Skip to main content
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1996 Oct 1;98(7):1519–1526. doi: 10.1172/JCI118943

A human non-XLA immunodeficiency disease characterized by blockage of B cell development at an early proB cell stage.

E Meffre 1, F LeDeist 1, G de Saint-Basile 1, A Deville 1, M Fougereau 1, A Fischer 1, C Schiff 1
PMCID: PMC507582  PMID: 8833898

Abstract

We report a detailed analysis of a B cell defect affecting a patient girl born from first cousin parents, characterized by a severe non-X-linked agammaglobulinemia with a total absence of CD19- cells in the periphery. In the bone marrow, CD19 expression was also highly impaired, resulting in the absence of both B and preB compartments. By contrast, CD34+CD10+, CD34psiL+, and some CD19+CD10+ mostly CD34+ early proB cells were present, although diminished. Semiquantitative RT-PCR analysis performed on mononuclear bone marrow cells indicated that lambda-like, VpreB, Rag-1, Rag-2, and TdT transcripts expressed during proB cell stages were found at normal levels whereas E2A, CD10, Syk, Pax-5, CD19, Igalpha, Igbeta, VH-Cmu, and Vkappa-Ckappa transcripts characteristic of later stages were severely depressed. This phenotype resembles that of Pax-5 knock-out mice, but since the coding sequence of the patient Pax-5 cDNA was shown to be normal, the defect might rather result from an altered regulation of this gene. All these data indicate that the patient suffers from a new genetic defect that results in an arrest of differentiation within the proB cell compartment, i.e., earlier than X-linked agammaglobulinemia, before the onset of Ig gene rearrangements.

Full Text

The Full Text of this article is available as a PDF (242.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams B., Dörfler P., Aguzzi A., Kozmik Z., Urbánek P., Maurer-Fogy I., Busslinger M. Pax-5 encodes the transcription factor BSAP and is expressed in B lymphocytes, the developing CNS, and adult testis. Genes Dev. 1992 Sep;6(9):1589–1607. doi: 10.1101/gad.6.9.1589. [DOI] [PubMed] [Google Scholar]
  2. Allen R. C., Zoghbi H. Y., Moseley A. B., Rosenblatt H. M., Belmont J. W. Methylation of HpaII and HhaI sites near the polymorphic CAG repeat in the human androgen-receptor gene correlates with X chromosome inactivation. Am J Hum Genet. 1992 Dec;51(6):1229–1239. [PMC free article] [PubMed] [Google Scholar]
  3. Alt F. W., Blackwell T. K., DePinho R. A., Reth M. G., Yancopoulos G. D. Regulation of genome rearrangement events during lymphocyte differentiation. Immunol Rev. 1986 Feb;89:5–30. doi: 10.1111/j.1600-065x.1986.tb01470.x. [DOI] [PubMed] [Google Scholar]
  4. Baker S. J., Reddy E. P. B cell differentiation: role of E2A and Pax5/BSAP transcription factors. Oncogene. 1995 Aug 3;11(3):413–426. [PubMed] [Google Scholar]
  5. Bauer S. R., Kudo A., Melchers F. Structure and pre-B lymphocyte restricted expression of the VpreB in humans and conservation of its structure in other mammalian species. EMBO J. 1988 Jan;7(1):111–116. doi: 10.1002/j.1460-2075.1988.tb02789.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Blackwell T. K., Alt F. W. Mechanism and developmental program of immunoglobulin gene rearrangement in mammals. Annu Rev Genet. 1989;23:605–636. doi: 10.1146/annurev.ge.23.120189.003133. [DOI] [PubMed] [Google Scholar]
