Combined immunodeficiency and Epstein-Barr virus–induced B cell malignancy in humans with inherited CD70 deficiency

H Abolhassani, ESJ Edwards, A Ikinciogullari… - Journal of Experimental …, 2017 - rupress.org
H Abolhassani, ESJ Edwards, A Ikinciogullari, H Jing, S Borte, M Buggert, L Du
Journal of Experimental Medicine, 2017rupress.org
In this study, we describe four patients from two unrelated families of different ethnicities with
a primary immunodeficiency, predominantly manifesting as susceptibility to Epstein-Barr
virus (EBV)–related diseases. Three patients presented with EBV-associated Hodgkin's
lymphoma and hypogammaglobulinemia; one also had severe varicella infection. The fourth
had viral encephalitis during infancy. Homozygous frameshift or in-frame deletions in CD70
in these patients abolished either CD70 surface expression or binding to its cognate …
In this study, we describe four patients from two unrelated families of different ethnicities with a primary immunodeficiency, predominantly manifesting as susceptibility to Epstein-Barr virus (EBV)–related diseases. Three patients presented with EBV-associated Hodgkin’s lymphoma and hypogammaglobulinemia; one also had severe varicella infection. The fourth had viral encephalitis during infancy. Homozygous frameshift or in-frame deletions in CD70 in these patients abolished either CD70 surface expression or binding to its cognate receptor CD27. Blood lymphocyte numbers were normal, but the proportions of memory B cells and EBV-specific effector memory CD8+ T cells were reduced. Furthermore, although T cell proliferation was normal, in vitro–generated EBV-specific cytotoxic T cell activity was reduced because of CD70 deficiency. This reflected impaired activation by, rather than effects during killing of, EBV-transformed B cells. Notably, expression of 2B4 and NKG2D, receptors implicated in controlling EBV infection, on memory CD8+ T cells from CD70-deficient individuals was reduced, consistent with their impaired killing of EBV-infected cells. Thus, autosomal recessive CD70 deficiency is a novel cause of combined immunodeficiency and EBV-associated diseases, reminiscent of inherited CD27 deficiency. Overall, human CD70–CD27 interactions therefore play a nonredundant role in T and B cell–mediated immunity, especially for protection against EBV and humoral immunity.
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