Genetic and B Cell Functional Studies of X-Linked Immunodeficiencies

Eight types of X-linked immunodeficiency diseases have been described. In this thesis, I will focus on four, viz X-linked agammaglobulinaemia (XLA), X-linked severe combined immunodeficiency (X-linked SCID), Wiskott-Aldrich syndrome (WAS) and X-linked hyperimmuno-globulinaemia M (X-linked hyperlgM). Their clinical features, treatment and prognosis as well as cellular and genetic aspects are reviewed in Chapter 1; followed by objectives of the studies presented in this thesis, viz localization of the gene loci of XLA and X-linked SCID, clinical application of the linked DNA probes in families with XLA and identification of the B cell defects in patients with XLA and WAS. The practical issues of collecting patients and families for linkage analysis, as well as their immunological profiles and pedigrees are given in Chapter 2. Various laboratory techniques employed in these studies are detailed in Chapter 3. There are five sections in Chapter 4, which is on the genetic studies of XLA. Section one reviews the principle of linkage analysis, genetic heterogeneity and restriction fragment length polymorphism (RFLP) . Results of the genetic localization of XLA to Xq21.3-q22 are presented in section two. Evidence of non-allelic genetic heterogeneity in XLA is presented in section three, followed by the analysis of all the family data of XLA in the literature in order to estimate the proportion of families unlinked to Xq21.3-q22, which is probably 10-20%. The posterior probability of each family being linked to Xq21.3-q22 is also estimated. Section four describes the clinical application of the two linked probes, S21 and pXG12, in the genetic counselling of thirteen families with XLA; as well as developing a method of risk calculation allowing for non-allelic genetic heterogeneity. Seven obligate carriers under the age of 45 can all be offered prenatal diagnosis. Of the thirty-four females at risk of being carriers, seventeen have their risks increased, fifteen decreased and two unchanged by the RFLP results. Eleven of the seventeen women whose risks were increased are under 45 years of age and seven of them can be offered prenatal diagnosis. Successful predictions have been made in a newborn male infant and a male fetus at risk of being affected with XLA. Section five presents the evidence that X-linked hyperlgM is not an allelic genetic disease with XLA. Chapter 5 presents the results of the genetic localization of X-linked SCID to Xqll-ql3 and the clinical application of the linked probe, cpX73, in carrier detection. The results of the functional studies of Epstein-Barr virus (EBV) tranformed B cell lines from patients with XLA and WAS are presented in Chapter 6. B cell lines from patients with WAS did not differ from normal B cell lines in any of the functional assays I have used. However, differences were found in B cells from patients with XLA. EBV-transformed B cell lines from patients with XLA did not proliferate in response to KGl-a supernatant and they did not produce IgG in the presence or absence of various B cell growth and differentiation factors. Finally, Chapter 7 summarises the two approaches of investigations adopted in this thesis, which are applicable in investigating any diseases of single gene defect; future directions are also speculated

Cellular and Molecular Defects Underlying Invasive Fungal Infections—Revelations from Endemic Mycoses

The global burden of fungal diseases has been increasing, as a result of the expanding number of susceptible individuals including people living with human immunodeficiency virus (HIV), hematopoietic stem cell or organ transplant recipients, patients with malignancies or immunological conditions receiving immunosuppressive treatment, premature neonates, and the elderly. Opportunistic fungal pathogens such as Aspergillus, Candida, Cryptococcus, Rhizopus, and Pneumocystis jiroveci are distributed worldwide and constitute the majority of invasive fungal infections (IFIs). Dimorphic fungi such as Histoplasma capsulatum, Coccidioides spp., Paracoccidioides spp., Blastomyces dermatiditis, Sporothrix schenckii, Talaromyces (Penicillium) marneffei, and Emmonsia spp. are geographically restricted to their respective habitats and cause endemic mycoses. Disseminated histoplasmosis, coccidioidomycosis, and T. marneffei infection are recognized as acquired immunodeficiency syndrome (AIDS)-defining conditions, while the rest also cause high rate of morbidities and mortalities in patients with HIV infection and other immunocompromised conditions. In the past decade, a growing number of monogenic immunodeficiency disorders causing increased susceptibility to fungal infections have been discovered. In particular, defects of the IL-12/IFN-γ pathway and T-helper 17-mediated response are associated with increased susceptibility to endemic mycoses. In this review, we put together the various forms of endemic mycoses on the map and take a journey around the world to examine how cellular and molecular defects of the immune system predispose to invasive endemic fungal infections, including primary immunodeficiencies, individuals with autoantibodies against interferon-γ, and those receiving biologic response modifiers. Though rare, these conditions provide importance insights to host defense mechanisms against endemic fungi, which can only be appreciated in unique climatic and geographical regions

