Mancebo Esther, Moreno-Pelayo Miguel A, Mencía Angeles, de la Calle-Martín Oscar, Allende Luis M, Sivadorai Padma, Kalaydjieva Luba, Bertranpetit Jaume, Coto Eliecer, Calleja-Antolín Sara, Ruiz-Contreras Jesus, Paz-Artal Estela
Servicio de Inmunología, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041 Madrid, Spain.
Mol Immunol. 2008 Jan;45(2):479-84. doi: 10.1016/j.molimm.2007.05.022. Epub 2007 Jul 20.
We describe the second case of CD8 immunodeficiency. It confirms the pathogenic effect of p.Gly111Ser, leading to complete deficit of CD8+ lymphocytes, although the clinical manifestations may vary in severity. Similarly to the first case reported, our patient is also from Spanish Gypsy origin and homozygous for the p.Gly111Ser mutation in CD8alpha chain. The patient has suffered repeated respiratory infections from childhood but with conservation of her pulmonary parenchyma, on the contrary to the first patient, who died because of his respiratory injury. We developed an AluI-PCR-RFLP assay to screen a total of 1127 unrelated control individuals: 734 subjects of Gypsy ancestry from different sub-isolates and geographic locations in Europe, and 393 of Spanish (non-Gypsy) ethnicity. The results indicate that p.Gly111Ser is confined to the Spanish Gypsy population, where it occurs at a carrier rate of 0.4%. Analysis of microsatellite markers flanking the CD8A mutated gene revealed a shared polymorphic haplotype suggesting a common founder for p.Gly111Ser mutation that causes CD8 deficiency in the Spanish Gypsy population. CD8 immunodeficiency should be given diagnostic consideration in Spanish Gypsies with recurrent infections. Our findings may also have implications for these patients in terms of specific recommendations in vaccination and healthy habits and for genetic counseling of affected families.
我们描述了第二例CD8免疫缺陷病例。该病例证实了p.Gly111Ser的致病作用,导致CD8+淋巴细胞完全缺乏,尽管临床表现的严重程度可能有所不同。与首例报道的病例相似,我们的患者也来自西班牙吉普赛族,且CD8α链中的p.Gly111Ser突变呈纯合状态。该患者自童年起就反复发生呼吸道感染,但肺实质得以保留,这与首例因呼吸损伤死亡的患者相反。我们开发了一种AluI-PCR-RFLP检测方法,对总共1127名无亲缘关系的对照个体进行筛查:734名来自欧洲不同亚隔离群体和地理位置的吉普赛族受试者,以及393名西班牙(非吉普赛)族受试者。结果表明,p.Gly111Ser仅见于西班牙吉普赛人群体,其携带率为0.4%。对CD8A突变基因侧翼微卫星标记的分析揭示了一个共享的多态性单倍型,表明p.Gly111Ser突变存在一个共同的起源,该突变导致西班牙吉普赛人群体出现CD8缺乏症。对于反复感染的西班牙吉普赛人,应考虑诊断CD8免疫缺陷。我们的研究结果在疫苗接种和健康习惯的具体建议以及对受影响家庭的遗传咨询方面,可能对这些患者也有意义。