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==Overview==
==Overview==
'''Bare lymphocyte syndrome''' is a condition caused by deficiencies in [[major histocompatibility complex]]:
'''Bare lymphocyte syndrome''' is a condition caused by [[mutation]]s in certain genes of the [[major histocompatibility complex]] or involved with the processing and presentation of MHC molecules. It is a form of [[severe combined immunodeficiency]].<ref name="pmid10938133">{{cite journal |vauthors=DeSandro AM, Nagarajan UM, Boss JM |title=Associations and interactions between bare lymphocyte syndrome factors |journal=Mol. Cell. Biol. |volume=20 |issue=17 |pages=6587–99 |date=September 2000 |pmid=10938133 |pmc=86141 |doi= 10.1128/MCB.20.17.6587-6599.2000|url=http://mcb.asm.org/cgi/pmidlookup?view=long&pmid=10938133}}</ref>


==Classification==
* Type 1: [[MHC class I]]
* Type 1: [[MHC class I]]
* Type 2: [[MHC class II]]
* Type 2: [[MHC class II]]


The bare lymphocyte syndrome, type II (BLS II) is a rare [[recessive]] genetic condition in which a group of genes called [[major histocompatibility complex]] class II (MHC class II) are not expressed. The result is that the [[immune system]] is severely compromised and cannot effectively fight [[infection]].  Clinically, this is known as a [[severe combined immunodeficiency]] (SCID).
==Presentation==
The bare lymphocyte syndrome, type II (BLS II) is a rare [[recessive]] genetic condition in which a group of genes called [[major histocompatibility complex]] class II (MHC class II) are not expressed.
 
The result is that the [[immune system]] is severely compromised and cannot effectively fight [[infection]].  Clinically, this is similar to [[severe combined immunodeficiency]] (SCID), in which [[lymphocyte]] precursor cells are improperly formed. As a notable contrast, however, bare lymphocyte syndrome does not result in decreased B- and T-cell counts, as the development of these cells is not impaired.
 
[[Diarrhea]] can be among the associated conditions.<ref name="urlImmunologic Disease and Disorders">{{cite web |url=http://www.lib.mcg.edu/edu/esimmuno/casehist/diseases/barelymp.htm |title=Immunologic Disease and Disorders |work= |accessdate=}}</ref>


The genetic basis for BLSII is not due to defects in the MHC II genes themselves. The genetic basis is the result of [[mutations]] in [[genes]] that code for proteins ([[transcription factors]]) that normally regulate the expression ([[gene transcription]]) of the MHC II genes. That is, one of the several proteins that are required to switch on MHC II genes in various cells types (primarily those in the immune system) is absent. The genes responsible were cloned by the laboratories of Bernard Mach<ref>{{cite journal |author=Reith W, Mach B |title=The bare lymphocyte syndrome and the regulation of MHC expression |journal=Annu. Rev. Immunol. |volume=19 |issue= |pages=331-73 |year=2001 |pmid=11244040 |doi=10.1146/annurev.immunol.19.1.331}}</ref> in Switzerland and Jeremy Boss<ref>{{cite journal |author=DeSandro A, Nagarajan UM, Boss JM |title=The bare lymphocyte syndrome: molecular clues to the transcriptional regulation of major histocompatibility complex class II genes |journal=Am. J. Hum. Genet. |volume=65 |issue=2 |pages=279-86 |year=1999 |pmid=10417269 |doi=}}</ref> at Emory University in Atlanta, Georgia. Mutation in any one of four genes can lead to BLS II. The genes' names are: class II trans-activator ([[CIITA]]), regulatory factor of the X box 5 (RFX5), RFX-associated protein (RFXAP) and RFX ankyrin repeats (RFXANK; also known as RFXB).
==Genetics==


Though BLSII is an attractive candidate for [[gene therapy]] , bone marrow transplant is currently the only treatment.
===BLS II===
The genetic basis for BLSII is not due to defects in the MHC II genes themselves.  The genetic basis is the result of [[mutations]] in [[genes]] that code for proteins ([[transcription factors]]) that normally regulate the expression ([[gene transcription]]) of the MHC II genes.  That is, one of the several proteins that are required to switch on MHC II genes in various cells types (primarily those in the immune system) is absent.  The genes responsible were cloned by the laboratories of Bernard Mach<ref>{{cite journal |vauthors=Reith W, Mach B |title=The bare lymphocyte syndrome and the regulation of MHC expression |journal=Annu. Rev. Immunol. |volume=19 |issue= |pages=331–73 |year=2001 |pmid=11244040 |doi=10.1146/annurev.immunol.19.1.331}}</ref> in Switzerland and Jeremy Boss<ref>{{cite journal |vauthors=DeSandro A, Nagarajan UM, Boss JM |title=The bare lymphocyte syndrome: molecular clues to the transcriptional regulation of major histocompatibility complex class II genes |journal=Am. J. Hum. Genet. |volume=65 |issue=2 |pages=279–86 |year=1999 |pmid=10417269 |doi=10.1086/302519 |pmc=1377925}}</ref> at Emory University in Atlanta, Georgia.