  7. Bossy D., Milili M., Zucman J., Thomas G., Fougereau M., Schiff C. Organization and expression of the lambda-like genes that contribute to the mu-psi light chain complex in human pre-B cells. Int Immunol. 1991 Nov;3(11):1081–1090. doi: 10.1093/intimm/3.11.1081. [DOI] [PubMed] [Google Scholar]
  8. Bossy D., Salamero J., Olive D., Fougereau M., Schiff C. Structure, biosynthesis, and transduction properties of the human mu-psi L complex: similar behavior of preB and intermediate preB-B cells in transducing ability. Int Immunol. 1993 May;5(5):467–478. doi: 10.1093/intimm/5.5.467. [DOI] [PubMed] [Google Scholar]
  9. Busslinger M., Urbánek P. The role of BSAP (Pax-5) in B-cell development. Curr Opin Genet Dev. 1995 Oct;5(5):595–601. doi: 10.1016/0959-437x(95)80028-x. [DOI] [PubMed] [Google Scholar]
  10. Campana D., Farrant J., Inamdar N., Webster A. D., Janossy G. Phenotypic features and proliferative activity of B cell progenitors in X-linked agammaglobulinemia. J Immunol. 1990 Sep 15;145(6):1675–1680. [PubMed] [Google Scholar]
  11. Campbell K. S., Hager E. J., Friedrich R. J., Cambier J. C. IgM antigen receptor complex contains phosphoprotein products of B29 and mb-1 genes. Proc Natl Acad Sci U S A. 1991 May 1;88(9):3982–3986. doi: 10.1073/pnas.88.9.3982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Conley M. E. B cells in patients with X-linked agammaglobulinemia. J Immunol. 1985 May;134(5):3070–3074. [PubMed] [Google Scholar]
  13. Conley M. E., Sweinberg S. K. Females with a disorder phenotypically identical to X-linked agammaglobulinemia. J Clin Immunol. 1992 Mar;12(2):139–143. doi: 10.1007/BF00918144. [DOI] [PubMed] [Google Scholar]
  14. Dorshkind K. Transcriptional control points during lymphopoiesis. Cell. 1994 Dec 2;79(5):751–753. doi: 10.1016/0092-8674(94)90065-5. [DOI] [PubMed] [Google Scholar]
  15. Engel P., Zhou L. J., Ord D. C., Sato S., Koller B., Tedder T. F. Abnormal B lymphocyte development, activation, and differentiation in mice that lack or overexpress the CD19 signal transduction molecule. Immunity. 1995 Jul;3(1):39–50. doi: 10.1016/1074-7613(95)90157-4. [DOI] [PubMed] [Google Scholar]
  16. Gong S., Nussenzweig M. C. Regulation of an early developmental checkpoint in the B cell pathway by Ig beta. Science. 1996 Apr 19;272(5260):411–414. doi: 10.1126/science.272.5260.411. [DOI] [PubMed] [Google Scholar]
  17. Grawunder U., Leu T. M., Schatz D. G., Werner A., Rolink A. G., Melchers F., Winkler T. H. Down-regulation of RAG1 and RAG2 gene expression in preB cells after functional immunoglobulin heavy chain rearrangement. Immunity. 1995 Nov;3(5):601–608. doi: 10.1016/1074-7613(95)90131-0. [DOI] [PubMed] [Google Scholar]
  18. Guelpa-Fonlupt V., Tonnelle C., Blaise D., Fougereau M., Fumoux F. Discrete early pro-B and pre-B stages in normal human bone marrow as defined by surface pseudo-light chain expression. Eur J Immunol. 1994 Jan;24(1):257–264. doi: 10.1002/eji.1830240140. [DOI] [PubMed] [Google Scholar]
