Abstract
Immune function in two brothers with a deficiency of purine nucleoside phosphorylase was evaluated in vivo and in vitro. Both patients had a history of recurrent infections and profound lymphopenia. Studies of cell-mediated immunity revealed an absence of delayed cutaneous reactivity to a number of antigens, including dinitrochlorobenzene, and significantly reduced lymphocyte proliferative responses to nonspecific mitogens, specific antigen, and allogeneic cells. E-rosetting cells were present but reduced in number (20.0% and 31.5%). Serum immunoglobulin levels, percentages of circulating immunoglobulin-and C3-receptor-bearing B cells, as well as the ability to produce antibody in response to specific antigen in vivo were normal. Moreover, studies of the in vitro induction of specific IgM antibody delineated the presence of T-helper and T-regulator cells. The normal induction of bone marrow precursor T-cell maturation by human thymic epithelium-conditioned medium or thymosin suggested that the initial stages of T-cell generation were intact in these patients. Attempts to reconstitute the in vitro proliferative response with a variety of reagents, including purine nucleoside phosphorylase itself, were unsuccessful. Selective impairment of certain aspects of T-cell function in these patients and a less severe clinical picture than previously described may be explained by the presence of a partial deficiency of nucleoside phosphorylase activity and incomplete block of purine catabolism.
Full text
PDF









Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Agarwal R. P., Sagar S. M., Parks R. E., Jr Adenosine deaminase from human erythrocytes: purification and effects of adenosine analogs. Biochem Pharmacol. 1975 Mar 15;24(6):693–701. doi: 10.1016/0006-2952(75)90245-2. [DOI] [PubMed] [Google Scholar]
- Benke P. J., Dittmar D. Purine dysfunction in cells from patients with adenosine deaminase deficiency. Pediatr Res. 1976 Jul;10(7):642–646. doi: 10.1203/00006450-197607000-00002. [DOI] [PubMed] [Google Scholar]
- Dosch H-M, Gelfand E. W. Generation of human plaque-forming cells in culture: tissue distribution, antigenic and cellular requirements. J Immunol. 1977 Jan;118(1):302–308. [PubMed] [Google Scholar]
- Dosch H. M., Gelfand E. W. In vitro induction and measurement of hemolytic plaque forming cells in man. J Immunol Methods. 1976;11(2):107–116. doi: 10.1016/0022-1759(76)90138-1. [DOI] [PubMed] [Google Scholar]
- Fox I. H., Andres C. M., Gelfand E. W., Biggar D. Purine nucleoside phosphorylase deficiency: altered kinetic properties of a mutant enzyme. Science. 1977 Sep 9;197(4308):1084–1086. doi: 10.1126/science.407651. [DOI] [PubMed] [Google Scholar]
- Gelfand E. W., Baumal R., Huber J., Crookston M. C., Shumak K. H. Polyclonal gammopathy and lymphoproliferation after transfer factor in severe combined immunodeficiency disease. N Engl J Med. 1973 Dec 27;289(26):1385–1389. doi: 10.1056/NEJM197312272892602. [DOI] [PubMed] [Google Scholar]
- Gelfand E. W., Berkel A. I., Godwin H. A., Rocklin R. E., David J. R., Rosen F. S. Pernicous anaemia, hypogammaglobulinaemia, and altered lymphocyte reactivity. A family study. Clin Exp Immunol. 1972 Jun;11(2):187–199. [PMC free article] [PubMed] [Google Scholar]
- Gelfand E. W. Role of the C3 receptor in antibody-dependent cytotoxicity. Transplantation. 1976 Jan;21(1):73–75. doi: 10.1097/00007890-197601000-00014. [DOI] [PubMed] [Google Scholar]
- Giblett E. R., Ammann A. J., Wara D. W., Sandman R., Diamond L. K. Nucleoside-phosphorylase deficiency in a child with severely defective T-cell immunity and normal B-cell immunity. Lancet. 1975 May 3;1(7914):1010–1013. doi: 10.1016/s0140-6736(75)91950-9. [DOI] [PubMed] [Google Scholar]
- Giblett E. R., Anderson J. E., Cohen F., Pollara B., Meuwissen H. J. Adenosine-deaminase deficiency in two patients with severely impaired cellular immunity. Lancet. 1972 Nov 18;2(7786):1067–1069. doi: 10.1016/s0140-6736(72)92345-8. [DOI] [PubMed] [Google Scholar]
- Green H., Chan T. Pyrimidine starvation induced by adenosine in fibroblasts and lymphoid cells: role of adenosine deaminase. Science. 1973 Nov 23;182(4114):836–837. doi: 10.1126/science.182.4114.836. [DOI] [PubMed] [Google Scholar]
