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Published in: European Journal of Pediatrics 5/2011

Open Access 01-05-2011 | Review

Educational paper

The expanding clinical and immunological spectrum of severe combined immunodeficiency

Authors: Mirjam van der Burg, Andy R. Gennery

Published in: European Journal of Pediatrics | Issue 5/2011

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Abstract

Severe combined immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency characterized by absence of functional T lymphocytes. It is a paediatric emergency, which is life-threatening when recognized too late. The clinical presentation varies from the classical form of SCID through atypical SCID to Omenn syndrome. In addition, there is a considerable immunological variation, which can hamper the diagnosis. In this educational review, we describe the immunopathological background, clinical presentations and diagnostic process of SCID, as well as the therapeutic possibilities.
Literature
1.
go back to reference Aiuti A, Cattaneo F, Galimberti S, Benninghoff U, Cassani B, Callegaro L, Scaramuzza S, Andolfi G, Mirolo M, Brigida I, Tabucchi A, Carlucci F, Eibl M, Aker M, Slavin S, Al-Mousa H, Al Ghonaium A, Ferster A, Duppenthaler A, Notarangelo L, Wintergerst U, Buckley RH, Bregni M, Marktel S, Valsecchi MG, Rossi P, Ciceri F, Miniero R, Bordignon C, Roncarolo MG (2009) Gene therapy for immunodeficiency due to adenosine deaminase deficiency. N Engl J Med 360:447–458PubMedCrossRef Aiuti A, Cattaneo F, Galimberti S, Benninghoff U, Cassani B, Callegaro L, Scaramuzza S, Andolfi G, Mirolo M, Brigida I, Tabucchi A, Carlucci F, Eibl M, Aker M, Slavin S, Al-Mousa H, Al Ghonaium A, Ferster A, Duppenthaler A, Notarangelo L, Wintergerst U, Buckley RH, Bregni M, Marktel S, Valsecchi MG, Rossi P, Ciceri F, Miniero R, Bordignon C, Roncarolo MG (2009) Gene therapy for immunodeficiency due to adenosine deaminase deficiency. N Engl J Med 360:447–458PubMedCrossRef
2.
go back to reference Appleton AL, Curtis A, Wilkes J, Cant AJ (1994) Differentiation of materno-fetal GVHD from Omenn’s syndrome in pre-BMT patients with severe combined immunodeficiency. Bone Marrow Transplant 14:157–159PubMed Appleton AL, Curtis A, Wilkes J, Cant AJ (1994) Differentiation of materno-fetal GVHD from Omenn’s syndrome in pre-BMT patients with severe combined immunodeficiency. Bone Marrow Transplant 14:157–159PubMed
3.
go back to reference Benke PJ, Dittmar D (1976) Purine dysfunction in cells from patients with adenosine deaminase deficiency. Pediatr Res 10:642–646PubMed Benke PJ, Dittmar D (1976) Purine dysfunction in cells from patients with adenosine deaminase deficiency. Pediatr Res 10:642–646PubMed
4.
go back to reference Berrington JE, Flood TJ, Abinun M, Galloway A, Cant AJ (2000) Unsuspected Pneumocystis carinii pneumonia at presentation of severe primary immunodeficiency. Arch Dis Child 82:144–147PubMedCrossRef Berrington JE, Flood TJ, Abinun M, Galloway A, Cant AJ (2000) Unsuspected Pneumocystis carinii pneumonia at presentation of severe primary immunodeficiency. Arch Dis Child 82:144–147PubMedCrossRef
5.
go back to reference Bertrand Y, Muller SM, Casanova JL, Morgan G, Fischer A, Friedrich W (2002) Reticular dysgenesis: HLA non-identical bone marrow transplants in a series of 10 patients. Bone Marrow Transplant 29:759–762PubMedCrossRef Bertrand Y, Muller SM, Casanova JL, Morgan G, Fischer A, Friedrich W (2002) Reticular dysgenesis: HLA non-identical bone marrow transplants in a series of 10 patients. Bone Marrow Transplant 29:759–762PubMedCrossRef
6.
go back to reference Blaese RM, Culver KW, Miller AD, Carter CS, Fleisher T, Clerici M, Shearer G, Chang L, Chiang Y, Tolstoshev P, Greenblatt JJ, Rosenberg SA, Klein H, Berger M, Mullen CA, Ramsey WJ, Muul L, Morgan RA, Anderson WF (1995) T lymphocyte-directed gene therapy for ADA- SCID: initial trial results after 4 years. Science 270:475–480PubMedCrossRef Blaese RM, Culver KW, Miller AD, Carter CS, Fleisher T, Clerici M, Shearer G, Chang L, Chiang Y, Tolstoshev P, Greenblatt JJ, Rosenberg SA, Klein H, Berger M, Mullen CA, Ramsey WJ, Muul L, Morgan RA, Anderson WF (1995) T lymphocyte-directed gene therapy for ADA- SCID: initial trial results after 4 years. Science 270:475–480PubMedCrossRef
7.
go back to reference Borghans JA, Bredius RG, Hazenberg MD, Roelofs H, Jol-van der Zijde EC, Heidt J, Otto SA, Kuijpers TW, Fibbe WE, Vossen JM, Miedema F, van Tol MJ (2006) Early determinants of long-term T-cell reconstitution after hematopoietic stem cell transplantation for severe combined immunodeficiency. Blood 108:763–769PubMedCrossRef Borghans JA, Bredius RG, Hazenberg MD, Roelofs H, Jol-van der Zijde EC, Heidt J, Otto SA, Kuijpers TW, Fibbe WE, Vossen JM, Miedema F, van Tol MJ (2006) Early determinants of long-term T-cell reconstitution after hematopoietic stem cell transplantation for severe combined immunodeficiency. Blood 108:763–769PubMedCrossRef
8.
go back to reference Brown L, Xu-Bayford J, Allwood Z, Slatter M, Cant A, Davies EG, Veys P, Gennery AR, Gaspar HB (2011) Neonatal diagnosis of severe combined immunodeficiency leads to significantly improved survival outcome: the case for newborn screening. Blood 117(11):3243–3246PubMedCrossRef Brown L, Xu-Bayford J, Allwood Z, Slatter M, Cant A, Davies EG, Veys P, Gennery AR, Gaspar HB (2011) Neonatal diagnosis of severe combined immunodeficiency leads to significantly improved survival outcome: the case for newborn screening. Blood 117(11):3243–3246PubMedCrossRef
9.
