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Blood, 1 February 2004, Vol. 103, No. 3, pp. 1033-1036.
Prepublished online as a Blood First Edition Paper on October 9, 2003; DOI 10.1182/blood-2003-07-2499.

Submitted July 24, 2003
Accepted September 25, 2003
LAD-III, a leukocyte adhesion deficiency syndrome associated with defective Rap1 activation and impaired stabilization of integrin bonds
Tatsuo Kinashi, Memet Aker, Maya Sokolovsky-Eisenberg, Valentin Grabovsky, Chisato Tanaka, Revital Shamri, Sara Feigelson, Amos Etzioni, and Ronen Alon*
Bayer-chair Department of Molecular Immunology and Allergy, Kyoto University Graduate School of Medicine, Kyoto, Japan
Division of Pediatric Hemato- Oncology, Hadassah Medical Center, Jerusalem, Israel
Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel
Department of Pediatrics, Meyer Children Hospital, Rambam Medical Center and the B. Rappaport School of Medicine, Technion, Israel
* Corresponding author; email: ronalon{at}wicc.weizmann.ac.il.
Recently, we reported a rare leukocyte adhesion deficiency (LAD) associated with severe defects in integrin activation by chemokine signals, despite normal ligand binding of leukocyte integrins. We now report that the small GTPase, Rap-1, a key regulator of inside-out integrin activation is abnormally regulated in LAD EBV lymphocyte cells. Both constitutive and chemokine-triggered activation of Rap-1 were abolished in LAD lymphocytes despite normal chemokine signaling. Nevertheless, Rap1 expression and activation by phorbol esters were intact, ruling out a LAD defect in Rap1 GTP loading. The VLA-4 integrin abnormally tethered LAD EBV lymphocytes to its ligand VCAM-1 under shear flow due to impaired generation of high avidity contacts despite normal ligand binding and intact avidity to surface-bound anti-VLA-4 mAb. Thus, a defect in constitutive Rap1 activation results in an inability of ligand-occupied integrins to generate high avidity binding to ligand under shear flow. This is a first report of an inherited Rap1 activation defect associated with a pathological disorder in leukocyte integrin function, we herein term LAD-III.

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