Department of Pediatric Research, Oslo University Hospital, Oslo, Norway.
Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.
J Clin Immunol. 2020 Apr;40(3):515-523. doi: 10.1007/s10875-020-00766-x. Epub 2020 Mar 9.
The 22q11.2 deletion syndrome (22q11.2 del), also known as DiGeorge syndrome, is a genetic disorder with an estimated incidence of 1:3000 to 1:6000 births. These patients may suffer from affection of many organ systems with cardiac malformations, immunodeficiency, hypoparathyroidism, autoimmunity, palate anomalies, and psychiatric disorders being the most frequent. The importance of the complement system in 22q11.2 del has not been investigated. The objective of this study was to evaluate the complement system in relation to clinical and immunological parameters in patients. A national cohort of patients (n = 69) with a proven heterozygous deletion of chromosome 22q11.2 and a group of age and sex matched controls (n = 56) were studied. Functional capacity of the classical, lectin, and alternative pathways of the complement system as well as complement activation products C3bc and terminal complement complex (TCC) were accessed and correlated to clinical features. All patients in our study had normal complement activation in both classical and alternative pathways. The frequency of mannose-binding lectin deficiency was comparable to the normal population. The patients had significantly raised plasma levels of C3bc and a slight, but not significant, increase in TCC compared with controls. This increase was associated with the presence of psychiatric disorders in patients. The present study shows no complement deficiencies in 22q11.2 deletion syndrome. On the contrary, there are signs of increased complement activation in these patients. Complement activation is particularly associated with the presence of psychiatric disorders.
22q11.2 缺失综合征(22q11.2del),又称 DiGeorge 综合征,是一种遗传疾病,估计发病率为每 3000 至 6000 例出生一例。这些患者可能会受到多个器官系统的影响,最常见的是心脏畸形、免疫缺陷、甲状旁腺功能减退、自身免疫、腭裂和精神障碍。补体系统在 22q11.2del 中的作用尚未得到研究。本研究的目的是评估补体系统与患者的临床和免疫参数的关系。对一组经证实存在 22q11.2 染色体杂合缺失的患者(n=69)和一组年龄和性别匹配的对照组(n=56)进行了研究。评估了补体系统经典途径、凝集素途径和替代途径的功能能力,以及补体激活产物 C3bc 和末端补体复合物(TCC),并与临床特征相关联。我们研究中的所有患者经典和替代途径的补体激活均正常。甘露聚糖结合凝集素缺乏症的频率与正常人群相当。与对照组相比,患者的 C3bc 血浆水平显著升高,TCC 略有但无统计学意义的升高。这种增加与患者存在精神障碍有关。本研究显示 22q11.2 缺失综合征患者没有补体缺乏。相反,这些患者存在补体激活增加的迹象。补体激活与精神障碍的存在尤其相关。