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  • 1
    Publication Date: 2014-05-30
    Description: Lymphocyte functions triggered by antigen recognition and co-stimulation signals are associated with a rapid and intense cell division, and hence with metabolism adaptation. The nucleotide cytidine 5' triphosphate (CTP) is a precursor required for the metabolism of DNA, RNA and phospholipids. CTP originates from two sources: a salvage pathway and a de novo synthesis pathway that depends on two enzymes, the CTP synthases (or synthetases) 1 and 2 (CTPS1 with CTPS2); the respective roles of these two enzymes are not known. CTP synthase activity is a potentially important step for DNA synthesis in lymphocytes. Here we report the identification of a loss-of-function homozygous mutation (rs145092287) in CTPS1 in humans that causes a novel and life-threatening immunodeficiency, characterized by an impaired capacity of activated T and B cells to proliferate in response to antigen receptor-mediated activation. In contrast, proximal and distal T-cell receptor (TCR) signalling events and responses were only weakly affected by the absence of CTPS1. Activated CTPS1-deficient cells had decreased levels of CTP. Normal T-cell proliferation was restored in CTPS1-deficient cells by expressing wild-type CTPS1 or by addition of exogenous CTP or its nucleoside precursor, cytidine. CTPS1 expression was found to be low in resting T cells, but rapidly upregulated following TCR activation. These results highlight a key and specific role of CTPS1 in the immune system by its capacity to sustain the proliferation of activated lymphocytes during the immune response. CTPS1 may therefore represent a therapeutic target of immunosuppressive drugs that could specifically dampen lymphocyte activation.〈br /〉〈span class="detail_caption"〉Notes: 〈/span〉Martin, Emmanuel -- Palmic, Noe -- Sanquer, Sylvia -- Lenoir, Christelle -- Hauck, Fabian -- Mongellaz, Cedric -- Fabrega, Sylvie -- Nitschke, Patrick -- Esposti, Mauro Degli -- Schwartzentruber, Jeremy -- Taylor, Naomi -- Majewski, Jacek -- Jabado, Nada -- Wynn, Robert F -- Picard, Capucine -- Fischer, Alain -- Arkwright, Peter D -- Latour, Sylvain -- G1001799/Medical Research Council/United Kingdom -- WT095219MA/Wellcome Trust/United Kingdom -- England -- Nature. 2014 Jun 12;510(7504):288-92. doi: 10.1038/nature13386. Epub 2014 May 28.〈br /〉〈span class="detail_caption"〉Author address: 〈/span〉1] Laboratoire Activation Lymphocytaire et Susceptibilite a l'EBV, INSERM UMR 1163, Hopital Necker Enfants-Malades, Paris 75015, France [2] Universite Paris Descartes Sorbonne Paris Cite, Institut Imagine, Paris 75015, France. ; Laboratoire de Biochimie Metabolomique et Proteomique, Hopital Necker Enfants-Malades, Paris 75015, France. ; Hematopoiesis and Immunotherapy, CNRS-UMR 5535, Institut de Genetique Moleculaire de Montpellier, Montpellier 34293, France. ; 1] Universite Paris Descartes Sorbonne Paris Cite, Institut Imagine, Paris 75015, France [2] Plateforme Vecteurs Viraux et Transfert de Genes, IFR94, Hopital Necker Enfants-Malades, Paris 75015, France. ; 1] Universite Paris Descartes Sorbonne Paris Cite, Institut Imagine, Paris 75015, France [2] Service de Bioinformatique, Hopital Necker Enfants-Malades, Paris 75015, France. ; 1] University of Manchester, Royal Manchester Children's Hospital, Manchester M13 0WL, UK [2] Italian Institute of Technology, Genoa 16163, Italy. ; McGill University and Genome Quebec Innovation Centre, Montreal H3A 0G1, Canada. ; 1] McGill University and Genome Quebec Innovation Centre, Montreal H3A 0G1, Canada [2] Department of Pediatrics, McGill University Health Center Research Institute, Montreal H3H 1P3, Canada. ; University of Manchester, Royal Manchester Children's Hospital, Manchester M13 0WL, UK. ; 1] Universite Paris Descartes Sorbonne Paris Cite, Institut Imagine, Paris 75015, France [2] Centre d'Etude des Deficits Immunitaires, Hopital Necker Enfants-Malades, AP-HP, Paris 75015, France [3] Laboratoire Genetique Humaine des Maladies Infectieuses, INSERM UMR 1163, Hopital Necker Enfants-Malades, Paris 75015, France. ; 1] Laboratoire Activation Lymphocytaire et Susceptibilite a l'EBV, INSERM UMR 1163, Hopital Necker Enfants-Malades, Paris 75015, France [2] Universite Paris Descartes Sorbonne Paris Cite, Institut Imagine, Paris 75015, France [3] Unite d'Immunologie et Hematologie Pediatrique, Assistance Publique-Hopitaux de Paris (AP-HP), Hopital Necker Enfants-Malades, Paris 75015, France [4] College de France, Paris 75005, France. ; 1] University of Manchester, Royal Manchester Children's Hospital, Manchester M13 0WL, UK [2]. ; 1] Laboratoire Activation Lymphocytaire et Susceptibilite a l'EBV, INSERM UMR 1163, Hopital Necker Enfants-Malades, Paris 75015, France [2] Universite Paris Descartes Sorbonne Paris Cite, Institut Imagine, Paris 75015, France [3] Laboratoire de Biochimie Metabolomique et Proteomique, Hopital Necker Enfants-Malades, Paris 75015, France [4].〈br /〉〈span class="detail_caption"〉Record origin:〈/span〉 〈a href="http://www.ncbi.nlm.nih.gov/pubmed/24870241" target="_blank"〉PubMed〈/a〉