Insulin-like growth factor I promotes cord blood T cell maturation through monocytes and inhibits their apoptosis in part through interleukin-6

<p>Abstract</p> <p>Background</p> <p>The functional immaturity of T cells contributes to the susceptibility of neonates to infections and the less severe graft-versus-host disease associated with cord blood (CB) transplantation. We have previously reported that insulin-like growth factor – I (IGF-I) promotes the phytohaemagglutinin (PHA)-induced CB T cell maturation and inhibits their apoptosis in mononuclear cell (MC) culture. We hypothesized that the effects of IGF-I may be mediated by accessory cells and soluble factors.</p> <p>Results</p> <p>This study showed that the kinetics of PHA-induced maturation in purified CD3+ T cell was delayed compared to that in CBMC. The addition of autologous CD14+ monocytes increased T cell maturation and potentiated the effect of IGF-I. The addition of IL-6 had no effect on CB T cell maturation but it reduced PHA-induced apoptosis significantly. We further demonstrated that the neutralisation of IL-6 in CBMC culture partially abrogated the anti-apoptotic effect of IGF-1 on T cells. The anti-apoptotic effect of IL-6 was not mediated via the reduction of Fas expression in T cell subsets.</p> <p>Conclusion</p> <p>Our results suggested that the maturation effect of IGF-1 is partially mediated by monocytes and the anti-apoptotic effect in part via IL-6. Further investigation is needed to explore the therapeutic use of IGF-I in enhancing neonatal immunity.</p

Promoter-sharing by different genes in human genome – CPNE1 and RBM12 gene pair as an example

<p>Abstract</p> <p>Background</p> <p>Regulation of gene expression plays important role in cellular functions. Co-regulation of different genes may indicate functional connection or even physical interaction between gene products. Thus analysis on genomic structures that may affect gene expression regulation could shed light on the functions of genes.</p> <p>Results</p> <p>In a whole genome analysis of alternative splicing events, we found that two distinct genes, <it>copine I </it>(<it>CPNE1</it>) and <it>RNA binding motif protein 12 </it>(<it>RBM12</it>), share the most 5' exons and therefore the promoter region in human. Further analysis identified many gene pairs in human genome that share the same promoters and 5' exons but have totally different coding sequences. Analysis of genomic and expressed sequences, either cDNAs or expressed sequence tags (ESTs) for <it>CPNE1 </it>and <it>RBM12</it>, confirmed the conservation of this phenomenon during evolutionary courses. The co-expression of the two genes initiated from the same promoter is confirmed by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) in different tissues in both human and mouse. High degrees of sequence conservation among multiple species in the 5'UTR region common to <it>CPNE1 </it>and <it>RBM12 </it>were also identified.</p> <p>Conclusion</p> <p>Promoter and 5'UTR sharing between <it>CPNE1 </it>and <it>RBM12 </it>is observed in human, mouse and zebrafish. Conservation of this genomic structure in evolutionary courses indicates potential functional interaction between the two genes. More than 20 other gene pairs in human genome were found to have the similar genomic structure in a genome-wide analysis, and it may represent a unique pattern of genomic arrangement that may affect expression regulation of the corresponding genes.</p

TLR5 signaling enhances the proliferation of human allogeneic CD40-activated B cell induced CD4hiCD25+ regulatory T cells

