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Blood, 1 February 2001, Vol. 97, No. 3, pp. 767-776
PHAGOCYTES
A novel syndrome of variant leukocyte adhesion deficiency
involving defects in adhesion mediated by 1 and
2 integrins
Estelle S. Harris,
Ann O. Shigeoka,
Wenhua Li,
Roberta H. Adams,
Stephen M. Prescott,
Thomas M. McIntyre,
Guy A. Zimmerman, and
Diane E. Lorant
From the Departments of Pediatrics, Internal Medicine,
and Experimental Pathology, the Huntsman Cancer Institute, and the
Program in Human Molecular Biology and Genetics, the University of Utah
School of Medicine, Salt Lake City, UT.
Leukocyte adhesion deficiency type I (LAD-1) is a disorder
associated with severe and recurrent bacterial infections, impaired extravascular targeting and accumulation of myeloid leukocytes, altered
wound healing, and significant morbidity that is caused by absent or
greatly diminished surface expression of integrins of the
2 class. We report clinical features and analysis of
functions of cells from a patient with a myelodysplastic syndrome and
infectious complications similar to those in the severe form of LAD-1,
but whose circulating neutrophils displayed normal levels of
2 integrins. Analysis of adhesion of these cells to
immobilized ligands and to endothelial cells and assays of cell-cell
aggregation and chemotaxis demonstrated a profound defect in adhesion
mediated by 2 integrins indicative of a variant form of
LAD-1. A novel cell line established from Epstein-Barr
virus-transformed lymphoblasts from the subject demonstrated deficient
2 integrin-dependent adhesive function similar to that
of the primary leukocytes. In addition, these cells had markedly
impaired 1 integrin-dependent adhesion. Sequence analysis and electrophoretic mobility of 1 and
2 proteins from the cell line demonstrated that the
defects were not a result of structural abnormalities in the integrin
subunit chains themselves and suggest that the adhesive phenotype of
these cells is due to one or more abnormalities of inside-out signaling
mechanisms that regulate the activity of integrins of these classes.
These features define a unique LAD-1 variant syndrome that may reveal important insights that are generally relevant to inside-out signaling of integrins, a molecular process that is as yet incompletely understood.

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