    Keywords: Antigens, CD3/immunology ; B-Lymphocytes/cytology/immunology/metabolism ; Carbon-Nitrogen Ligases/*deficiency/genetics/*metabolism ; Cell Proliferation ; Child, Preschool ; Cytidine Triphosphate/metabolism ; Female ; Humans ; Immunologic Deficiency Syndromes/enzymology/genetics ; Infant ; Infant, Newborn ; *Lymphocyte Activation/genetics ; Lymphocytes/*cytology/immunology/metabolism ; Male ; Mutation/genetics ; Receptors, Antigen, T-Cell/immunology ; T-Lymphocytes/cytology/immunology/metabolism
    Print ISSN: 0028-0836
    Electronic ISSN: 1476-4687
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
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  • 2
    Publication Date: 2017-06-08
    Description: Changes in the incidence, patterns and outcomes of graft failure following hematopoietic stem cell transplantation for Hurler syndrome Bone Marrow Transplantation 52, 846 (June 2017). doi:10.1038/bmt.2017.5 Authors: S H Lum, W P Miller, S Jones, K Poulton, W Ogden, H Lee, A Logan, D Bonney, T C Lund, P J Orchard & R F Wynn
    Print ISSN: 0268-3369
    Electronic ISSN: 1476-5365
    Topics: Medicine
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  • 3
    Publication Date: 2013-07-05
    Description: Congenital sideroblastic anemias (CSAs) are a heterogeneous group of inherited disorders identified by pathological erythroid precursors with perinuclear mitochondrial iron deposition in bone marrow. An international collaborative group of physicians and laboratory scientists collated clinical information on cases of CSA lacking known causative mutations, identifying a clinical subgroup of CSA associated with B immunodeficiency, periodic fevers, and development delay. Twelve cases from 10 families were identified. Median age at presentation was 2 months. Anemia at diagnosis was sideroblastic, typically severe (median hemoglobin, 7.1 g/dL) and markedly microcytic (median mean corpuscular volume, 62.0 fL). Clinical course involved recurrent febrile illness and gastrointestinal disturbance, lacking an infective cause. Investigation revealed B-cell lymphopenia (CD19 + range, 0.016-0.22 x 10 9 /L) and panhypogammaglobulinemia in most cases. Children displayed developmental delay alongside variable neurodegeneration, seizures, cerebellar abnormalities, sensorineural deafness, and other multisystem features. Most required regular blood transfusion, iron chelation, and intravenous immunoglobulin replacement. Median survival was 48 months, with 7 deaths caused by cardiac or multiorgan failure. One child underwent bone marrow transplantation aged 9 months, with apparent cure of the hematologic and immunologic manifestations. We describe and define a novel CSA and B-cell immunodeficiency syndrome with additional features resembling a mitochondrial cytopathy. The molecular etiology is under investigation.
    Keywords: Pediatric Hematology, Immunobiology, Free Research Articles, Red Cells, Iron, and Erythropoiesis
    Print ISSN: 0006-4971
    Electronic ISSN: 1528-0020
    Topics: Biology , Medicine
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  • 4
    Publication Date: 2012-06-23
    Description: To determine whether in vivo T-cell depletion, which lowers GVHD, abrogates the antileukemic benefits of myeloablative total body irradiation–based conditioning and unrelated donor transplantation, in the present study, we analyzed 715 children with acute lymphoblastic leukemia. Patients were grouped for analysis according to whether conditioning included antithymocyte globulin (ATG; n = 191) or alemtuzumab (n = 132) and no in vivo T-cell depletion (n = 392). The median follow-up time was 3.5 years for the ATG group and 5 years for the alemtuzumab and T cell–replete groups. Using Cox regression analysis, we compared transplantation outcomes between groups. Compared with no T-cell depletion, grade 2-4 acute and chronic GVHD rates were significantly lower after in vivo T-cell depletion with ATG (relative risk [RR] = 0.66; P = .005 and RR = 0.55; P 〈 .0001, respectively) or alemtuzumab (RR = 0.09; P 〈 .003 and RR = 0.21; P 〈 .0001, respectively). Despite lower GVHD rates after in vivo T-cell depletion, nonrelapse mortality, relapse, overall survival, and leukemia-free survival (LFS) did not differ significantly among the treatment groups. The 3-year probabilities of LFS after ATG-containing, alemtuzumab-containing, and T cell–replete transplantations were 43%, 49%, and 46%, respectively. These data suggest that in vivo T-cell depletion lowers GVHD without compromising LFS among children with acute lymphoblastic leukemia who are undergoing unrelated donor transplantation with myeloablative total body irradiation–based regimens.
