Update on the hyper immunoglobulin M syndromes.

Update on the hyper immunoglobulin M syndromes.
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DOI:
10.1111/j.1365-2141.2010.08077.x
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发表时间:
2010-04
影响因子:
6.5
通讯作者:
Thrasher AJ
Thrasher AJ
中科院分区:
医学2区
文献类型:
--
作者:
Davies EG;Thrasher AJ

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高免疫球蛋白M综合征(HIGH M)是一组异质性遗传性疾病,其导致免疫球蛋白类别转换重组(CSR)缺陷,伴或不伴体细胞超突变(SHM)缺陷。它们可以被分类为通过CD 40的信号传导缺陷,导致体液免疫缺陷和对机会性感染的易感性,或导致纯体液免疫缺陷的CSR机制的B细胞中的内在缺陷。一个高图像也可以被看作是DNA修复和抗体缺乏综合征,如常见的可变免疫缺陷的一般性缺陷的一部分。CD40信号传导缺陷可能需要骨髓移植的纠正治疗。基因治疗作为一种潜在的治疗方法,目前仍是一个遥远的前景。那些有缺陷的CSR机制通常做好免疫球蛋白替代治疗。并发症可能包括自身免疫、淋巴增生,在某些情况下,易患淋巴恶性肿瘤。
The Hyper-immunoglobulin M syndromes (HIGM) are a heterogeneous group of genetic disorders resulting in defects of immunoglobulin class switch recombination (CSR), with or without defects of somatic hypermutation (SHM). They can be classified as defects of signalling through CD40 causing both a humoral immunodeficiency and a susceptibility to opportunistic infections, or intrinsic defects in B cells of the mechanism of CSR resulting in a pure humoral immunodeficiency. A HIGM picture can also be seen as part of generalized defects of DNA repair and in antibody deficiency syndromes, such as common variable immunodeficiency. CD40 signalling defects may require corrective therapy with bone marrow transplantation. Gene therapy, a potential curative approach in the future, currently remains a distant prospect. Those with a defective CSR mechanism generally do well on immunologoblulin replacement therapy. Complications may include autoimmunity, lymphoid hyperplasia and, in some cases, a predisposition to lymphoid malignancy.
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