Primary B cell immunodeficiencies: comparisons and contrasts

ME Conley, AK Dobbs, DM Farmer… - Annual review of …, 2009 - annualreviews.org
ME Conley, AK Dobbs, DM Farmer, S Kilic, K Paris, S Grigoriadou, E Coustan-Smith…
Annual review of immunology, 2009annualreviews.org
Sophisticated genetic tools have made possible the identification of the genes responsible
for most well-described immunodeficiencies in the past 15 years. Mutations in Btk,
components of the pre-B cell and B cell receptor (λ5, Igα, Igβ), or the scaffold protein BLNK
account for approximately 90% of patients with defects in early B cell development. Hyper-
IgM syndromes result from mutations in CD40 ligand, CD40, AID, or UNG in 70–80% of
affected patients. Rare defects in ICOS or CD19 can result in a clinical picture that is …
Sophisticated genetic tools have made possible the identification of the genes responsible for most well-described immunodeficiencies in the past 15 years. Mutations in Btk, components of the pre-B cell and B cell receptor (λ5, Igα, Igβ), or the scaffold protein BLNK account for approximately 90% of patients with defects in early B cell development. Hyper-IgM syndromes result from mutations in CD40 ligand, CD40, AID, or UNG in 70–80% of affected patients. Rare defects in ICOS or CD19 can result in a clinical picture that is consistent with common variable immunodeficiency, and as many as 10% of patients with this disorder have heterozygous amino acid substitutions in TACI. For all these disorders, there is considerable clinical heterogeneity in patients with the same mutation. Identifying the genetic and environmental factors that influence the clinical phenotype may enhance patient care and our understanding of normal B cell development.
Annual Reviews