  19. Hermanson G. G., Eisenberg D., Kincade P. W., Wall R. B29: a member of the immunoglobulin gene superfamily exclusively expressed on beta-lineage cells. Proc Natl Acad Sci U S A. 1988 Sep;85(18):6890–6894. doi: 10.1073/pnas.85.18.6890. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Hollis G. F., Evans R. J., Stafford-Hollis J. M., Korsmeyer S. J., McKearn J. P. Immunoglobulin lambda light-chain-related genes 14.1 and 16.1 are expressed in pre-B cells and may encode the human immunoglobulin omega light-chain protein. Proc Natl Acad Sci U S A. 1989 Jul;86(14):5552–5556. doi: 10.1073/pnas.86.14.5552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Karasuyama H., Rolink A., Shinkai Y., Young F., Alt F. W., Melchers F. The expression of Vpre-B/lambda 5 surrogate light chain in early bone marrow precursor B cells of normal and B cell-deficient mutant mice. Cell. 1994 Apr 8;77(1):133–143. doi: 10.1016/0092-8674(94)90241-0. [DOI] [PubMed] [Google Scholar]
  22. Kerner J. D., Appleby M. W., Mohr R. N., Chien S., Rawlings D. J., Maliszewski C. R., Witte O. N., Perlmutter R. M. Impaired expansion of mouse B cell progenitors lacking Btk. Immunity. 1995 Sep;3(3):301–312. doi: 10.1016/1074-7613(95)90115-9. [DOI] [PubMed] [Google Scholar]
  23. Kerr W. G., Cooper M. D., Feng L., Burrows P. D., Hendershot L. M. Mu heavy chains can associate with a pseudo-light chain complex (psi L) in human pre-B cell lines. Int Immunol. 1989;1(4):355–361. doi: 10.1093/intimm/1.4.355. [DOI] [PubMed] [Google Scholar]
  24. Khan W. N., Alt F. W., Gerstein R. M., Malynn B. A., Larsson I., Rathbun G., Davidson L., Müller S., Kantor A. B., Herzenberg L. A. Defective B cell development and function in Btk-deficient mice. Immunity. 1995 Sep;3(3):283–299. doi: 10.1016/1074-7613(95)90114-0. [DOI] [PubMed] [Google Scholar]
  25. Kitamura D., Kudo A., Schaal S., Müller W., Melchers F., Rajewsky K. A critical role of lambda 5 protein in B cell development. Cell. 1992 May 29;69(5):823–831. doi: 10.1016/0092-8674(92)90293-l. [DOI] [PubMed] [Google Scholar]
  26. Kozmik Z., Wang S., Dörfler P., Adams B., Busslinger M. The promoter of the CD19 gene is a target for the B-cell-specific transcription factor BSAP. Mol Cell Biol. 1992 Jun;12(6):2662–2672. doi: 10.1128/mcb.12.6.2662. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Kudo A., Sakaguchi N., Melchers F. Organization of the murine Ig-related lambda 5 gene transcribed selectively in pre-B lymphocytes. EMBO J. 1987 Jan;6(1):103–107. doi: 10.1002/j.1460-2075.1987.tb04725.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Lassoued K., Nuñez C. A., Billips L., Kubagawa H., Monteiro R. C., LeBlen T. W., Cooper M. D. Expression of surrogate light chain receptors is restricted to a late stage in pre-B cell differentiation. Cell. 1993 Apr 9;73(1):73–86. doi: 10.1016/0092-8674(93)90161-i. [DOI] [PubMed] [Google Scholar]
  29. Le Deist F., Thoenes G., Corado J., Lisowska-Grospierre B., Fischer A. Immunodeficiency with low expression of the T cell receptor/CD3 complex. Effect on T lymphocyte activation. Eur J Immunol. 1991 Jul;21(7):1641–1647. doi: 10.1002/eji.1830210709. [DOI] [PubMed] [Google Scholar]
