カトウ タマキ   Tamaki Kato
  加藤 環
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Clinical and Immunological Characterization of ICF Syndrome in Japan.
掲載誌名 正式名:Journal of clinical immunology
略  称:J Clin Immunol
ISSNコード:15732592/02719142
掲載区分国外
巻・号・頁 38(8),pp.927-937
著者・共著者 Kamae Chikako, Imai Kohsuke, Kato Tamaki, Okano Tsubasa, Honma Kenichi, Nakagawa Noriko, Yeh Tzu-Wen, Noguchi Emiko, Ohara Akira, Shigemura Tomonari, Takahashi Hiroshi, Takakura Shunichi, Hayashi Masatoshi, Honma Aoi, Watanabe Seiichi, Shigemori Tomoko, Ohara Osamu, Sasaki Hiroyuki, Kubota Takeo, Morio Tomohiro, Kanegane Hirokazu, Nonoyama Shigeaki
発行年月 2018/11
概要 OBJECTIVE:Immunodeficiency, centromeric instability, and facial anomalies (ICF) syndrome is a rare autosomal recessive primary immunodeficiency. Hypogammaglobulinemia is a major manifestation of ICF syndrome, but immunoglobulin replacement therapy does not seem to be effective for some ICF patients. Therefore, we aimed to reassess the immunological characteristics of this syndrome.METHODS:Eleven Japanese patients with ICF syndrome were enrolled. We performed whole-exome sequencing in four cases and homozygosity mapping using SNP analysis in two. We evaluated their clinical manifestations and immunological status.RESULTS:We newly diagnosed six ICF patients who had tentatively been diagnosed with common variable immunodeficiency. We identified two novel mutations in the DNMT3B gene and one novel mutation in the ZBTB24 gene. All patients showed low serum IgG and/or IgG2 levels and were treated by periodic immunoglobulin replacement therapy. Three of the six patients showed worse results of the mitogen-induced lymphocyte proliferation test. Analyses of lymphocyte subpopulations revealed that CD19+CD27+ memory B cells were low in seven of nine patients, CD3+ T cells were low in three patients, CD4/8 ratio was inverted in five patients, CD31+ recent thymic emigrant cells were low in two patients, and CD19+ B cells were low in four patients compared with those in the normal controls. ICF2 patients showed lower proportions of CD19+ B cells and CD16+56+ NK cells and significantly higher proportions of CD3+ T cells than ICF1 patients. T cell receptor excision circles were undetectable in two patients. Despite being treated by immunoglobulin replacement therapy, three patients died of influenza virus, fatal viral infection with persistent Epstein-Barr virus infection, or JC virus infection. One of three dead patients showed normal intelligence with mild facial anomaly. Two patients presented with autoimmune or inflammatory manifestations. Infectious episodes decreased in three
DOI 10.1007/s10875-018-0559-y
PMID 30353301