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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3821-3827.
Prepublished online as a Blood First Edition Paper on January 15, 2004; DOI 10.1182/blood-2003-09-3359.

Submitted September 30, 2003
Accepted December 26, 2003
SAP mediates specific cytotoxic T cell functions in X-linked lymphoproliferative disease
Reza Sharifi, Joanna C Sinclair, Kimberly C Gilmour, Peter D Arkwright, Christine Kinnon, Adrian J Thrasher, and Hubert B Gaspar*
Molecular Immunology Unit, Institute of Child Health, London, United Kingdom
Clinical Immunology, Great Ormond Street Hospital NHS Trust, London, United Kingdom; Molecular Immunology Unit, Institute of Child Health, London, United Kingdom
Child Health Unit, University of Manchester, Manchester, United Kingdom
Molecular Immunology Unit, Institute of Child Health, London, United Kingdom; Clinical Immunology, Great Ormond Street Hospital NHS Trust, London, United Kingdom
* Corresponding author; email: h.gaspar{at}ich.ucl.ac.uk.
Cytotoxic T cells (CTLs) and natural killer cells play a major role in the immune response to Epstein-Barr virus (EBV) infection. In X-linked lymphoproliferative (XLP) disease, a severe immunodeficiency, immunodysregulatory phenomena are observed following EBV infection suggesting that defects exist in these effector populations. The gene defective in XLP is SAP (SLAM-associated protein), an adaptor protein that mediates signals through SLAM and other immunoglobulin superfamily receptors including 2B4. We generated EBV specific T cell lines from controls and XLP patients and examined CTL function in response to different stimuli. We show that XLP patients can generate EBV-T cell lines that are phenotypically similar to those from controls. XLP patient EBV-T cell lines showed a significant decrease in interferon-gamma (IFN- ) production in response to 2B4 and autologous EBV transformed lymphoblastoid cell line (LCL) stimulation but not in response to SLAM. Furthermore, XLP EBV-T cell lines demonstrated markedly decreased cytotoxic activity against autologous LCLs. By retroviral gene transfer of the SAP gene into XLP EBV-T cell lines, we show reconstitution of IFN- production and of cytotoxic activity confirming SAP dependent defects. These studies demonstrate that in XLP the lack of SAP affects specific signaling pathways resulting in severe disruption of CTL function.

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