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Blood, 26 March 2009, Vol. 113, No. 13, pp. 3027-3030.
Prepublished online as a Blood First Edition Paper on January 27, 2009; DOI 10.1182/blood-2008-09-179630.
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Submitted September 18, 2008
Accepted December 21, 2008
FAS-L, IL-10, and double-negative CD4-CD8-TCR alpha/beta+ T cells are reliable markers of ALPS associated with FAS loss of function
Aude Magerus-Chatinet, Marie-Claude Stolzenberg, Maria S. Loffredo, Benedicte Neven, Catherine Schaffner, Nicolas Ducrot, Peter D. Arkwright, Brigitte Bader-Meunier, Jose Barbot, Stephane Blanche, Jean-Laurent Casanova, Marianne Debre, Alina Ferster, Claire Fieschi, Benoit Florkin, Claire Galambrun, Olivier Hermine, Olivier Lambotte, Eric Solary, Caroline Thomas, Francoise Le Deist, Capucine Picard, Alain Fischer, and Frederic Rieux-Laucat*
Inserm, U768, Paris, France
Universite Paris Descartes, Paris, France
Department of Pediatrics, School of Medicine, University of Bari, Bari, Italy
Hopital Necker-Enfants Malades, Paris, France
Department of Pediatric Immunology, Newcastle General Hospital, Newcastle upon Tyne, United Kingdom
Unite d'Immunologie et d'Hematologie Pediatrique, Paris, France
Service d'Hematologie, Hopital de Criancas Maria Pia, Porto, Portugal
Assistance Publique des Hopitaux de Paris, Paris, France
Inserm U550, Paris, France
Hopital Universitaire des Enfants-Reine Fabiola, Bruxelles, Belgium
Unite d'immunopathologie, Departement d'Immunologie Clinique, Hopital Saint-Louis, Paris, France
Departement de Pediatrie, Centre Hospitalier Universitaire de Liege, Liege, Belgium
Service d'hematologie pediatrique, Hopital des enfants de la Timone, Marseille, France
CNRS UMR 8147, Service d'hematologie et centre de reference des mastocytoses, Paris, France
Service de Medecine Interne, Hopital de Bicetre, Le Kremlin-Bicetre, France
UMR 866, Faculte de Medecine, Dijon, France
Service d'Oncologie Pediatrique, Hopital Mere Enfant, Nantes, France
Department of Microbiology and Immunology, CHU Sainte-Justine, University of Montreal, Montreal, Canada
Centre d'Etude des Deficits Immunitaires, Paris, France
* Corresponding author; email: frederic.rieux-laucat{at}inserm.fr.
Autoimmune lymphoproliferative syndrome (ALPS) is characterized by splenomegaly, lymphadenopathy, hypergammaglobulinemia, accumulation of double-negative TCR +CD4-CD8- T cells (DNT cells) and autoimmunity. Previously, DNT cells detection and a functional defect of T cells in a FAS-induced apoptosis test in vitro have been used for ALPS diagnosis. However, a functional defect can also be detected in mutation-positive relatives (MPRs) who remain free of any ALPS-related disease. In contrast, lymphocytes from patients carrying a somatic mutation of FAS exhibit normal sensitivity to FAS-induced apoptosis in vitro. We assessed the soluble FAS-L concentration in the plasma of ALPS patients carrying FAS mutations. Overall, we showed that determination of the FAS-L represents, together with the IL-10 concentration and the DNT cells percentage, a reliable tool for the diagnosis of ALPS.

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