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Blood, 1 January 2008, Vol. 111, No. 1, pp. 271-274. Prepublished online as a Blood First Edition Paper on September 21, 2007; DOI 10.1182/blood-2007-06-096487.
IMMUNOBIOLOGY Lack of iNKT cells in patients with combined immune deficiency due to hypomorphic RAG mutations1 Division of Immunology, Children's Hospital Boston, Harvard Medical School, Boston, MA; 2 Immunology Institute, Department of Medicine, Mount Sinai School of Medicine, New York, NY; 3 Department of Pediatrics and Angelo Nocivelli Institute for Molecular Medicine, University of Brescia, Brescia, Italy; 4 Department of Pediatrics, Tor Vergata University, Rome, Italy; 5 Istituto Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Segrate, Milan, Italy; and 6 Istituto Clinico Humanitas, Rozzano, Milan, Italy Hypomorphic mutations of the RAG genes in humans are associated with a spectrum of clinical and immunologic presentations that range from T– B– severe combined immune deficiency (SCID) to Omenn syndrome. In most cases, residual V(D)J recombination activity allows for development of few T-cell clones, which expand in the periphery and infiltrate target organs, resulting in tissue damage. Invariant natural killer T (iNKT) cells play an important immunoregulatory role and have been associated with protection against autoimmunity. We now report on 5 unrelated cases of combined immune deficiency due to hypomorphic RAG mutations, and demonstrate the absence of iNKT cells in all 5 patients. These findings suggest that lack of this important immunoregulatory cell population may contribute to the pathophysiology of Omenn syndrome.
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