  30. Li Y. S., Hayakawa K., Hardy R. R. The regulated expression of B lineage associated genes during B cell differentiation in bone marrow and fetal liver. J Exp Med. 1993 Sep 1;178(3):951–960. doi: 10.1084/jem.178.3.951. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Milili M., Le Deist F., de Saint-Basile G., Fischer A., Fougereau M., Schiff C. Bone marrow cells in X-linked agammaglobulinemia express pre-B-specific genes (lambda-like and V pre-B) and present immunoglobulin V-D-J gene usage strongly biased to a fetal-like repertoire. J Clin Invest. 1993 Apr;91(4):1616–1629. doi: 10.1172/JCI116369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Neale G. A., Kitchingman G. R. mRNA transcripts initiating within the human immunoglobulin mu heavy chain enhancer region contain a non-translatable exon and are extremely heterogeneous at the 5' end. Nucleic Acids Res. 1991 May 11;19(9):2427–2433. doi: 10.1093/nar/19.9.2427. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Nishimoto N., Kubagawa H., Ohno T., Gartland G. L., Stankovic A. K., Cooper M. D. Normal pre-B cells express a receptor complex of mu heavy chains and surrogate light-chain proteins. Proc Natl Acad Sci U S A. 1991 Jul 15;88(14):6284–6288. doi: 10.1073/pnas.88.14.6284. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Nuñez C., Nishimoto N., Gartland G. L., Billips L. G., Burrows P. D., Kubagawa H., Cooper M. D. B cells are generated throughout life in humans. J Immunol. 1996 Jan 15;156(2):866–872. [PubMed] [Google Scholar]
  35. Peschon J. J., Morrissey P. J., Grabstein K. H., Ramsdell F. J., Maraskovsky E., Gliniak B. C., Park L. S., Ziegler S. F., Williams D. E., Ware C. B. Early lymphocyte expansion is severely impaired in interleukin 7 receptor-deficient mice. J Exp Med. 1994 Nov 1;180(5):1955–1960. doi: 10.1084/jem.180.5.1955. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Sakaguchi N., Kashiwamura S., Kimoto M., Thalmann P., Melchers F. B lymphocyte lineage-restricted expression of mb-1, a gene with CD3-like structural properties. EMBO J. 1988 Nov;7(11):3457–3464. doi: 10.1002/j.1460-2075.1988.tb03220.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Sakaguchi N., Melchers F. Lambda 5, a new light-chain-related locus selectively expressed in pre-B lymphocytes. Nature. 1986 Dec 11;324(6097):579–582. doi: 10.1038/324579a0. [DOI] [PubMed] [Google Scholar]
  38. Sanyanusin P., Schimmenti L. A., McNoe L. A., Ward T. A., Pierpont M. E., Sullivan M. J., Dobyns W. B., Eccles M. R. Mutation of the PAX2 gene in a family with optic nerve colobomas, renal anomalies and vesicoureteral reflux. Nat Genet. 1995 Apr;9(4):358–364. doi: 10.1038/ng0495-358. [DOI] [PubMed] [Google Scholar]
  39. Sun X. H. Constitutive expression of the Id1 gene impairs mouse B cell development. Cell. 1994 Dec 2;79(5):893–900. doi: 10.1016/0092-8674(94)90078-7. [DOI] [PubMed] [Google Scholar]
  40. Thompson A., Timmers E., Kenter M. J., Kraakman M. E., Hendriks R. W., Schuurman R. K. Immunoglobulin kappa light chain germ-line transcripts in human precursor B lymphocytes. Eur J Immunol. 1992 Dec;22(12):3167–3171. doi: 10.1002/eji.1830221221. [DOI] [PubMed] [Google Scholar]
  41. Thompson A., Timmers E., Schuurman R. K., Hendriks R. W. Immunoglobulin heavy chain germ-line JH-C mu transcription in human precursor B lymphocytes initiates in a unique region upstream of DQ52. Eur J Immunol. 1995 Jan;25(1):257–261. doi: 10.1002/eji.1830250142. [DOI] [PubMed] [Google Scholar]
  42. Tsukada S., Saffran D. C., Rawlings D. J., Parolini O., Allen R. C., Klisak I., Sparkes R. S., Kubagawa H., Mohandas T., Quan S. Deficient expression of a B cell cytoplasmic tyrosine kinase in human X-linked agammaglobulinemia. Cell. 1993 Jan 29;72(2):279–290. doi: 10.1016/0092-8674(93)90667-f. [DOI] [PubMed] [Google Scholar]
