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Blood, 15 March 2007, Vol. 109, No. 6, pp. 2416-2418.
Prepublished online as a Blood First Edition Paper on November 30, 2006; DOI 10.1182/blood-2005-10-039578.

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HEMATOPOIESIS

Brief Report

Defective apoptosis of peripheral-blood lymphocytes in hyper-IgD and periodic fever syndrome

Evelien J. Bodar1, Jeroen C.H. van der Hilst1, Waander van Heerde2, Jos W. M. van der Meer1, Joost P. H. Drenth3, and Anna Simon1

1 Department of General Internal Medicine, 2 Department of Haematology, and 3 Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Hereditary periodic fever syndromes are characterized by incapacitating attacks of fever and generalized inflammation. While the mutated genes for the major syndromes in this group are known, the pathogenesis remains unclear. The aim of this study was to investigate apoptosis in patients with periodic fever as a possible pathogenic factor. We measured anisomycin-induced apoptosis with annexin-V flow cytometry and caspase-3/7 activity in peripheral-blood lymphocytes from symptom-free patients with hyper-IgD and periodic fever syndrome (HIDS; n = 10), TNF-receptor–associated periodic syndrome (TRAPS; n = 7), and familial Mediterranean fever (FMF; n = 2). HIDS lymphocytes showed a decreased percentage of apoptosis during remission by both methods compared with controls (17.8% vs 55.4%), whereas no difference was observed in TRAPS or FMF lymphocytes. This defective apoptosis of lymphocytes may be a central pathogenic mechanism in HIDS, since dysfunction of one of the inhibitory mechanisms to curtail the immunologic response could cause an unbridled generalized inflammation after a trivial stimulus.


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