Search

A 13-year-old boy with immunodeficiency with hyper-IgM was analyzed for mutations in the CD40L gene. An insertional mutation of an extra T in a run of four T's was found in the second exon of the gene, leading to a premature translation stop. Genetic counselling of the family was performed, based on mutation detection by PCR/oligohybridization.

The patterns of X chromosome inactivation were determined in 14 females from three unrelated X-linked severe combined immunodeficiency (XSCID) pedigrees. All the females were found to be heterozygous for the hypervariable DXS255 locus, enabling analysis of differential methylation of this locus in peripheral blood haematopoietic cells. All six obligate carriers manifested a unilateral X chromosome inactivation in the T lymphocyte population. Differential methylation analysis of T lymphocytes was subsequently applied to establish the carrier status of females at risk in the XSCID pedigrees. In the B lymphocyte population of four XSCID carriers a unilateral X chromosome inactivation was observed. Four other carriers had minor fractions and one carrier had a substantial fraction of B lymphocytes with the XSCID gene defect on the active X chromosome. Within single XSCID pedigrees the carriers manifested different patterns. In two pedigrees the granulocyte populations of all carriers showed a random distribution of X chromosome inactivation. In the third pedigree the granulocytes of the three carriers analyzed manifested complete inactivation of the X chromosome that carried the XSCID mutation, exposing a selective disadvantage of granulocytes that express the XSCID defect. The pedigree-dependent differences in the involvement of the granulocyte population suggest the existence of two distinct XSCID defects.

X-linked agammaglobulinemia (XLA) is a severe antibody deficiency disease reflecting an arrest of B lymphocyte differentiation at the level of precursor B cells. The disease is inherited in an X-linked recessive mode. In a single eight-generation pedigree the XLA gene was mapped to the Xq21.3-Xq22 area of the X chromosome. The data establish close linkage of the XLA locus to the DXS17 restriction fragment length polymorphic (RFLP) marker locus (the lod score exceeding 6 at phi = 0). A series of RFLP markers around the DXS17 locus provided an RFLP haplotype of use in genetic counselling within this pedigree. In one other pedigree a phenotypically identical disease was inherited but was accompanied by a high frequency of recombination with the DXS17 locus, which made localisation of the gene at the DXS17 locus highly unlikely (lod score less than -3). This genetic heterogeneity complicates genetic counselling within particular pedigrees, especially when the localization of the XLA gene involved in those pedigrees has not been established.