go back to reference Buck D, Malivert L, de Chasseval R, Barraud A, Fondaneche MC, Sanal O, Plebani A, Stephan JL, Hufnagel M, le Deist F, Fischer A, Durandy A, de Villartay JP, Revy P (2006) Cernunnos, a novel nonhomologous end-joining factor, is mutated in human immunodeficiency with microcephaly. Cell 124:287–299PubMedCrossRef Buck D, Malivert L, de Chasseval R, Barraud A, Fondaneche MC, Sanal O, Plebani A, Stephan JL, Hufnagel M, le Deist F, Fischer A, Durandy A, de Villartay JP, Revy P (2006) Cernunnos, a novel nonhomologous end-joining factor, is mutated in human immunodeficiency with microcephaly. Cell 124:287–299PubMedCrossRef
10.
go back to reference Cavazzana-Calvo M, Carlier F, Le Deist F, Morillon E, Taupin P, Gautier D, Radford-Weiss I, Caillat-Zucman S, Neven B, Blanche S, Cheynier R, Fischer A, Hacein-Bey-Abina S (2007) Long-term T-cell reconstitution after hematopoietic stem-cell transplantation in primary T-cell-immunodeficient patients is associated with myeloid chimerism and possibly the primary disease phenotype. Blood 109:4575–4581PubMedCrossRef Cavazzana-Calvo M, Carlier F, Le Deist F, Morillon E, Taupin P, Gautier D, Radford-Weiss I, Caillat-Zucman S, Neven B, Blanche S, Cheynier R, Fischer A, Hacein-Bey-Abina S (2007) Long-term T-cell reconstitution after hematopoietic stem-cell transplantation in primary T-cell-immunodeficient patients is associated with myeloid chimerism and possibly the primary disease phenotype. Blood 109:4575–4581PubMedCrossRef
11.
go back to reference Cavazzana-Calvo M, Hacein-Bey S, de Saint BG, Gross F, Yvon E, Nusbaum P, Selz F, Hue C, Certain S, Casanova JL, Bousso P, Deist FL, Fischer A (2000) Gene therapy of human severe combined immunodeficiency (SCID)-X1 disease. Science 288:669–672PubMedCrossRef Cavazzana-Calvo M, Hacein-Bey S, de Saint BG, Gross F, Yvon E, Nusbaum P, Selz F, Hue C, Certain S, Casanova JL, Bousso P, Deist FL, Fischer A (2000) Gene therapy of human severe combined immunodeficiency (SCID)-X1 disease. Science 288:669–672PubMedCrossRef
12.
go back to reference Cohen A, Doyle D, Martin DW Jr, Ammann AJ (1976) Abnormal purine metabolism and purine overproduction in a patient deficient in purine nucleoside phosphorylase. N Engl J Med 295:1449–1454PubMedCrossRef Cohen A, Doyle D, Martin DW Jr, Ammann AJ (1976) Abnormal purine metabolism and purine overproduction in a patient deficient in purine nucleoside phosphorylase. N Engl J Med 295:1449–1454PubMedCrossRef
13.
go back to reference Comans-Bitter WM, De Groot R, Van den Beemd R, Neijens HJ, Hop WCJ, Groeneveld K, Hooijkaas H, Van Dongen JJM (1997) Immunophenotyping of blood lymphocytes in childhood. J Pediatr 130:388–393PubMedCrossRef Comans-Bitter WM, De Groot R, Van den Beemd R, Neijens HJ, Hop WCJ, Groeneveld K, Hooijkaas H, Van Dongen JJM (1997) Immunophenotyping of blood lymphocytes in childhood. J Pediatr 130:388–393PubMedCrossRef
14.
go back to reference de Saint-Basile G, Le Deist F, de Villartay JP, Cerf-Bensussan N, Journet O, Brousse N, Griscelli C, Fischer A (1991) Restricted heterogeneity of T lymphocytes in combined immunodeficiency with hypereosinophilia (Omenn’s syndrome). J Clin Invest 87:1352–1359PubMedCrossRef de Saint-Basile G, Le Deist F, de Villartay JP, Cerf-Bensussan N, Journet O, Brousse N, Griscelli C, Fischer A (1991) Restricted heterogeneity of T lymphocytes in combined immunodeficiency with hypereosinophilia (Omenn’s syndrome). J Clin Invest 87:1352–1359PubMedCrossRef
16.
go back to reference de Villartay JP, Lim A, Al-Mousa H, Dupont S, Dechanet-Merville J, Coumau-Gatbois E, Gougeon ML, Lemainque A, Eidenschenk C, Jouanguy E, Abel L, Casanova JL, Fischer A, Le Deist F (2005) A novel immunodeficiency associated with hypomorphic RAG1 mutations and CMV infection. J Clin Invest 115:3291–3299PubMedCrossRef de Villartay JP, Lim A, Al-Mousa H, Dupont S, Dechanet-Merville J, Coumau-Gatbois E, Gougeon ML, Lemainque A, Eidenschenk C, Jouanguy E, Abel L, Casanova JL, Fischer A, Le Deist F (2005) A novel immunodeficiency associated with hypomorphic RAG1 mutations and CMV infection. J Clin Invest 115:3291–3299PubMedCrossRef
17.
go back to reference De Vries E (2006) Patient-centred screening for primary immunodeficiency: a multi-stage diagnostic protocol designed for non-immunologists. Clin Exp Immunol 145:204–214PubMedCrossRef De Vries E (2006) Patient-centred screening for primary immunodeficiency: a multi-stage diagnostic protocol designed for non-immunologists. Clin Exp Immunol 145:204–214PubMedCrossRef
18.
go back to reference de Vries E, Driessen G (2011) Educational paper: primary immunodeficiencies in children: a diagnostic challenge. Eur J Pediatr 170:169–177PubMedCrossRef de Vries E, Driessen G (2011) Educational paper: primary immunodeficiencies in children: a diagnostic challenge. Eur J Pediatr 170:169–177PubMedCrossRef
19.
go back to reference Ehl S, Schwarz K, Enders A, Duffner U, Pannicke U, Kuhr J, Mascart F, Schmitt-Graeff A, Niemeyer C, Fisch P (2005) A variant of SCID with specific immune responses and predominance of gamma delta T cells. J Clin Invest 115:3140–3148PubMedCrossRef Ehl S, Schwarz K, Enders A, Duffner U, Pannicke U, Kuhr J, Mascart F, Schmitt-Graeff A, Niemeyer C, Fisch P (2005) A variant of SCID with specific immune responses and predominance of gamma delta T cells. J Clin Invest 115:3140–3148PubMedCrossRef
20.
