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Blood, 1 January 2008, Vol. 111, No. 1, pp. 271-274.
Prepublished online as a Blood First Edition Paper on September 21, 2007; DOI 10.1182/blood-2007-06-096487.


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Submitted June 18, 2007
Accepted September 19, 2007

Lack of iNKT cells in patients with combined immune deficiency due to hypomorphic RAG mutations

Ponpan Matangkasombut, Muriel Pichavant, Doris E Saez, Silvia Giliani, Evelina Mazzolari, Andrea Finocchi, Anna Villa, Cristina Sobacchi, Patricia Cortes, Dale T Umetsu, and Luigi D. Notarangelo*

Division of Immunology, Children's Hospital Boston, Harvard Medical School, Boston, MA, United States
Immunology Institute, Department of Medicine, Mount Sinai School of Medicine, New York, NY, United States
Department of Pediatrics, and "Angelo Nocivelli" Institute for Molecular Medicine, University of Brescia, Brescia, Italy
Department of Pediatrics, Tor Vergata University, Rome, Italy
Istituto Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Milan, Italy
Istituto Clinico Humanitas, Milan, Italy

* Corresponding author; email: luigi.notarangelo{at}childrens.harvard.edu.

Hypomorphic mutations of the RAG genes in humans are associated with a spectrum of clinical and immunological presentations that range from T- B- Severe Combined Immune Deficiency (SCID) to Omenn syndrome. In most cases, residual V(D)J recombination activity allows for development of few T cell clones, that expand in the periphery and infiltrate target organs, resulting in tissue damage. Invariant Natural Killer T (iNKT) cells play an important immunoregulatory role and have been associated with protection against autoimmunity. We now report on five unrelated cases of combined immune deficiency due to hypomorphic RAG mutations, and demonstrate the absence of iNKT cells in all five patients. These findings suggest that lack of this important immunoregulatory cell population may contribute to the pathophysiology of Omenn syndrome.


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