==References==
Mutation in any one of four genes can lead to BLS II.  The genes' names are:
{{Reflist|2}}
* class II trans-activator ([[CIITA]])
* regulatory factor of the X box 5 ([[RFX5]])
* RFX-associated protein ([[RFXAP]])
* RFX ankyrin repeats ([[RFXANK]]; also known as RFXB)


{{Immune disorders}}
===BLS I===
BLS I, also called "HLA class I deficiency", which is much more rare, is associated with [[TAP2]], [[TAP1]], or [[TAPBP]].<ref name=OMIM>{{OMIM|604571|title=BARE LYMPHOCYTE SYNDROME, TYPE I}}</ref>


==Treatment==
Though BLSII is an attractive candidate for [[gene therapy]], bone marrow transplant is currently the only treatment.


[[Category:Genetic disorders]]
== References ==
{{reflist|2}}


[[pl:Zespół nagich limfocytów]]
{{Immune disorders}}


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Revision as of 21:28, 3 June 2016

Bare lymphocyte syndrome
ICD-10 D81.6
OMIM 604571 209920
DiseasesDB 29570 Template:DiseasesDB2
MeSH D016511

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Bare lymphocyte syndrome is a condition caused by mutations in certain genes of the major histocompatibility complex or involved with the processing and presentation of MHC molecules. It is a form of severe combined immunodeficiency.[1]

Classification

Presentation

The bare lymphocyte syndrome, type II (BLS II) is a rare recessive genetic condition in which a group of genes called major histocompatibility complex class II (MHC class II) are not expressed.

The result is that the immune system is severely compromised and cannot effectively fight infection. Clinically, this is similar to severe combined immunodeficiency (SCID), in which lymphocyte precursor cells are improperly formed. As a notable contrast, however, bare lymphocyte syndrome does not result in decreased B- and T-cell counts, as the development of these cells is not impaired.

Diarrhea can be among the associated conditions.[2]

Genetics

BLS II

The genetic basis for BLSII is not due to defects in the MHC II genes themselves. The genetic basis is the result of mutations in genes that code for proteins (transcription factors) that normally regulate the expression (gene transcription) of the MHC II genes. That is, one of the several proteins that are required to switch on MHC II genes in various cells types (primarily those in the immune system) is absent. The genes responsible were cloned by the laboratories of Bernard Mach[3] in Switzerland and Jeremy Boss[4] at Emory University in Atlanta, Georgia.

Mutation in any one of four genes can lead to BLS II. The genes' names are:

  • class II trans-activator (CIITA)
  • regulatory factor of the X box 5 (RFX5)
  • RFX-associated protein (RFXAP)
  • RFX ankyrin repeats (RFXANK; also known as RFXB)

BLS I

BLS I, also called "HLA class I deficiency", which is much more rare, is associated with TAP2, TAP1, or TAPBP.[5]

Treatment

Though BLSII is an attractive candidate for gene therapy, bone marrow transplant is currently the only treatment.

References

  1. DeSandro AM, Nagarajan UM, Boss JM (September 2000). "Associations and interactions between bare lymphocyte syndrome factors". Mol. Cell. Biol. 20 (17): 6587–99. doi:10.1128/MCB.20.17.6587-6599.2000. PMC 86141. PMID 10938133.
  2. "Immunologic Disease and Disorders".
  3. Reith W, Mach B (2001). "The bare lymphocyte syndrome and the regulation of MHC expression". Annu. Rev. Immunol. 19: 331–73. doi:10.1146/annurev.immunol.19.1.331. PMID 11244040.
  4. DeSandro A, Nagarajan UM, Boss JM (1999). "The bare lymphocyte syndrome: molecular clues to the transcriptional regulation of major histocompatibility complex class II genes". Am. J. Hum. Genet. 65 (2): 279–86. doi:10.1086/302519. PMC 1377925. PMID 10417269.
  5. Online Mendelian Inheritance in Man (OMIM) 604571