INDUCED CYTIDINE DEAMINASE, MAJOR HISTOCOMPATIBILITY COMPLEX, ANTIBODY-DEFICIENCY SYNDROME, AUTOSOMAL RECESSIVE FORM, DISEASE GENE SH2D1A

Abstract

Sophisticated genetic tools have made possible the identification of the genes responsible for most well-described immunodeficiencies in the past 15 years. Mutations in Btk, components of the pre-B cell and B cell receptor (lambda 5, Ig alpha, Ig beta), or the scaffold protein BLNK account for approximately 90% of patients with defects in early B cell development. Hyper-IgM syndromes result from mutations in CD40 ligand, CD40, AID, or UNG in 70-80% of affected patients. Rare defects in ICOS or CD 19 can result in a clinical picture that is consistent with common variable immunodeficiency, and as many as 10% of patients with this disorder have hetetozygous amino acid substitutions in TACI. For all these disorders, there is considerable clinical heterogeneity in patients with the same mutation. Identifying the genetic and environmental factors that influence the clinical phenotype may enhance patient care and our understanding of normal B cell development.