21.
go back to reference Fischer A, de Saint BG, Le Deist F (2005) CD3 deficiencies. Curr Opin Allergy Clin Immunol 5:491–495PubMedCrossRef Fischer A, de Saint BG, Le Deist F (2005) CD3 deficiencies. Curr Opin Allergy Clin Immunol 5:491–495PubMedCrossRef
22.
go back to reference Gaspar HB, Bjorkegren E, Parsley K, Gilmour KC, King D, Sinclair J, Zhang F, Giannakopoulos A, Adams S, Fairbanks LD, Gaspar J, Henderson L, Xu-Bayford JH, Davies EG, Veys PA, Kinnon C, Thrasher AJ (2006) Successful reconstitution of immunity in ADA-SCID by stem cell gene therapy following cessation of PEG-ADA and use of mild preconditioning. Mol Ther 14:505–513PubMedCrossRef Gaspar HB, Bjorkegren E, Parsley K, Gilmour KC, King D, Sinclair J, Zhang F, Giannakopoulos A, Adams S, Fairbanks LD, Gaspar J, Henderson L, Xu-Bayford JH, Davies EG, Veys PA, Kinnon C, Thrasher AJ (2006) Successful reconstitution of immunity in ADA-SCID by stem cell gene therapy following cessation of PEG-ADA and use of mild preconditioning. Mol Ther 14:505–513PubMedCrossRef
23.
go back to reference Gaspar HB, Gilmour KC, Jones AM (2001) Severe combined immunodeficiency—molecular pathogenesis and diagnosis. Arch Dis Child 84:169–173PubMedCrossRef Gaspar HB, Gilmour KC, Jones AM (2001) Severe combined immunodeficiency—molecular pathogenesis and diagnosis. Arch Dis Child 84:169–173PubMedCrossRef
24.
go back to reference Gennery AR, Slatter MA, Grandin L, Taupin P, Cant AJ, Veys P, Amrolia PJ, Gaspar HB, Davies EG, Friedrich W, Hoenig M, Notarangelo LD, Mazzolari E, Porta F, Bredius RG, Lankester AC, Wulffraat NM, Seger R, Gungor T, Fasth A, Sedlacek P, Neven B, Blanche S, Fischer A, Cavazzana-Calvo M, Landais P (2010) Transplantation of hematopoietic stem cells and long-term survival for primary immunodeficiencies in Europe: entering a new century, do we do better? J Allergy Clin Immunol 126(602–610):e601–e611 Gennery AR, Slatter MA, Grandin L, Taupin P, Cant AJ, Veys P, Amrolia PJ, Gaspar HB, Davies EG, Friedrich W, Hoenig M, Notarangelo LD, Mazzolari E, Porta F, Bredius RG, Lankester AC, Wulffraat NM, Seger R, Gungor T, Fasth A, Sedlacek P, Neven B, Blanche S, Fischer A, Cavazzana-Calvo M, Landais P (2010) Transplantation of hematopoietic stem cells and long-term survival for primary immunodeficiencies in Europe: entering a new century, do we do better? J Allergy Clin Immunol 126(602–610):e601–e611
25.
go back to reference Gilmour KC, Cranston T, Loughlin S, Gwyther J, Lester T, Espanol T, Hernandez M, Savoldi G, Davies EG, Abinun M, Kinnon C, Jones A, Gaspar HB (2001) Rapid protein-based assays for the diagnosis of T-B+ severe combined immunodeficiency. Br J Haematol 112:671–676PubMedCrossRef Gilmour KC, Cranston T, Loughlin S, Gwyther J, Lester T, Espanol T, Hernandez M, Savoldi G, Davies EG, Abinun M, Kinnon C, Jones A, Gaspar HB (2001) Rapid protein-based assays for the diagnosis of T-B+ severe combined immunodeficiency. Br J Haematol 112:671–676PubMedCrossRef
26.
go back to reference Girard PM, Kysela B, Harer CJ, Doherty AJ, Jeggo PA (2004) Analysis of DNA ligase IV mutations found in LIG4 syndrome patients: the impact of two linked polymorphisms. Hum Mol Genet 13:2369–2376PubMedCrossRef Girard PM, Kysela B, Harer CJ, Doherty AJ, Jeggo PA (2004) Analysis of DNA ligase IV mutations found in LIG4 syndrome patients: the impact of two linked polymorphisms. Hum Mol Genet 13:2369–2376PubMedCrossRef
27.
go back to reference Hacein-Bey-Abina S, Von Kalle C, Schmidt M, McCormack MP, Wulffraat N, Leboulch P, Lim A, Osborne CS, Pawliuk R, Morillon E, Sorensen R, Forster A, Fraser P, Cohen JI, de Saint BG, Alexander I, Wintergerst U, Frebourg T, Aurias A, Stoppa-Lyonnet D, Romana S, Radford-Weiss I, Gross F, Valensi F, Delabesse E, Macintyre E, Sigaux F, Soulier J, Leiva LE, Wissler M, Prinz C, Rabbitts TH, Le Deist F, Fischer A, Cavazzana-Calvo M (2003) LMO2-associated clonal T cell proliferation in two patients after gene therapy for SCID-X1. Science 302:415–419PubMedCrossRef Hacein-Bey-Abina S, Von Kalle C, Schmidt M, McCormack MP, Wulffraat N, Leboulch P, Lim A, Osborne CS, Pawliuk R, Morillon E, Sorensen R, Forster A, Fraser P, Cohen JI, de Saint BG, Alexander I, Wintergerst U, Frebourg T, Aurias A, Stoppa-Lyonnet D, Romana S, Radford-Weiss I, Gross F, Valensi F, Delabesse E, Macintyre E, Sigaux F, Soulier J, Leiva LE, Wissler M, Prinz C, Rabbitts TH, Le Deist F, Fischer A, Cavazzana-Calvo M (2003) LMO2-associated clonal T cell proliferation in two patients after gene therapy for SCID-X1. Science 302:415–419PubMedCrossRef
28.
