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  • Hypomorphic Janus kinase 3 ...
    Cattaneo, Federica, MD; Recher, Mike, MD; Masneri, Stefania, MS; Baxi, Sachin N., MD; Fiorini, Claudia, PhD; Antonelli, Francesca, BS; Wysocki, Christian A., MD, PhD; Calderon, Jose G., MD; Eibel, Hermann, PhD; Smith, Angela R., MD, MS; Bonilla, Francisco A., MD, PhD; Tsitsikov, Erdyni, PhD; Giliani, Silvia, PhD; Notarangelo, Luigi D., MD; Pai, Sung-Yun, MD

    Journal of allergy and clinical immunology, 04/2013, Letnik: 131, Številka: 4
    Journal Article

    Background Mutations in Janus kinase 3 (JAK3) are a cause of severe combined immunodeficiency, but hypomorphic JAK3 defects can result in a milder clinical phenotype, with residual development and function of autologous T cells. Maternal T-cell engraftment is a common finding in infants with severe combined immunodeficiency but is not typically observed in patients with residual T-cell development. Objective We sought to study in detail the molecular, cellular, and humoral immune phenotype and function of 3 patients with hypomorphic JAK3 mutations. Methods We analyzed the distribution and function of T and B lymphocytes in 3 patients and studied the in vitro and in vivo responses of maternal T lymphocytes in 1 patient with maternal T-cell engraftment and residual production of autologous T lymphocytes. Results B cells were present in normal numbers but with abnormal distribution of marginal zone–like and memory B cells. B-cell differentiation to plasmablasts in vitro in response to CD40 ligand and IL-21 was abolished. In 2 patients the T-cell repertoire was moderately restricted. Surprisingly, 1 patient showed coexistence of maternal and autologous T lymphocytes. By using an mAb recognizing the maternal noninherited HLA-A2 antigen, we found that autologous cells progressively accumulated in vivo but did not compete with maternal cells in vitro. Conclusion The study of 3 patients with hypomorphic JAK3 mutations suggests that terminal B-cell maturation/differentiation requires intact JAK3 function, even if partially functioning T lymphocytes are present. Maternal T-cell engraftment can occur in patients with JAK3 mutations despite the presence of autologous T cells.