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Blood, 1 November 2006, Vol. 108, No. 9, pp. 3085-3093.
Prepublished online as a Blood First Edition Paper on June 20, 2006; DOI 10.1182/blood-2006-04-018929.
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IMMUNOBIOLOGY
Hypogammaglobulinemia and exacerbated CD8 T-cellmediated immunopathology in SAP-deficient mice with chronic LCMV infection mimics human XLP disease
Shane Crotty,
Megan M. McCausland,
Rachael D. Aubert,
E. John Wherry, and
Rafi Ahmed
From the Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, San Diego, CA; Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA; and The Wistar Institute, Philadelphia, PA.
The human genetic disease X-linked lymphoproliferative disease (XLP), which is caused by mutations in SH2D1A/SAP that encode SLAM-associated protein (SAP), is characterized by an inability to control Epstein-Barr virus (EBV) and hypogammaglobulinemia. It is unclear which aspects of XLP disease are specific to herpesvirus infection and which reflect general immunologic functions performed by SAP. We examined SAP mice during a chronic LCMV infection, specifically to address the following question: Which SAP deficiency immunologic problems are general, and which are EBV specific? Illness, weight loss, and prolonged viral replication were much more severe in SAP mice. Aggressive immunopathology was observed. This inability to control chronic LCMV was associated with both CD8 T-cell and B-cell response defects. Importantly, we demonstrate that SAP CD8 T cells are the primary cause of the immunopathology and clinical illness, because depletion of CD8 T cells blocked disease. This is the first direct demonstration of SAP CD8 T-cellmediated immunopathology, confirming 30 years of XLP clinical observations and indirect experimentation. In addition, germinal center formation was extremely defective in chronically infected SAP animals, and hypogammaglobulinemia was observed. These findings in a chronic viral infection mouse model recapitulate key features of human XLP and clarify SAP's critical role regulating both cellular and humoral immunity.

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