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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3821-3827.
Prepublished online as a Blood First Edition Paper on January 15, 2004; DOI 10.1182/blood-2003-09-3359.
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IMMUNOBIOLOGY
SAP mediates specific cytotoxic T-cell functions in X-linked lymphoproliferative disease
Reza Sharifi,
Joanna C. Sinclair,
Kimberly C. Gilmour,
Peter D. Arkwright,
Christine Kinnon,
Adrian J. Thrasher, and
H. Bobby Gaspar
From the Molecular Immunology Unit, Institute of Child Health, University College London, London, United Kingdom; the Department of Clinical Immunology, Great Ormond Street Hospital National Health Service (NHS) Trust, London, United Kingdom; and the Academic Unit of Child Health, University of Manchester, St Mary's Hospital, Manchester, United Kingdom.
Cytotoxic T cells (CTLs) and natural killer cells play a major role in the immune response to Epstein-Barr virus (EBV) infection. In X-linked lymphoproliferative (XLP) disease, a severe immunodeficiency, immunodysregulatory phenomena are observed following EBV infection, suggesting that defects exist in these effector populations. The gene defective in XLP is SAP (signaling lymphocytic activation molecule [SLAM]associated protein), an adaptor protein that mediates signals through SLAM and other immunoglobulin superfamily receptors including 2B4. We generated EBV-specific T-cell lines from controls and XLP patients and examined CTL function in response to different stimuli. We show that XLP patients can generate EBVT-cell lines that are phenotypically similar to those from controls. XLP patient EBVT-cell lines showed a significant decrease in interferon-gamma (IFN- ) production in response to 2B4 and autologous EBV-transformed lymphoblastoid cell line (LCL) stimulation but not in response to SLAM. Furthermore, XLP EBVT-cell lines demonstrated markedly decreased cytotoxic activity against autologous LCLs. By retroviral gene transfer of the SAP gene into XLP EBVT-cell lines, we show reconstitution of IFN- production and of cytotoxic activity confirming SAP-dependent defects. These studies demonstrate that in XLP the lack of SAP affects specific signaling pathways resulting in severe disruption of CTL function.

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