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Lugo-Reyes SO, Pastor N, González-Serrano E, Yamazaki-Nakashimada MA, Scheffler-Mendoza S, Berron-Ruiz L, Wakida G, Nuñez-Nuñez ME, Macias-Robles AP, Staines-Boone AT, Venegas-Montoya E, Alaez-Verson C, Molina-Garay C, Flores-Lagunes LL, Carrillo-Sanchez K, Niemela J, Rosenzweig SD, Gaytan P, Yañez JA, Martinez-Duncker I, Notarangelo LD, Espinosa-Padilla S, Cruz-Munoz ME. Clinical Manifestations, Mutational Analysis, and Immunological Phenotype in Patients with RAG1/2 Mutations: First Cases Series from Mexico and Description of Two Novel Mutations. J Clin Immunol 2021; 41:1291-1302. [PMID: 33954879 DOI: 10.1007/s10875-021-01052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/20/2021] [Indexed: 11/25/2022]
Abstract
Mutations in recombinase activating genes 1 and 2 (RAG1/2) result in human severe combined immunodeficiency (SCID). The products of these genes are essential for V(D)J rearrangement of the antigen receptors during lymphocyte development. Mutations resulting in null-recombination activity in RAG1 or RAG2 are associated with the most severe clinical and immunological phenotypes, whereas patients with hypomorphic mutations may develop leaky SCID, including Omenn syndrome (OS). A group of previously unrecognized clinical phenotypes associated with granulomata and/or autoimmunity have been described as a consequence of hypomorphic mutations. Here, we present six patients from unrelated families with missense variants in RAG1 or RAG2. Phenotypes observed in these patients ranged from OS to severe mycobacterial infections and granulomatous disease. Moreover, we report the first evidence of two variants that had not been associated with immunodeficiency. This study represents the first case series of RAG1- or RAG2-deficient patients from Mexico and Latin America.
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Affiliation(s)
| | - Nina Pastor
- Centro de Investigación en Dinámica Celular, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | | | | | | | - Laura Berron-Ruiz
- Laboratorio de Inmunodeficiencias, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Guillermo Wakida
- Laboratorio de Inmunodeficiencias, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | | | | | - Edna Venegas-Montoya
- Unidad Médica de Alta Especialidad 25, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | | | | | | | - Julie Niemela
- Laboratory of Clinical Immunology and Microbiology, National Institute of Health, Mexico City, Mexico
| | - Sergio D Rosenzweig
- Laboratory of Clinical Immunology and Microbiology, National Institute of Health, Mexico City, Mexico
| | - Paul Gaytan
- Instituto de Biotecnología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jorge A Yañez
- Instituto de Biotecnología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ivan Martinez-Duncker
- Centro de Investigación en Dinámica Celular, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Health, Mexico City, Mexico
| | - Sara Espinosa-Padilla
- Laboratorio de Inmunodeficiencias, Instituto Nacional de Pediatría, Mexico City, Mexico.
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Muriel-Vizcaíno R, Treviño-Garza G, Murata C, Staines-Boone AT, Yamazaki-Nakashimada MA, Espinosa-Padilla SE, Espinosa-Rosales FJ. Respuesta a la carta al Editor. Acta Pediatr Mex 2017. [DOI: 10.18233/apm38no2pp136-1381367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Le agradecemos por darnos la oportunidad de contestar a la carta “Magnitud del tamaño del efecto y su importancia en la investigación pediátrica”1 del Dr. Tomás Caycho. También quisiéramos agradecer por las observaciones y comentarios del Dr. Caycho, a través de los cuales se señala la importancia y necesidad de reportar tamaño de efecto en los resultados de análisis estadístico en las investigaciones y de nuestro trabajo: “Calidad de vida de los pacientes con inmunodeficiencias primarias de anticuerpos”2 publicado en esta revista.
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