RAG deficiencies: Recent advances in disease pathogenesis and novel therapeutic approaches.

RAG deficiencies: Recent advances in disease pathogenesis and novel therapeutic approaches.
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DOI:
10.1002/eji.202048880
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发表时间:
2021-05
影响因子:
5.4
通讯作者:
Notarangelo LD
Notarangelo LD
中科院分区:
医学3区
文献类型:
--
作者:
Bosticardo M;Pala F;Notarangelo LD

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RAG1和RAG2蛋白启动V(D)J重组过程,在获得性免疫中发挥重要作用。虽然RAG基因的零突变会导致严重的联合免疫缺陷,并缺乏T和B细胞(T、−、B、−、SCID),以及对危及生命的早发性感染的易感性,但在人类和小鼠的研究表明,RAG基因的亚型突变与中枢和外周免疫耐受缺陷有关,从而导致免疫失调。在这篇综述中,我们提供了人类RAG缺陷的广谱及其相关的临床和免疫学表型的概述。我们讨论了控制RAG表达和功能的机制,扰乱的RAG活性对淋巴发育和免疫稳态的影响的最新进展,并提出了纠正这类疾病的新方法。
The RAG1 and RAG2 proteins initiate the process of V(D)J recombination and therefore play an essential role in adaptive immunity. While null mutations in the RAG genes cause severe combined immune deficiency with lack of T and B cells (T−B− SCID) and susceptibility to life-threatening, early-onset infections, studies in humans and mice have demonstrated that hypomorphic RAG mutations are associated with defects of central and peripheral tolerance resulting in immune dysregulation. In this review, we provide an overview of the extended spectrum of RAG deficiencies and their associated clinical and immunological phenotypes in humans. We discuss recent advances in the mechanisms that control RAG expression and function, the effects of perturbed RAG activity on lymphoid development and immune homeostasis, and propose novel approaches to correct this group of disorders.
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