    Keywords: Transplantation, Lymphoid Neoplasia, Clinical Trials and Observations
    Print ISSN: 0006-4971
    Electronic ISSN: 1528-0020
    Topics: Biology , Medicine
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  • 5
    Publication Date: 2014-12-27
    Description: Mucopolysaccharidosis I Hurler (MPSI-H) is a pediatric lysosomal storage disease caused by genetic deficiencies in IDUA, coding for α-l-iduronidase. Idua−/− mice share similar clinical pathology with patients, including the accumulation of the undegraded glycosaminoglycans (GAGs) heparan sulfate (HS), and dermatan sulfate (DS), progressive neurodegeneration, and dysostosis multiplex. Hematopoietic stem cell transplantation (HSCT) is the most effective treatment for Hurler patients, but reduced intensity conditioning is a risk factor in transplantation, suggesting an underlying defect in hematopoietic cell engraftment. HS is a co-receptor in the CXCL12/CXCR4 axis of hematopoietic stem and progenitor cell (HSPC) migration to the bone marrow (BM), but the effect of HS alterations on HSPC migration, or the functional role of HS in MPSI-H are unknown. We demonstrate defective WT HSPC engraftment and migration in Idua−/− recipient BM, particularly under reduced intensity conditioning. Both intra- but especially extracellular Idua−/− BM HS was significantly increased and abnormally sulfated. Soluble heparinase-sensitive GAGs from Idua−/− BM and specifically 2-O-sulfated HS, elevated in Idua−/− BM, both inhibited CXCL12-mediated WT HSPC transwell migration, while DS had no effect. Thus we have shown that excess overly sulfated extracellular HS binds, and sequesters CXCL12, limiting hematopoietic migration and providing a potential mechanism for the limited scope of HSCT in Hurler disease.
    Print ISSN: 0021-9258
    Electronic ISSN: 1083-351X
    Topics: Biology , Chemistry and Pharmacology
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  • 6
    Publication Date: 2014-10-31
    Description: Mutations in genes encoding proteins that are involved in mitochondrial heme synthesis, iron-sulfur cluster biogenesis, and mitochondrial protein synthesis have previously been implicated in the pathogenesis of the congenital sideroblastic anemias (CSAs). We recently described a syndromic form of CSA associated with B-cell immunodeficiency, periodic fevers, and developmental delay (SIFD). Here we demonstrate that SIFD is caused by biallelic mutations in TRNT1 , the gene encoding the CCA-adding enzyme essential for maturation of both nuclear and mitochondrial transfer RNAs. Using budding yeast lacking the TRNT1 homolog, CCA1, we confirm that the patient-associated TRNT1 mutations result in partial loss of function of TRNT1 and lead to metabolic defects in both the mitochondria and cytosol, which can account for the phenotypic pleiotropy.
    Keywords: Pediatric Hematology, Immunobiology, Red Cells, Iron, and Erythropoiesis, Brief Reports
    Print ISSN: 0006-4971
    Electronic ISSN: 1528-0020
    Topics: Biology , Medicine
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  • 7
    Publication Date: 2015-03-27
    Description: Mucopolysaccharidosis type I–Hurler syndrome (MPS-IH) is a lysosomal storage disease characterized by multisystem morbidity and death in early childhood. Although hematopoietic cell transplantation (HCT) has been performed in these patients for more than 30 years, large studies on the long-term outcome of patients with MPS-IH after HCT are lacking. The goal of this international study was to identify predictors of the long-term outcome of patients with MPS-IH after successful HCT. Two hundred seventeen patients with MPS-IH successfully engrafted with a median follow-up age of 9.2 years were included in this retrospective analysis. Primary endpoints were neurodevelopmental outcomes and growth. Secondary endpoints included neurologic, orthopedic, cardiac, respiratory, ophthalmologic, audiologic, and endocrinologic outcomes. Considerable residual disease burden was observed in the majority of the transplanted patients with MPS-IH, with high variability between patients. Preservation of cognitive function at HCT and a younger age at transplantation were major predictors for superior cognitive development posttransplant. A normal α- l -iduronidase enzyme level obtained post-HCT was another highly significant predictor for superior long-term outcome in most organ systems. The long-term prognosis of patients with MPS-IH receiving HCT can be improved by reducing the age at HCT through earlier diagnosis, as well as using exclusively noncarrier donors and achieving complete donor chimerism.
    Keywords: Pediatric Hematology, Transplantation
    Print ISSN: 0006-4971
    Electronic ISSN: 1528-0020
    Topics: Biology , Medicine
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