  43. Turner M., Mee P. J., Costello P. S., Williams O., Price A. A., Duddy L. P., Furlong M. T., Geahlen R. L., Tybulewicz V. L. Perinatal lethality and blocked B-cell development in mice lacking the tyrosine kinase Syk. Nature. 1995 Nov 16;378(6554):298–302. doi: 10.1038/378298a0. [DOI] [PubMed] [Google Scholar]
  44. Uckun F. M., Ledbetter J. A. Immunobiologic differences between normal and leukemic human B-cell precursors. Proc Natl Acad Sci U S A. 1988 Nov;85(22):8603–8607. doi: 10.1073/pnas.85.22.8603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Urbánek P., Wang Z. Q., Fetka I., Wagner E. F., Busslinger M. Complete block of early B cell differentiation and altered patterning of the posterior midbrain in mice lacking Pax5/BSAP. Cell. 1994 Dec 2;79(5):901–912. doi: 10.1016/0092-8674(94)90079-5. [DOI] [PubMed] [Google Scholar]
  46. Vetrie D., Vorechovský I., Sideras P., Holland J., Davies A., Flinter F., Hammarström L., Kinnon C., Levinsky R., Bobrow M. The gene involved in X-linked agammaglobulinaemia is a member of the src family of protein-tyrosine kinases. Nature. 1993 Jan 21;361(6409):226–233. doi: 10.1038/361226a0. [DOI] [PubMed] [Google Scholar]
  47. Vorechovský I., Koskinen S., Paganelli R., Smith C. I., Busslinger M., Hammarström L. The PAX5 gene: a linkage and mutation analysis in candidate human primary immunodeficiencies. Immunogenetics. 1995;42(2):149–152. doi: 10.1007/BF00178590. [DOI] [PubMed] [Google Scholar]
  48. Winkler T. H., Rolink A., Melchers F., Karasuyama H. Precursor B cells of mouse bone marrow express two different complexes with the surrogate light chain on the surface. Eur J Immunol. 1995 Feb;25(2):446–450. doi: 10.1002/eji.1830250221. [DOI] [PubMed] [Google Scholar]
  49. Wörmann B., Anderson J. M., Liberty J. A., Gajl-Peczalska K., Brunning R. D., Silberman T. L., Arthur D. C., LeBien T. W. Establishment of a leukemic cell model for studying human pre-B to B cell differentiation. J Immunol. 1989 Jan 1;142(1):110–117. [PubMed] [Google Scholar]
  50. Zhuang Y., Soriano P., Weintraub H. The helix-loop-helix gene E2A is required for B cell formation. Cell. 1994 Dec 2;79(5):875–884. doi: 10.1016/0092-8674(94)90076-0. [DOI] [PubMed] [Google Scholar]
  51. de Weers M., Verschuren M. C., Kraakman M. E., Mensink R. G., Schuurman R. K., van Dongen J. J., Hendriks R. W. The Bruton's tyrosine kinase gene is expressed throughout B cell differentiation, from early precursor B cell stages preceding immunoglobulin gene rearrangement up to mature B cell stages. Eur J Immunol. 1993 Dec;23(12):3109–3114. doi: 10.1002/eji.1830231210. [DOI] [PubMed] [Google Scholar]
  52. de la Morena M., Haire R. N., Ohta Y., Nelson R. P., Litman R. T., Day N. K., Good R. A., Litman G. W. Predominance of sterile immunoglobulin transcripts in a female phenotypically resembling Bruton's agammaglobulinemia. Eur J Immunol. 1995 Mar;25(3):809–815. doi: 10.1002/eji.1830250327. [DOI] [PubMed] [Google Scholar]
  53. ten Boekel E., Melchers F., Rolink A. The status of Ig loci rearrangements in single cells from different stages of B cell development. Int Immunol. 1995 Jun;7(6):1013–1019. doi: 10.1093/intimm/7.6.1013. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES