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Blood, 15 December 2007, Vol. 110, No. 13, pp. 4285-4292. Prepublished online as a Blood First Edition Paper on August 27, 2007; DOI 10.1182/blood-2007-05-088286.
Submitted May 3, 2007
INSERM, U768; Universite Rene Descartes-Paris 5, Hopital Necker-Enfants Malades, Paris, France * Corresponding author; email: rieux{at}necker.fr.
Activation-Induced Cell Death (AICD) is involved in peripheral tolerance by controlling the expansion of repeatedly stimulated T cells via an apoptotic Fas (CD95; APO-1)-dependent pathway. The TNFRSF-6 gene encoding Fas is mutated in children suffering Autoimmune Lymphoproliferative Syndrome (ALPS), characterized by lymphoproliferation and autoimmunity. In this study, we examined AICD in Fas deficient T-cells from ALPS patients. We showed that primary activated Fas-deficient T-cells die by apoptosis after repeated TCR stimulation despite resistance to Fas-mediated cell death. This Fas-independent AICD was found to be mediated through a cytotoxic granules-dependent pathway as it is inhibited by compounds that inactivated the cytotoxic-granules content. Cytotoxic granules-mediated AICD was also detected in normal T-lymphocytes though to a lesser extent. As expected, the cytotoxic granules-dependent AICD was abolished in T cells from Rab27a- or perforin-deficient patients that exhibited defective granules-dependent cytotoxicity. Supporting an in-vivo relevance of the cytotoxic granules-dependent AICD in ALPS patients, we detected increased number of circulating T lymphocytes expressing granzymes A and B. Altogether, these data indicated that the cytotoxic granules-dependent cell-death in ALPS may compensate for Fas-deficiency in T lymphocytes. Furthermore, they identified a novel AICD pathway as a unique alternative to Fas apoptosis in human peripheral T-lymphocytes.
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