go back to reference Hague RA, Rassam S, Morgan G, Cant AJ (1994) Early diagnosis of severe combined immunodeficiency syndrome. Arch Dis Child 70:260–263PubMedCrossRef Hague RA, Rassam S, Morgan G, Cant AJ (1994) Early diagnosis of severe combined immunodeficiency syndrome. Arch Dis Child 70:260–263PubMedCrossRef
29.
go back to reference Hershfield MS (1993) Enzyme replacement therapy of adenosine deaminase deficiency with polyethylene glycol-modified adenosine deaminase (PEG-ADA). Immunodeficiency 4:93–97PubMed Hershfield MS (1993) Enzyme replacement therapy of adenosine deaminase deficiency with polyethylene glycol-modified adenosine deaminase (PEG-ADA). Immunodeficiency 4:93–97PubMed
30.
go back to reference IJspeert H, Lankester AC, Van den Berg JM, Wiegant W, Van Zelm MC, Weemaes CMR, Warris A, Pan-Hammarström Q, Pastink A, Van Tol MJD, Van Dongen JJM, Van Gent DC, Van der Burg M (2011) Artemis splice defects cause atypical SCID and can be restored in vitro by an antisense oligonucleotide. Genes Immun (in press) IJspeert H, Lankester AC, Van den Berg JM, Wiegant W, Van Zelm MC, Weemaes CMR, Warris A, Pan-Hammarström Q, Pastink A, Van Tol MJD, Van Dongen JJM, Van Gent DC, Van der Burg M (2011) Artemis splice defects cause atypical SCID and can be restored in vitro by an antisense oligonucleotide. Genes Immun (in press)
31.
go back to reference Kovanen PE, Leonard WJ (2004) Cytokines and immunodeficiency diseases: critical roles of the gamma(c)-dependent cytokines interleukins 2, 4, 7, 9, 15, and 21, and their signaling pathways. Immunol Rev 202:67–83PubMedCrossRef Kovanen PE, Leonard WJ (2004) Cytokines and immunodeficiency diseases: critical roles of the gamma(c)-dependent cytokines interleukins 2, 4, 7, 9, 15, and 21, and their signaling pathways. Immunol Rev 202:67–83PubMedCrossRef
32.
go back to reference Kumaki S, Villa A, Asada H, Kawai S, Ohashi Y, Takahashi M, Hakozaki I, Nitanai E, Minegishi M, Tsuchiya S (2001) Identification of anti-herpes simplex virus antibody-producing B cells in a patient with an atypical RAG1 immunodeficiency. Blood 98:1464–1468PubMedCrossRef Kumaki S, Villa A, Asada H, Kawai S, Ohashi Y, Takahashi M, Hakozaki I, Nitanai E, Minegishi M, Tsuchiya S (2001) Identification of anti-herpes simplex virus antibody-producing B cells in a patient with an atypical RAG1 immunodeficiency. Blood 98:1464–1468PubMedCrossRef
33.
go back to reference Laffort C, Le Deist F, Favre M, Caillat-Zucman S, Radford-Weiss I, Debre M, Fraitag S, Blanche S, Cavazzana-Calvo M, de Saint BG, de Villartay JP, Giliani S, Orth G, Casanova JL, Bodemer C, Fischer A (2004) Severe cutaneous papillomavirus disease after haemopoietic stem-cell transplantation in patients with severe combined immune deficiency caused by common gammac cytokine receptor subunit or JAK-3 deficiency. Lancet 363:2051–2054PubMedCrossRef Laffort C, Le Deist F, Favre M, Caillat-Zucman S, Radford-Weiss I, Debre M, Fraitag S, Blanche S, Cavazzana-Calvo M, de Saint BG, de Villartay JP, Giliani S, Orth G, Casanova JL, Bodemer C, Fischer A (2004) Severe cutaneous papillomavirus disease after haemopoietic stem-cell transplantation in patients with severe combined immune deficiency caused by common gammac cytokine receptor subunit or JAK-3 deficiency. Lancet 363:2051–2054PubMedCrossRef
34.
go back to reference Langerak AW, Szczepanski T, van der Burg M, Wolvers-Tettero ILM, van Dongen JJM (1997) Heteroduplex PCR analysis of rearranged T cell receptor genes for clonality assessment in suspect T cell proliferations. Leukemia 11:2192–2199PubMedCrossRef Langerak AW, Szczepanski T, van der Burg M, Wolvers-Tettero ILM, van Dongen JJM (1997) Heteroduplex PCR analysis of rearranged T cell receptor genes for clonality assessment in suspect T cell proliferations. Leukemia 11:2192–2199PubMedCrossRef
35.
go back to reference Langerak AW, van Den Beemd R, Wolvers-Tettero IL, Boor PP, van Lochem EG, Hooijkaas H, van Dongen JJ (2001) Molecular and flow cytometric analysis of the Vbeta repertoire for clonality assessment in mature TCRalphabeta T-cell proliferations. Blood 98:165–173PubMedCrossRef Langerak AW, van Den Beemd R, Wolvers-Tettero IL, Boor PP, van Lochem EG, Hooijkaas H, van Dongen JJ (2001) Molecular and flow cytometric analysis of the Vbeta repertoire for clonality assessment in mature TCRalphabeta T-cell proliferations. Blood 98:165–173PubMedCrossRef
36.
go back to reference Leonard WJ, Lin JX (2000) Cytokine receptor signaling pathways. J Allergy Clin Immunol 105:877–888PubMedCrossRef Leonard WJ, Lin JX (2000) Cytokine receptor signaling pathways. J Allergy Clin Immunol 105:877–888PubMedCrossRef
37.