Although diverse functions of different toll-like receptors (TLR) on human natural regulatory T cells have been demonstrated recently, the role of TLR-related signals on human induced regulatory T cells remain elusive. Previously our group developed an ex vivo high-efficient system in generating human alloantigen-specific CD4(hi)CD25(+) regulatory T cells from naive CD4(+)CD25(-) T cells using allogeneic CD40-activated B cells as stimulators. In this study, we investigated the role of TLR5-related signals on the generation and function of these novel CD4(hi)CD25(+) regulatory T cells. It was found that induced CD4(hi)CD25(+) regulatory T cells expressed an up-regulated level of TLR5 compared to their precursors. The blockade of TLR5 using anti-TLR5 antibodies during the co-culture decreased CD4(hi)CD25(+) regulatory T cells proliferation by induction of S phase arrest. The S phase arrest was associated with reduced ERK1/2 phosphorylation. However, TLR5 blockade did not decrease the CTLA-4, GITR and FOXP3 expressions, and the suppressive function of CD4(hi)CD25(+) regulatory T cells. In conclusion, we discovered a novel function of TLR5-related signaling in enhancing the proliferation of CD4(hi)CD25(+) regulatory T cells by promoting S phase progress but not involved in the suppressive function of human CD40-activated B cell-induced CD4(hi)CD25(+) regulatory T cells, suggesting a novel role of TLR5-related signals in the generation of induced regulatory T cells.published_or_final_versio

Toll-like receptors, chemokine receptors and death receptor ligands responses in SARS coronavirus infected human monocyte derived dendritic cells

<p>Abstract</p> <p>Background</p> <p>The SARS outbreak in 2003 provides a unique opportunity for the study of human responses to a novel virus. We have previously reported that dendritic cells (DCs) might be involved in the immune escape mechanisms for SARS-CoV. In this study, we focussed on the gene expression of toll-like receptors (TLRs), chemokine receptors (CCRs) and death receptor ligands in SARS-CoV infected DCs. We also compared adult and cord blood (CB) DCs to find a possible explanation for the age-dependent severity of SARS.</p> <p>Results</p> <p>Our results demonstrates that SARS-CoV did not modulate TLR-1 to TLR-10 gene expression but significantly induced the expression of CCR-1, CCR-3, and CCR-5. There was also strong induction of TNF-related apoptosis-inducing ligand (TRAIL), but not Fas ligand gene expression in SARS-CoV infected DCs. Interestingly, the expressions of most genes studied were higher in CB DCs than adult DCs.</p> <p>Conclusion</p> <p>The upregulation of chemokines and CCRs may facilitate DC migration from the infection site to the lymph nodes, whereas the increase of TRAIL may induce lymphocyte apoptosis. These findings may explain the increased lung infiltrations and lymphoid depletion in SARS patients. Further explorations of the biological significance of these findings are warranted.</p

X-linked hyper-IgM syndrome with CD40LG mutation: Two case reports and literature review in Taiwanese patients

Hyper-IgM syndrome (HIGM) is a rare primary immunodeficiency disorder characterized by elevated or normal serum IgM and decreased IgG, IgA, and IgE due to defective immunoglobulin class switching. X-linked HIGM (XHIGM, HIGM1) is the most frequent type, is caused by mutations in the CD40 ligand gene, and is regarded as a combined T and B immunodeficiency. We report an 18-year-old male who was diagnosed initially with hypogammaglobulinemia in infancy, but developed repeated pneumonia, sepsis, cellulitis, perianal abscess, pericarditis, and bronchiectasis despite regular intravenous immunoglobulin replacement therapy. The patient died at age 18 years due to pneumonia and tension pneumothorax. Mutation analysis revealed CD40L gene mutation within Exon 5 at nucleotide position 476 (cDNA 476G > A). This nonsense mutation predicted a tryptophan codon (TGG) change to a stop codon (TGA) at position 140 (W140X), preventing CD40L protein expression. Sequence analysis in the family confirmed a de novo mutation. The second case of 6-month-old male infant presented as Pneumocystis jiroveci pneumonia and acute respiratory distress syndrome. Gene analysis of the CD40L gene revealed G to C substitution in Intron 4 (c.409 + 5G > C) and mother was a carrier. Hematopoietic stem cell transplantation, the only cure for XHIGM, was arranged in the second case