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Blood, 15 February 2004, Vol. 103, No. 4, pp. 1376-1382.
Prepublished online as a Blood First Edition Paper on October 30, 2003; DOI 10.1182/blood-2003-05-1748.

Submitted June 3, 2003
Accepted August 3, 2003
High levels of osteopontin associated to polymorphisms in its gene are a risk factor for development of autoimmunity/lymphoproliferation
Annalisa Chiocchetti, Manuela Indelicato, Thea Bensi, Riccardo Mesturini, Mara Giordano, Selina Sametti, Luca Castelli, Flavia Bottarel, Maria Clorinda Mazzarino, Letizia Garbarini, Francesca Giacopelli, Guido Valesini, Claudio Santoro, Irma Dianzani, Ugo Ramenghi, and Umberto Dianzani*
Department of Medical Science and IRCAD, University of Eastern Piedmont, Novara, Italy
Department of Biomedical Science, University of Catania, Catania, Italy
Department of Pediatrics, University of Turin, Turin, Italy
Department of Pediatrics and CEBR, University of Genoa, Genoa, Italy
Department of Medical Therapy, University of Rome, Rome, Italy
* Corresponding author; email: dianzani{at}med.unipmn.it.
The autoimmune/lymphoproliferative syndrome (ALPS) displays defective function of Fas, autoimmunities, lymphadenopathy/splenomegaly, expansion of CD4/CD8 double-negative (DN) T-cells. Dianzani's autoimmune/lymphoproliferative disease (DALD) is an ALPS variant lacking DN cells. Both forms have been ascribed to inherited mutations hitting the Fas system, but other factors may be involved. A pilot cDNA array analysis on a DALD patient detected overexpression of the cytokine osteopontin (OPN). This observation was confirmed by ELISA detection of higher OPN serum levels in DALD patients (n=25) than in controls (n=50). Analysis of the OPN cDNA identified four polymorphisms forming three haplotypes (A, B, and C). Their overall distribution and genotypic combinations were different in patients (n=26) and controls (n=158) (p<0.01). Subjects carrying haplotype-B and/or -C had a 8-fold higher risk of developing DALD than haplotype-A homozygotes. Several data suggest that these haplotypes influence OPN levels: 1) in DALD families, high levels co-segregated with haplotype-B or -C; 2) in healthy controls, haplotype-B or -C carriers displayed higher levels than haplotype-A homozygotes; 3) in AB and AC heterozygotes, mRNA for haplotype-B or -C was more abundant than that for haplotype-A. In vitro, exogenous OPN decreased activation-induced T-cell death, which suggests that high OPN levels are involved in the apoptosis defect.

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