go back to reference Lin JX, Leonard WJ (2000) The role of Stat5a and Stat5b in signaling by IL-2 family cytokines. Oncogene 19:2566–2576PubMedCrossRef Lin JX, Leonard WJ (2000) The role of Stat5a and Stat5b in signaling by IL-2 family cytokines. Oncogene 19:2566–2576PubMedCrossRef
38.
go back to reference Macchi P, Villa A, Giliani S, Sacco MG, Frattini A, Porta F, Ugazio AG, Johnston JA, Candotti F, O’Shea JJ, Vezzoni P, Notarangelo LD (1995) Mutations of Jak-3 gene in patients with autosomal severe combined immune deficiency (SCID). Nature 377:65–68PubMedCrossRef Macchi P, Villa A, Giliani S, Sacco MG, Frattini A, Porta F, Ugazio AG, Johnston JA, Candotti F, O’Shea JJ, Vezzoni P, Notarangelo LD (1995) Mutations of Jak-3 gene in patients with autosomal severe combined immune deficiency (SCID). Nature 377:65–68PubMedCrossRef
39.
go back to reference Mazzolari E, de Martiis D, Forino C, Lanfranchi A, Giliani S, Marzollo R, Airo P, Imberti L, Porta F, Notarangelo LD (2009) Single-center analysis of long-term outcome after hematopoietic cell transplantation in children with congenital severe T cell immunodeficiency. Immunol Res 44:4–17PubMedCrossRef Mazzolari E, de Martiis D, Forino C, Lanfranchi A, Giliani S, Marzollo R, Airo P, Imberti L, Porta F, Notarangelo LD (2009) Single-center analysis of long-term outcome after hematopoietic cell transplantation in children with congenital severe T cell immunodeficiency. Immunol Res 44:4–17PubMedCrossRef
40.
go back to reference Moshous D, Callebaut I, de Chasseval R, Corneo B, Cavazzana-Calvo M, Le Deist F, Tezcan I, Sanal O, Bertrand Y, Philippe N, Fischer A, de Villartay JP (2001) Artemis, a novel DNA double-strand break repair/V(D)J recombination protein, is mutated in human severe combined immune deficiency. Cell 105:177–186PubMedCrossRef Moshous D, Callebaut I, de Chasseval R, Corneo B, Cavazzana-Calvo M, Le Deist F, Tezcan I, Sanal O, Bertrand Y, Philippe N, Fischer A, de Villartay JP (2001) Artemis, a novel DNA double-strand break repair/V(D)J recombination protein, is mutated in human severe combined immune deficiency. Cell 105:177–186PubMedCrossRef
41.
go back to reference Muller SM, Ege M, Pottharst A, Schulz AS, Schwarz K, Friedrich W (2001) Transplacentally acquired maternal T lymphocytes in severe combined immunodeficiency: a study of 121 patients. Blood 98:1847–1851PubMedCrossRef Muller SM, Ege M, Pottharst A, Schulz AS, Schwarz K, Friedrich W (2001) Transplacentally acquired maternal T lymphocytes in severe combined immunodeficiency: a study of 121 patients. Blood 98:1847–1851PubMedCrossRef
42.
go back to reference Neven B, Leroy S, Decaluwe H, Le Deist F, Picard C, Moshous D, Mahlaoui N, Debre M, Casanova JL, Dal Cortivo L, Madec Y, Hacein-Bey-Abina S, de Saint BG, de Villartay JP, Blanche S, Cavazzana-Calvo M, Fischer A (2009) Long-term outcome after hematopoietic stem cell transplantation of a single-center cohort of 90 patients with severe combined immunodeficiency. Blood 113:4114–4124PubMedCrossRef Neven B, Leroy S, Decaluwe H, Le Deist F, Picard C, Moshous D, Mahlaoui N, Debre M, Casanova JL, Dal Cortivo L, Madec Y, Hacein-Bey-Abina S, de Saint BG, de Villartay JP, Blanche S, Cavazzana-Calvo M, Fischer A (2009) Long-term outcome after hematopoietic stem cell transplantation of a single-center cohort of 90 patients with severe combined immunodeficiency. Blood 113:4114–4124PubMedCrossRef
43.
go back to reference Niehues T, Perez-Becker R, Schuetz C (2010) More than just SCID—the phenotypic range of combined immunodeficiencies associated with mutations in the recombinase activating genes (RAG) 1 and 2. Clin Immunol 135:183–192PubMedCrossRef Niehues T, Perez-Becker R, Schuetz C (2010) More than just SCID—the phenotypic range of combined immunodeficiencies associated with mutations in the recombinase activating genes (RAG) 1 and 2. Clin Immunol 135:183–192PubMedCrossRef
44.
go back to reference Noordzij JG, De Bruin-Versteeg S, Verkaik NS, Vossen JMJJ, De Groot R, Bernatowska E, Langerak AW, Van Gent DC, Van Dongen JJM (2002) The immunophenotypic and immunogenotypic B-cell differentiation arrest in bone marrow of RAG deficient SCID patients corresponds to residual recombination activities of mutated RAG proteins. Blood 100:2145–2152PubMed Noordzij JG, De Bruin-Versteeg S, Verkaik NS, Vossen JMJJ, De Groot R, Bernatowska E, Langerak AW, Van Gent DC, Van Dongen JJM (2002) The immunophenotypic and immunogenotypic B-cell differentiation arrest in bone marrow of RAG deficient SCID patients corresponds to residual recombination activities of mutated RAG proteins. Blood 100:2145–2152PubMed
45.
go back to reference Noordzij JG, Verkaik NS, Van der Burg M, Van Veelen LR, De Bruin-Versteeg S, Wiegant W, Vossen JMJJ, Weemaes CMR, De Groot R, Zdzienicka MZ, Van Gent DC, Van Dongen JJM (2003) Radiosensitive SCID patients with Artemis gene mutations show a complete B-cell differentiation arrest at the pre-B-cell receptor checkpoint in bone marrow. Blood 101:1446–1452PubMedCrossRef Noordzij JG, Verkaik NS, Van der Burg M, Van Veelen LR, De Bruin-Versteeg S, Wiegant W, Vossen JMJJ, Weemaes CMR, De Groot R, Zdzienicka MZ, Van Gent DC, Van Dongen JJM (2003) Radiosensitive SCID patients with Artemis gene mutations show a complete B-cell differentiation arrest at the pre-B-cell receptor checkpoint in bone marrow. Blood 101:1446–1452PubMedCrossRef
46.
