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Blood, 1 May 2004, Vol. 103, No. 9, pp. 3431-3439.
Prepublished online as a Blood First Edition Paper on January 15, 2004; DOI 10.1182/blood-2003-02-0400.

Submitted February 10, 2003
Accepted December 10, 2003
Dysregulated NK Receptor Expression in Patients with Lymphoproliferative Disease of Granular Lymphocytes
P K Epling-Burnette*, Jeffrey S Painter, Pratima Chaurasia, Fanqi Bai, Sheng Wei, Julie Y Djeu, and Thomas P Loughran
Hematolotic Malignancies, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Interdisciplinary Oncology, University of South Florida, Tampa, FL, USA; Research, Veterans' Administration Hospital, Tampa, FL, USA
Hematolotic Malignancies, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Interdisciplinary Oncology, University of South Florida, Tampa, FL, USA
Immunology Program, H. Lee Moffitt Cancer Center, Tampa, FL, USA; Department of Interdisciplinary Oncology, University of South Florida, Tampa, FL, USA
Center Director, Penn State Cancer Center, Hershey, PA, USA
* Corresponding author; email: burnetpk{at}moffitt.usf.edu.
The NK type of Lymphoproliferative Disease of Granular Lymphocytes (LDGL) is associated with the expansion of CD3-, CD16+ and/or CD56+ lymphocytes. We have examined the repertoire of NK receptors expressed on these cells and delineated the functional activity. We found skewed NK receptor expression on patient NK cells. Reactivity to a single anti-KIR antibody was noted in 7 of 13 patients. LDGL patients variably expressed NKp30, NKp44, and NKp46 RNA. In contrast, CD94 and its inhibitory heterodimerization partner NKG2A were homogenously expressed at high levels on these NK cells. Interestingly, these patients expressed a large number of activating KIR receptors by genotype analysis. Semi-quantitative RT-PCR demonstrated that lower than normal levels of RNA of the inhibitory KIR was present in some patients in contrast to normal NK cells. Consistent with a high level of activating receptors, we found the NK-LDGL cells have potent cytolytic function in both direct and redirected cytotoxicity assays. These results demonstrate that patients with NK-LDGL have an increased activating to inhibitory KIR ratio. This altered ratio might induce inappropriate lysis or cytokine production and impact the disease pathogenesis.

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