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| X-linked lymphoproliferative disease Classification and external resources |
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| ICD-10 | D82.3 |
|---|---|
| OMIM | 308240 |
| DiseasesDB | 3998 |
| eMedicine | med/1370 |
| MeSH | D008232 |
X-linked lymphoproliferative disease is a lymphoproliferative disorder.
Contents |
Causes
There is a mutation on the X chromosome that has been found to be associated with a T and NK cell lymphoproliferative disorder. The mutation is on the long arm of the chromosome, at position 25, which is denoted as Xq25. At this position, there is a deletion in the SH2D1A gene, which codes for an SH2 domain on a signal transducing protein called SLAM-associated protein (SAP).
The term SH2 domain stands for src-homology 2 domain, which is a three-dimensional domain structure of about 100 amino acid residues. These domains are present in many signaling proteins because they permit specific, non-covalent bonding to proteins that contain phosphotyrosines. The amino acid residues adjacent to the phosphotyrosine on the target protein are what determine the unique binding specificity.1
The SAP protein is important in the signaling events that activate T and NK cells2 because it functions as an intracellular adapter that transduces T and NK cell activation. Normally, the SAP protein is expressed in the cytoplasm of T and NK cells, where it binds to the cytoplasmic domain of the surface receptor called Signaling Lymphocyte Activation Molecule (SLAM). This binding initiates a signal transduction pathway, which results in the modulation of IFN-γ. A deletion in the SH2D1A gene leads to a non-functional SH2 domain on the SAP protein, which means it is unable to bind to the SLAM molecule, leading to a lack of modulation of IFN-γ, causing uncontrolled cell proliferation.
Presentation
Strangely, in boys with X-linked lymphoproliferative disorder there is an overwhelming T-cell mediated response to the Epstein-Barr virus (EBV), which often leads to death from bone marrow failure, irreversible hepatitis, and malignant lymphoma. However, the connection between EBV and X-linked lymphoproliferative disorder is yet to be determined.3
Patients produce insufficient numbers of CD27 memory B cells.4
References
- ^ Abbas, A.K and Lichtman, A.H. Cellular and Molecular Immunology. Fifth Edition. Elsevier Saunders. Philadelphia. 2005
- ^ "X-linked Lymphoproliferative Syndrome: Immunodeficiency Disorders: Merck Manual Professional". Retrieved on 2008-03-01.
- ^ Winter, S.S. Lymphoproliferative disorders. Emedicine. December 20, 2006. http://www.emedicine.com/ped/topic1345.htm. Accessed March 2007.
- ^ Ma CS, Pittaluga S, Avery DT, et al (February 2006). "Selective generation of functional somatically mutated IgM+CD27+, but not Ig isotype-switched, memory B cells in X-linked lymphoproliferative disease". J. Clin. Invest. 116 (2): 322–33. doi:. PMID 16424938. PMC: 1332028, http://dx.doi.org/10.1172/JCI25720.
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Wikipedia content modification information:
- This page was last modified on 17 September 2008, at 19:08.
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