47.
go back to reference Notarangelo LD, Fischer A, Geha RS, Casanova JL, Chapel H, Conley ME, Cunningham-Rundles C, Etzioni A, Hammartrom L, Nonoyama S, Ochs HD, Puck J, Roifman C, Seger R, Wedgwood J (2009) Primary immunodeficiencies: 2009 update. J Allergy Clin Immunol 124:1161–1178PubMedCrossRef Notarangelo LD, Fischer A, Geha RS, Casanova JL, Chapel H, Conley ME, Cunningham-Rundles C, Etzioni A, Hammartrom L, Nonoyama S, Ochs HD, Puck J, Roifman C, Seger R, Wedgwood J (2009) Primary immunodeficiencies: 2009 update. J Allergy Clin Immunol 124:1161–1178PubMedCrossRef
48.
go back to reference Pannicke U, Honig M, Hess I, Friesen C, Holzmann K, Rump EM, Barth TF, Rojewski MT, Schulz A, Boehm T, Friedrich W, Schwarz K (2009) Reticular dysgenesis (aleukocytosis) is caused by mutations in the gene encoding mitochondrial adenylate kinase 2. Nat Genet 41:101–105PubMedCrossRef Pannicke U, Honig M, Hess I, Friesen C, Holzmann K, Rump EM, Barth TF, Rojewski MT, Schulz A, Boehm T, Friedrich W, Schwarz K (2009) Reticular dysgenesis (aleukocytosis) is caused by mutations in the gene encoding mitochondrial adenylate kinase 2. Nat Genet 41:101–105PubMedCrossRef
49.
go back to reference Poinsignon C, Moshous D, Callebaut I, de Chasseval R, Villey I, de Villartay JP (2004) The metallo-beta-lactamase/beta-CASP domain of Artemis constitutes the catalytic core for V(D)J recombination. J Exp Med 199:315–321PubMedCrossRef Poinsignon C, Moshous D, Callebaut I, de Chasseval R, Villey I, de Villartay JP (2004) The metallo-beta-lactamase/beta-CASP domain of Artemis constitutes the catalytic core for V(D)J recombination. J Exp Med 199:315–321PubMedCrossRef
50.
go back to reference Puel A, Ziegler SF, Buckley RH, Leonard WJ (1998) Defective IL7R expression in T(−)B(+)NK(+) severe combined immunodeficiency. Nat Genet 20:394–397PubMedCrossRef Puel A, Ziegler SF, Buckley RH, Leonard WJ (1998) Defective IL7R expression in T(−)B(+)NK(+) severe combined immunodeficiency. Nat Genet 20:394–397PubMedCrossRef
51.
go back to reference Qasim W, Gaspar HB, Thrasher AJ (2009) Progress and prospects: gene therapy for inherited immunodeficiencies. Gene Ther 16:1285–1291PubMedCrossRef Qasim W, Gaspar HB, Thrasher AJ (2009) Progress and prospects: gene therapy for inherited immunodeficiencies. Gene Ther 16:1285–1291PubMedCrossRef
52.
go back to reference Rieux-Laucat F, Hivroz C, Lim A, Mateo V, Pellier I, Selz F, Fischer A, Le Deist F (2006) Inherited and somatic CD3zeta mutations in a patient with T-cell deficiency. N Engl J Med 354:1913–1921PubMedCrossRef Rieux-Laucat F, Hivroz C, Lim A, Mateo V, Pellier I, Selz F, Fischer A, Le Deist F (2006) Inherited and somatic CD3zeta mutations in a patient with T-cell deficiency. N Engl J Med 354:1913–1921PubMedCrossRef
53.
go back to reference Rogers MH, Lwin R, Fairbanks L, Gerritsen B, Gaspar HB (2001) Cognitive and behavioral abnormalities in adenosine deaminase deficient severe combined immunodeficiency. J Pediatr 139:44–50PubMedCrossRef Rogers MH, Lwin R, Fairbanks L, Gerritsen B, Gaspar HB (2001) Cognitive and behavioral abnormalities in adenosine deaminase deficient severe combined immunodeficiency. J Pediatr 139:44–50PubMedCrossRef
54.
go back to reference Sauer AV, Aiuti A (2009) New insights into the pathogenesis of adenosine deaminase-severe combined immunodeficiency and progress in gene therapy. Curr Opin Allergy Clin Immunol 9:496–502PubMedCrossRef Sauer AV, Aiuti A (2009) New insights into the pathogenesis of adenosine deaminase-severe combined immunodeficiency and progress in gene therapy. Curr Opin Allergy Clin Immunol 9:496–502PubMedCrossRef
55.
go back to reference Schuetz C, Huck K, Gudowius S, Megahed M, Feyen O, Hubner B, Schneider DT, Manfras B, Pannicke U, Willemze R, Knuchel R, Gobel U, Schulz A, Borkhardt A, Friedrich W, Schwarz K, Niehues T (2008) An immunodeficiency disease with RAG mutations and granulomas. N Engl J Med 358:2030–2038PubMedCrossRef Schuetz C, Huck K, Gudowius S, Megahed M, Feyen O, Hubner B, Schneider DT, Manfras B, Pannicke U, Willemze R, Knuchel R, Gobel U, Schulz A, Borkhardt A, Friedrich W, Schwarz K, Niehues T (2008) An immunodeficiency disease with RAG mutations and granulomas. N Engl J Med 358:2030–2038PubMedCrossRef
56.
go back to reference Schwarz K, Gauss GH, Ludwig L, Pannicke U, Li Z, Lindner D, Friedrich W, Seger RA, Hansen-Hagge TE, Desiderio S, Lieber MR, Bartram CR (1996) RAG mutations in human B cell-negative SCID. Science 274:97–99PubMedCrossRef Schwarz K, Gauss GH, Ludwig L, Pannicke U, Li Z, Lindner D, Friedrich W, Seger RA, Hansen-Hagge TE, Desiderio S, Lieber MR, Bartram CR (1996) RAG mutations in human B cell-negative SCID. Science 274:97–99PubMedCrossRef
57.