- Hartzman R. J., Segall M., Bach M. L., Bach F. H. Histocompatibility matching. VI. Miniaturization of the mixed leukocyte culture test: a preliminary report. Transplantation. 1971 Mar;11(3):268–273. doi: 10.1097/00007890-197103000-00005. [DOI] [PubMed] [Google Scholar]
- Kretschmer R., Say B., Brown D., Rosen F. S. Congenital aplasia of the thymus gland (DiGeorge's syndrome). N Engl J Med. 1968 Dec 12;279(24):1295–1301. doi: 10.1056/NEJM196812122792401. [DOI] [PubMed] [Google Scholar]
- Lux S. E., Johnston R. B., Jr, August C. S., Say B., Penchaszadeh V. B., Rosen F. S., McKusick V. A. Chronic neutropenia and abnormal cellular immunity in cartilage-hair hypoplasia. N Engl J Med. 1970 Jan 29;282(5):231–236. doi: 10.1056/NEJM197001292820501. [DOI] [PubMed] [Google Scholar]
- MacLennan I. C. Antibody in the induction and inhibition of lymphocyte cytotoxicity. Transplant Rev. 1972;13:67–90. doi: 10.1111/j.1600-065x.1972.tb00060.x. [DOI] [PubMed] [Google Scholar]
- Miller J. F. T-cell regulation of immune responsiveness. Ann N Y Acad Sci. 1975 Feb 28;249:9–26. doi: 10.1111/j.1749-6632.1975.tb29052.x. [DOI] [PubMed] [Google Scholar]
- Perlmann P., Perlmann H., Wigzell H. Lymphocyte mediated cytotoxicity in vitro. Induction and inhibition by humoral antibody and nature of effector cells. Transplant Rev. 1972;13:91–114. doi: 10.1111/j.1600-065x.1972.tb00061.x. [DOI] [PubMed] [Google Scholar]
- Polmar S. H., Stern R. C., Schwartz A. L., Wetzler E. M., Chase P. A., Hirschhorn R. Enzyme replacement therapy for adenosine deaminase deficiency and severe combined immunodeficiency. N Engl J Med. 1976 Dec 9;295(24):1337–1343. doi: 10.1056/NEJM197612092952402. [DOI] [PubMed] [Google Scholar]
- Pyke K. W., Dosch H., Ipp M. M., Gelfand E. W. Demonstration of an intrathymic defect in a case of severe combined immunodeficiency disease. N Engl J Med. 1975 Aug 28;293(9):424–428. doi: 10.1056/NEJM197508282930904. [DOI] [PubMed] [Google Scholar]
- Pyke K. W., Gelfand E. W. Detection of T-precursor cells in human bone marrow and foetal liver. Differentiation. 1976 Jun 4;5(2-3):189–191. doi: 10.1111/j.1432-0436.1976.tb00914.x. [DOI] [PubMed] [Google Scholar]
- Pyke K. W., Gelfand E. W. Morphological and functional maturation of human thymic epithelium in culture. Nature. 1974 Oct 4;251(5474):421–423. doi: 10.1038/251421a0. [DOI] [PubMed] [Google Scholar]
- Stoop J. W., Zegers B. J., Hendrickx G. F., van Heukelom L. H., Staal G. E., de Bree P. K., Wadman S. K., Ballieux R. E. Purine nucleoside phosphorylase deficiency associated with selective cellular immunodeficiency. N Engl J Med. 1977 Mar 24;296(12):651–655. doi: 10.1056/NEJM197703242961203. [DOI] [PubMed] [Google Scholar]
- Strober W., Wochner R. D., Carbone P. P., Waldmann T. A. Intestinal lymphangiectasia: a protein-losing enteropathy with hypogammaglobulinemia, lymphocytopenia and impaired homograft rejection. J Clin Invest. 1967 Oct;46(10):1643–1656. doi: 10.1172/JCI105656. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stutman O., Yunis E. J., Good R. A. Carcinogen-induced tumors of the thymus. IV. Humoral influences of normal thymus and functional thymomas and influence of posthymectomy period on restoration. J Exp Med. 1969 Oct 1;130(4):809–819. doi: 10.1084/jem.130.4.809. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ullman B., Cohen A., Martin D. W. Characterization of a cell culture model for the study of adenosine deaminase- and purine nucleoside phosphorylase-deficient immunologic disease. Cell. 1976 Oct;9(2):205–211. doi: 10.1016/0092-8674(76)90111-2. [DOI] [PubMed] [Google Scholar]
- Wara D. W., Goldstein A. L., Doyle N. E., Ammann A. J. Thymosin activity in patients with cellular immunodeficiency. N Engl J Med. 1975 Jan 9;292(2):70–74. doi: 10.1056/NEJM197501092920204. [DOI] [PubMed] [Google Scholar]
- Weiden P. L., Blaese R. M., Strober W., Block J. B., Waldmann T. A. Impaired lymphocyte transformation in intestinal lymphangiectasia: evidence for at least two functionally distinct lymphocyte populations in man. J Clin Invest. 1972 Jun;51(6):1319–1325. doi: 10.1172/JCI106928. [DOI] [PMC free article] [PubMed] [Google Scholar]