title: CD40 ligand (CD40L) expression and B cell function in agammaglobulinemia with normal or elevated levels of IgM (HIM). Comparison of X-linked, autosomal recessive, and non-X-linked forms of the disease, and obligate carriers.
abstract: Hyper-IgM syndrome is a rare immunodeficiency characterized by low or absent IgG, IgA, and IgE with normal or elevated levels of IgM. It can occur as an acquired or familial disorder with either X-linked or autosomal modes of inheritance. The X-linked form (HIGM1) is a result of mutations in the CD40 ligand (CD40L) gene, but the defect in non-X-linked forms of the disease (HIM) has not been determined. We show here that CD40L expression on activated T cells from non-X-linked patients can be detected by CD40Fc, 5c8 Mab, and anti-TRAP, whereas activated T cells from HIGM1 patients either had no detectable CD40L (Type I), or stained with anti-TRAP but not CD40Fc or 5c8 (Type II). Activated T cells from obligate carriers varied from low to normal expression of CD40L. B cells from HIGM1 and non-X-linked HIM patients proliferated in response to CD40L. Costimulation of B cells from HIGM1, from sporadic HIM, or from non-X-linked HIM patients with CD40L plus IL-2 resulted in some IgM production, but no significant IgG or IgA. Costimulation with CD40L plus IL-10 resulted in significant IgG and/or IgA secretion by B cells from some HIGM1 patients, but consistently failed to stimulate IgG or IgA secretion by B cells from non-X-linked patients. In addition, costimulation with CD40L and IL-4 failed to induce IgE secretion by B cells from one non-X-linked HIM patient, and induced a weak response in another. These results suggest that patients with non-X-linked forms of HIM may have an intrinsic B cell defect preventing heavy chain switching, which is not related to expression of CD40L.
authors.affiliation: Cellular Immunology Unit, Institute of Child Health, London, UK.
authors.forename: R E
authors.initials: RE
authors.lastname: Callard
authors.forename: S H
authors.initials: SH
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Herbert
authors.forename: G
authors.initials: G
authors.lastname: Morgan
authors.forename: M
authors.initials: M
authors.lastname: Padayachee
authors.forename: S
authors.initials: S
authors.lastname: Lederman
authors.forename: L
authors.initials: L
authors.lastname: Chess
authors.forename: R A
authors.initials: RA
authors.lastname: Kroczek
authors.forename: W C
authors.initials: WC
authors.lastname: Fanslow
authors.forename: R J
authors.initials: RJ
authors.lastname: Armitage
mesh_terms: D000293:Adolescent; D000328:Adult; D000361:Agammaglobulinemia / Q000235:genetics / Q000276:immunology*; D000917:Antibody Formation; D001402:B-Lymphocytes / Q000276:immunology*; D023201:CD40 Ligand; D002648:Child; D002675:Child, Preschool; D005260:Female; D006579:Heterozygote; D006801:Humans; D007075:Immunoglobulin M / Q000378:metabolism*; D016753:Interleukin-10 / Q000494:pharmacology; D007376:Interleukin-2 / Q000494:pharmacology; D008213:Lymphocyte Activation; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D013601:T-Lymphocytes / Q000378:metabolism*; D014960:X Chromosome
chemical_list: D007075:Immunoglobulin M; D007376:Interleukin-2; D008562:Membrane Glycoproteins; D016753:Interleukin-10; D023201:CD40 Ligand