go back to reference Slatter MA, Angus B, Windebank K, Taylor A, Meaney C, Lester T, Norbury G, Hambleton S, Abinun M, Flood TJ, Cant AJ, Gennery AR (2011) Polymorphous lymphoproliferative disorder with Hodgkin-like features in common gamma-chain-deficient severe combined immunodeficiency. J Allergy Clin Immunol 127:533–535PubMedCrossRef Slatter MA, Angus B, Windebank K, Taylor A, Meaney C, Lester T, Norbury G, Hambleton S, Abinun M, Flood TJ, Cant AJ, Gennery AR (2011) Polymorphous lymphoproliferative disorder with Hodgkin-like features in common gamma-chain-deficient severe combined immunodeficiency. J Allergy Clin Immunol 127:533–535PubMedCrossRef
58.
go back to reference Slatter MA, Brigham K, Dickinson AM, Harvey HL, Barge D, Jackson A, Bown N, Flood TJ, Cant AJ, Abinun M, Gennery AR (2008) Long-term immune reconstitution after anti-CD52-treated or anti-CD34-treated hematopoietic stem cell transplantation for severe T-lymphocyte immunodeficiency. J Allergy Clin Immunol 121:361–367PubMedCrossRef Slatter MA, Brigham K, Dickinson AM, Harvey HL, Barge D, Jackson A, Bown N, Flood TJ, Cant AJ, Abinun M, Gennery AR (2008) Long-term immune reconstitution after anti-CD52-treated or anti-CD34-treated hematopoietic stem cell transplantation for severe T-lymphocyte immunodeficiency. J Allergy Clin Immunol 121:361–367PubMedCrossRef
59.
go back to reference Speckmann C, Pannicke U, Wiech E, Schwarz K, Fisch P, Friedrich W, Niehues T, Gilmour K, Buiting K, Schlesier M, Eibel H, Rohr J, Superti-Furga A, Gross-Wieltsch U, Ehl S (2008) Clinical and immunologic consequences of a somatic reversion in a patient with X-linked severe combined immunodeficiency. Blood 112:4090–4097PubMedCrossRef Speckmann C, Pannicke U, Wiech E, Schwarz K, Fisch P, Friedrich W, Niehues T, Gilmour K, Buiting K, Schlesier M, Eibel H, Rohr J, Superti-Furga A, Gross-Wieltsch U, Ehl S (2008) Clinical and immunologic consequences of a somatic reversion in a patient with X-linked severe combined immunodeficiency. Blood 112:4090–4097PubMedCrossRef
60.
go back to reference Stephan V, Wahn V, Le Deist F, Dirksen U, Broker B, Muller-Fleckenstein I, Horneff G, Schroten H, Fischer A, de Saint BG (1996) Atypical X-linked severe combined immunodeficiency due to possible spontaneous reversion of the genetic defect in T cells. N Engl J Med 335:1563–1567PubMedCrossRef Stephan V, Wahn V, Le Deist F, Dirksen U, Broker B, Muller-Fleckenstein I, Horneff G, Schroten H, Fischer A, de Saint BG (1996) Atypical X-linked severe combined immunodeficiency due to possible spontaneous reversion of the genetic defect in T cells. N Engl J Med 335:1563–1567PubMedCrossRef
61.
go back to reference Treleaven J, Gennery A, Marsh J, Norfolk D, Page L, Parker A, Saran F, Thurston J, Webb D (2011) Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. Br J Haematol 152:35–51PubMedCrossRef Treleaven J, Gennery A, Marsh J, Norfolk D, Page L, Parker A, Saran F, Thurston J, Webb D (2011) Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. Br J Haematol 152:35–51PubMedCrossRef
62.
go back to reference Turul T, Tezcan I, Artac H, de Bruin-Versteeg S, Barendregt BH, Reisli I, Sanal O, van Dongen JJ, van der Burg M (2009) Clinical heterogeneity can hamper the diagnosis of patients with ZAP70 deficiency. Eur J Pediatr 168:87–93PubMedCrossRef Turul T, Tezcan I, Artac H, de Bruin-Versteeg S, Barendregt BH, Reisli I, Sanal O, van Dongen JJ, van der Burg M (2009) Clinical heterogeneity can hamper the diagnosis of patients with ZAP70 deficiency. Eur J Pediatr 168:87–93PubMedCrossRef
63.
go back to reference van den Beemd R, Boor PP, van Lochem EG, Hop WC, Langerak AW, Wolvers-Tettero IL, Hooijkaas H, van Dongen JJ (2000) Flow cytometric analysis of the Vbeta repertoire in healthy controls. Cytometry 40:336–345PubMedCrossRef van den Beemd R, Boor PP, van Lochem EG, Hop WC, Langerak AW, Wolvers-Tettero IL, Hooijkaas H, van Dongen JJ (2000) Flow cytometric analysis of the Vbeta repertoire in healthy controls. Cytometry 40:336–345PubMedCrossRef
64.
go back to reference van der Burg M, Ijspeert H, Verkaik NS, Turul T, Wiegant WW, Morotomi-Yano K, Mari PO, Tezcan I, Chen DJ, Zdzienicka MZ, van Dongen JJ, van Gent DC (2009) A DNA-PKcs mutation in a radiosensitive T-B- SCID patient inhibits Artemis activation and nonhomologous end-joining. J Clin Invest 119:91–98PubMed van der Burg M, Ijspeert H, Verkaik NS, Turul T, Wiegant WW, Morotomi-Yano K, Mari PO, Tezcan I, Chen DJ, Zdzienicka MZ, van Dongen JJ, van Gent DC (2009) A DNA-PKcs mutation in a radiosensitive T-B- SCID patient inhibits Artemis activation and nonhomologous end-joining. J Clin Invest 119:91–98PubMed
65.
