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Patients with T(+/low) NK(+) IL-2 receptor γ chain deficiency have differentially-impaired cytokine signaling resulting in severe combined immunodeficiency.
[severe combined immunodeficiency]
X-
linked
severe
combined
immunodeficiency
(
X-
SCID
)
leads
to
a
T
(
-
)
NK
(
-
)
B
(
+
)
immunophenotype
and
is
caused
by
mutations
in
the
gene
encoding
the
IL
-
2
receptor
γ-chain
(
IL
2
RG
)
.
IL
2
RG
(
R
222
C
)
leads
to
atypical
SCID
with
a
severe
early
onset
phenotype
despite
largely
normal
NK-
and
T
-
cell
numbers
.
To
address
this
discrepancy
,
we
performed
a
detailed
analysis
of
T
,
B
,
and
NK
cells
,
including
quantitative
STAT
phosphorylation
and
functional
responses
to
the
cytokines
IL
-
2
,
IL
-
4
,
IL
-
15
,
and
IL
-
21
in
a
patient
with
the
IL
2
RG
(
R
222
C
)
mutation
.
Moreover
,
we
identified
nine
additional
unpublished
patients
with
the
same
mutations
,
all
with
a
full
SCID
phenotype
,
and
confirmed
selected
immunological
observations
.
T
-
cell
development
was
variably
affected
,
but
led
to
borderline
T
-
cell
receptor
excision
circle
(
TREC
)
levels
and
a
normal
repertoire
.
T
cells
showed
moderately
reduced
proliferation
,
failing
enhancement
by
IL
-
2
.
While
NK-cell
development
was
normal
,
IL
-
2
enhancement
of
NK-cell
degranulation
and
IL
-
15
-
induced
cytokine
production
were
absent
.
IL
-
2
or
IL
-
21
failed
to
enhance
B-
cell
proliferation
and
plasmablast
differentiation
.
These
functional
alterations
were
reflected
by
a
differential
impact
of
IL
2
RG
(
R
222
C
)
on
cytokine
signal
transduction
,
with
a
gradient
IL
-
4
<
IL
-
2
/
IL
-
15
<
IL
-
21
.
Thus
,
IL
2
RG
(
R
222
C
)
causes
a
consistently
severe
clinical
phenotype
that
is
not
predicted
by
the
variable
and
moderate
impairment
of
T
-
cell
immunity
or
TREC
analysis
.
Diseases
Validation
Diseases presenting
"moderately reduced proliferation"
symptom
severe combined immunodeficiency
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