Somatic mosaicism caused by monoallelic reversion of a mutation in T cells of a patient with ADA-SCID and the effects of enzyme replacement therapy on the revertant phenotype

Details

Serval ID
serval:BIB_AD8F58EE8EA0
Type
Article: article from journal or magazin.
Collection
Publications
Title
Somatic mosaicism caused by monoallelic reversion of a mutation in T cells of a patient with ADA-SCID and the effects of enzyme replacement therapy on the revertant phenotype
Journal
Scand J Immunol
Author(s)
Moncada-Velez M., Velez-Ortega A., Orrego J., Santisteban I., Jagadeesh J., Olivares M., Olaya N., Hershfield M., Candotti F., Franco J.
ISSN
1365-3083 (Electronic)
ISSN-L
0300-9475
Publication state
Published
Issued date
11/2011
Volume
74
Number
5
Pages
471-81
Language
english
Notes
Moncada-Velez, M
Velez-Ortega, A
Orrego, J
Santisteban, I
Jagadeesh, J
Olivares, M
Olaya, N
Hershfield, M
Candotti, F
Franco, J
eng
Z01 HG000122-10/Intramural NIH HHS/
Z01 HG000122-11/Intramural NIH HHS/
Z99 HG999999/Intramural NIH HHS/
ZIA HG000122-13/Intramural NIH HHS/
Case Reports
Research Support, Non-U.S. Gov't
England
Scand J Immunol. 2011 Nov;74(5):471-81. doi: 10.1111/j.1365-3083.2011.02593.x.
Abstract
Patients with adenosine deaminase (ADA) deficiency exhibit spontaneous and partial clinical remission associated with somatic reversion of inherited mutations. We report a child with severe combined immunodeficiency (T-B- SCID) due to ADA deficiency diagnosed at the age of 1 month, whose lymphocyte counts including CD4+ and CD8+ T and NK cells began to improve after several months with normalization of ADA activity in Peripheral blood lymphocytes (PBL), as a result of somatic mosaicism caused by monoallelic reversion of the causative mutation in the ADA gene. He was not eligible for haematopoietic stem cell transplantation (HSCT) or gene therapy (GT); therefore he was placed on enzyme replacement therapy (ERT) with bovine PEG-ADA. The follow-up of metabolic and immunologic responses to ERT included gradual improvement in ADA activity in erythrocytes and transient expansion of most lymphocyte subsets, followed by gradual stabilization of CD4+ and CD8+ T (with naive phenotype) and NK cells, and sustained expansion of TCRgammadelta+ T cells. This was accompanied by the disappearance of the revertant T cells as shown by DNA sequencing from PBL. Although the patient's clinical condition improved marginally, he later developed a germinal cell tumour and eventually died at the age of 67 months from sepsis. This case adds to our current knowledge of spontaneous reversion of mutations in ADA deficiency and shows that the effects of the ERT may vary among these patients, suggesting that it could depend on the cell and type in which the somatic mosaicism is established upon reversion.
Keywords
Adenosine Deaminase/administration & dosage/genetics/immunology/*metabolism, Animals, CD4-Positive T-Lymphocytes/drug effects/immunology/metabolism/pathology, CD8-Positive T-Lymphocytes/drug effects/immunology/metabolism/pathology, Cattle, Cell Count, Child, Child, Preschool, DNA Mutational Analysis, *Enzyme Replacement Therapy, Fatal Outcome, Humans, Immunophenotyping, Infant, Killer Cells, Natural/pathology, Lung Neoplasms/complications/*genetics/physiopathology/secondary/*therapy, Male, Mosaicism/drug effects, Mutation/genetics, Neoplasms, Unknown, Primary/complications/*genetics/pathology/physiopathology/*therapy, Receptors, Antigen, T-Cell/metabolism, Severe Combined, Immunodeficiency/complications/*genetics/pathology/physiopathology/*therapy, Shock, Septic
Pubmed
Open Access
Yes
Create date
01/11/2017 10:29
Last modification date
20/08/2019 15:17
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