go back to reference van der Burg M, van Veelen LR, Verkaik NS, Wiegant WW, Hartwig NG, Barendregt BH, Brugmans L, Raams A, Jaspers NG, Zdzienicka MZ, van Dongen JJ, van Gent DC (2006) A new type of radiosensitive T-B-NK+ severe combined immunodeficiency caused by a LIG4 mutation. J Clin Invest 116:137–145PubMedCrossRef van der Burg M, van Veelen LR, Verkaik NS, Wiegant WW, Hartwig NG, Barendregt BH, Brugmans L, Raams A, Jaspers NG, Zdzienicka MZ, van Dongen JJ, van Gent DC (2006) A new type of radiosensitive T-B-NK+ severe combined immunodeficiency caused by a LIG4 mutation. J Clin Invest 116:137–145PubMedCrossRef
66.
go back to reference van der Burg M, van Zelm MC, van Dongen JJ (2009) Molecular diagnostics of primary immunodeficiencies: benefits and future challenges. Adv Exp Med Biol 634:231–241PubMed van der Burg M, van Zelm MC, van Dongen JJ (2009) Molecular diagnostics of primary immunodeficiencies: benefits and future challenges. Adv Exp Med Biol 634:231–241PubMed
67.
go back to reference van der Burg M, Verkaik NS, den Dekker AT, Barendregt BH, Pico-Knijnenburg I, Tezcan I, vanDongen JJ, van Gent DC (2007) Defective Artemis nuclease is characterized by coding joints with microhomology in long palindromic-nucleotide stretches. Eur J Immunol 37:3522–3528PubMedCrossRef van der Burg M, Verkaik NS, den Dekker AT, Barendregt BH, Pico-Knijnenburg I, Tezcan I, vanDongen JJ, van Gent DC (2007) Defective Artemis nuclease is characterized by coding joints with microhomology in long palindromic-nucleotide stretches. Eur J Immunol 37:3522–3528PubMedCrossRef
68.
go back to reference van der Burg M, Weemaes CM, Preijers F, Brons P, Barendregt BH, van Tol MJ, Hoogerbrugge P, van Dongen JJ (2006) B-cell recovery after stem cell transplantation of Artemis-deficient SCID requires elimination of autologous bone marrow precursor-B-cells. Haematologica 91:1705–1709PubMed van der Burg M, Weemaes CM, Preijers F, Brons P, Barendregt BH, van Tol MJ, Hoogerbrugge P, van Dongen JJ (2006) B-cell recovery after stem cell transplantation of Artemis-deficient SCID requires elimination of autologous bone marrow precursor-B-cells. Haematologica 91:1705–1709PubMed
69.
go back to reference Van Gent DC, McBlane JF, Ramsden DA, Sadofsky MJ, Hesse JE, Gellert M (1996) Initiation of V(D)J recombinations in a cell-free system by RAG1 and RAG2 proteins. Curr Top Microbiol Immunol 217:1–10PubMed Van Gent DC, McBlane JF, Ramsden DA, Sadofsky MJ, Hesse JE, Gellert M (1996) Initiation of V(D)J recombinations in a cell-free system by RAG1 and RAG2 proteins. Curr Top Microbiol Immunol 217:1–10PubMed
70.
go back to reference van Gent DC, van der Burg M (2007) Non-homologous end-joining, a sticky affair. Oncogene 26:7731–7740PubMedCrossRef van Gent DC, van der Burg M (2007) Non-homologous end-joining, a sticky affair. Oncogene 26:7731–7740PubMedCrossRef
71.
go back to reference Villa A, Notarangelo LD, Roifman CM (2008) Omenn syndrome: inflammation in leaky severe combined immunodeficiency. J Allergy Clin Immunol 122:1082–1086PubMedCrossRef Villa A, Notarangelo LD, Roifman CM (2008) Omenn syndrome: inflammation in leaky severe combined immunodeficiency. J Allergy Clin Immunol 122:1082–1086PubMedCrossRef
72.
go back to reference Villa A, Santagata S, Bozzi F, Giliani S, Frattini A, Imberti L, Gatta LB, Ochs HD, Schwarz K, Notarangelo LD, Vezzoni P, Spanopoulou E (1998) Partial V(D)J recombination activity leads to Omenn syndrome. Cell 93:885–896PubMedCrossRef Villa A, Santagata S, Bozzi F, Giliani S, Frattini A, Imberti L, Gatta LB, Ochs HD, Schwarz K, Notarangelo LD, Vezzoni P, Spanopoulou E (1998) Partial V(D)J recombination activity leads to Omenn syndrome. Cell 93:885–896PubMedCrossRef
73.
go back to reference Wada T, Candotti F (2008) Somatic mosaicism in primary immune deficiencies. Curr Opin Allergy Clin Immunol 8:510–514PubMedCrossRef Wada T, Candotti F (2008) Somatic mosaicism in primary immune deficiencies. Curr Opin Allergy Clin Immunol 8:510–514PubMedCrossRef
74.
go back to reference Wada T, Toma T, Okamoto H, Kasahara Y, Koizumi S, Agematsu K, Kimura H, Shimada A, Hayashi Y, Kato M, Yachie A (2005) Oligoclonal expansion of T lymphocytes with multiple second-site mutations leads to Omenn syndrome in a patient with RAG1-deficient severe combined immunodeficiency. Blood 106:2099–2101PubMedCrossRef Wada T, Toma T, Okamoto H, Kasahara Y, Koizumi S, Agematsu K, Kimura H, Shimada A, Hayashi Y, Kato M, Yachie A (2005) Oligoclonal expansion of T lymphocytes with multiple second-site mutations leads to Omenn syndrome in a patient with RAG1-deficient severe combined immunodeficiency. Blood 106:2099–2101PubMedCrossRef
75.
go back to reference Walshe D, Gaspar HB, Thrasher AJ, Cale CM, Gilmour KC (2009) Signal transducer and activator of transcription 5 tyrosine phosphorylation for the diagnosis and monitoring of patients with severe combined immunodeficiency. J Allergy Clin Immunol 123:505–508PubMedCrossRef Walshe D, Gaspar HB, Thrasher AJ, Cale CM, Gilmour KC (2009) Signal transducer and activator of transcription 5 tyrosine phosphorylation for the diagnosis and monitoring of patients with severe combined immunodeficiency. J Allergy Clin Immunol 123:505–508PubMedCrossRef
Metadata
Title
Educational paper
The expanding clinical and immunological spectrum of severe combined immunodeficiency
Authors
Mirjam van der Burg
Andy R. Gennery
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 5/2011
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-011-1452-3

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