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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.
Submitted June 18, 2007
Division of Immunology, Children's Hospital Boston, Harvard Medical School, Boston, MA, United States * 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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