[HTML][HTML] A novel immunodeficiency associated with hypomorphic RAG1 mutations and CMV infection

JP De Villartay, A Lim, H Al-Mousa… - The Journal of …, 2005 - Am Soc Clin Investig
JP De Villartay, A Lim, H Al-Mousa, S Dupont, J Déchanet-Merville, E Coumau-Gatbois…
The Journal of clinical investigation, 2005Am Soc Clin Investig
Amorphic mutations in the recombination activating genes RAG1 and RAG2 have been
reported to cause T–B–SCID, whereas hypomorphic mutations led to the expansion of a few
autoimmune T cell clones responsible for the Omenn syndrome phenotype. We report here
a novel clinical and immunological phenotype associated with recessive RAG1
hypomorphic mutations in 4 patients from 4 different families. The immunological phenotype
consists of the oligoclonal expansion of TCRγδ T cells combined with TCRαβ T cell …
Amorphic mutations in the recombination activating genes RAG1 and RAG2 have been reported to cause TB SCID, whereas hypomorphic mutations led to the expansion of a few autoimmune T cell clones responsible for the Omenn syndrome phenotype. We report here a novel clinical and immunological phenotype associated with recessive RAG1 hypomorphic mutations in 4 patients from 4 different families. The immunological phenotype consists of the oligoclonal expansion of TCRγδ T cells combined with TCRαβ T cell lymphopenia. The clinical phenotype consists of severe, disseminated CMV infection and autoimmune blood cell manifestations. Repertoire studies suggest that CMV infection, in the setting of this particular T cell immunodeficiency, may have driven the TCRγδ T cell clonal expansion. This observation extends the range of clinical and immunological phenotypes associated with RAG mutations, emphasizing the role of the genetic background and microbial environment in determining disease phenotype.
The Journal of Clinical Investigation