Regulation of genes for HLA class II antigens in cell lines from patients with severe combined immunodeficiency

Successful treatment with an unrelated-donor bone marrow transplant in an HLA-deficient patient with severe combined immune deficiency ("bare lymphocyte syndrome")

An 8-month-old white female infant with Pneumocystis carinii pneumonia had a normal blastogenic response to mitogens but no response to a variety of antigens, as well as a poor response to allogeneic cells in one-way mixed lymphocyte culture assays. The patient's mononuclear cells had defective class I (HLA-A, -B, -C) and absent class II (HLA-D) antigen expression on their surface, thus establishing the diagnosis of HLA-deficient severe combined immune deficiency (bare lymphocyte syndrome). Family HLA typing, in vitro stimulation of patient mononuclear cells, and sequence-specific oligonucleotide probe hybridization allowed the patients HLA phenotype to be determined. An unrelated bone marrow donor whose phenotype matched at all but a single A locus was found. The patient was conditioned with busulfan and cyclophosphamide, followed by infusion of T-cell-depleted bone marrow cells. The patient has been infection free with a successful marrow graft documented by HLA typing and chromosomal analysis. Sequence-specific oligonucleotide probe hybridization allows determination of the HLA phenotype in patients with HLA-deficient severe combined immune deficiency which, in turn, makes marrow transplantation an option for the reconstitution of these patients' immune system.

The MHC class II deficiency syndrome: heterogeneity at the level of the response to 5-azadeoxycytidine

The involvement of DNA methylation in aberrant MHC class II gene expression in EBV-transformed B-cell lines from 2 patients (THF and DGN) with the MHC class II deficiency syndrome (bare lymphocyte syndrome) was investigated. Incubation of the cells in the presence of various concentrations of 5-azadeoxycytidine resulted in the induction of expression of HLA DR genes in the DGN cell line, whereas, in the THF cell line, no effect of 5-azadeoxycytidine treatment on the expression of the HLA DR genes could be detected. Subsequent Southern blot analysis using methylation-sensitive restriction enzymes (ApyI, EcoRII and HhaI) and 5-azadeoxcycytidine-treated and untreated genomic DNA, indicated that the lack of HLA DR-A expression in the DGN cell line is not caused by hypermethylation of the 5' region of the HLA DR-A gene. These results indicate that 5-azadeoxycytidine treatment of the DGN cell line leads to activation of a methylation-sensitive factor that is involved in the regulation of transcription of the DR-A gene. In cell line THF, however, demethylation does not restore the activity of this factor. The lack of MHC class II expression in this cell line is caused by some other defect. The results of our analysis indicate that at least two different factors are involved in regulation of MHC class II gene expression.

Mutational analysis of the DRA promoter: cis-acting sequences and trans-acting factors

Class II major histocompatibility genes are expressed at high levels in B lymphocytes and are gamma interferon (IFN-gamma) inducible in many other cells. Previously, we observed that DRA promoter sequences from positions -150 to +31 determine the tissue specificity of this class II gene. Moreover, Z and X boxes located between positions -145 and -87 conferred B-cell specificity and IFN-gamma inducibility upon a heterologous promoter. In this study, sequences from positions -145 to -35 in the DRA promoter were systematically mutated by using oligonucleotide cassettes. Z (-131 to -125), pyrimidine (-116 to -109), X (-108 to -95), Y (-73 to -61), and octamer (-52 to -45) boxes were required for B-cell specificity and, with the exception of the octamer box, for IFN-gamma inducibility. Z box and sequences flanking Z and X boxes helped to determine low levels of expression in T and uninduced cells. In phenotypically distinct cells, shared and distinct proteins bound to these conserved upstream sequences. However, few correlations between expression and DNA-binding proteins could be made. Similar proteins bound to Z and X boxes, and the Z box most likely represents a duplication of the X box.

Congenital immunodeficiencies associated with absence of HLA class II antigens on lymphocytes result from distinct mutations in trans-acting factors

Coordinate regulation of HLA class II gene expression during development and coinduction of class II genes by soluble factors suggests that common trans-acting factor(s) control expression of these genes. In B-lymphoblastoid cell lines derived from two independent class II-deficient bare lymphocyte syndrome patients, we observed a drastic decrease in transcription rates of the class II genes. When these cell lines are fused, class II genes are reexpressed, indicating that immunodeficiencies in bare lymphocyte syndrome patients are the result of two distinct mutations. Further studies show that genes governing the expression of class II antigens fall into at least three complementation groups; two of these were previously unidentified in mutant cell lines generated in vitro. In addition, we report the identification of two discrete complexes, NFX1.1 and NFX1.2, that bind to the DRA X consensus element. Though the mutation in at least one mutant line generated in vitro (RJ2.2.5) affects products functioning via interaction with the X box, clear alterations in either NFX1.1 or NFX1.2 are not found in any of the mutant cell lines.

Monoclonal antibodies for diagnosis of immunodeficiencies

Progress in immunophenotyping is characterized by the availability of monoclonal antibodies and an increased number of clusters of differentiation consisting of reagents with known specificity and defined reactivity patterns. Technical improvements have lead to standardization of immunofluorescence staining procedures and broad application of flow cytometry. These developments have contributed to better diagnosis of immunodeficiencies characterized by the lack of certain lymphocyte subsets or more broadly expressed, functionally important cell-surface molecules. Antibodies valuable for routine immunophenotyping of immunodeficiencies as well as examples of the different antibody groups desirable for immunofluorescence studies are presented. When used in concert with clinical and other laboratory tests, immunophenotyping provides a valuable instrument for differential diagnosis of defects in the immune system. As a consequence, detection of new defects of cell surface antigens and respective cell subpopulations is facilitated and a basis is provided for further study of the genetic and molecular regulatory aspects of immunologic disorders.

Cloning of the major histocompatibility complex class II promoter binding protein affected in a hereditary defect in class II gene regulation

The regulation of major histocompatibility complex class II gene expression is directly involved in the control of normal and abnormal immune responses. In humans, HLA-DR, -DQ, and -DP class II heterodimers are encoded by a family of alpha- and beta-chain genes clustered in the major histocompatibility complex. Their expression is developmentally controlled and normally restricted to certain cell types. This control is mediated by cis-acting sequences in class II promoters and by trans-acting regulatory factors. Several nuclear proteins bind to class II promoter sequences. In a form of hereditary immunodeficiency characterized by a defect in a trans-acting regulatory factor controlling class II gene transcription, we have observed that one of these nuclear factors (RF-X) does not bind to its target sequence (the class II X box). A cDNA encoding RF-X was isolated by screening a phage expression library with an X-box binding-site probe. The recombinant protein has the binding specificity of RF-X, including a characteristic gradient of affinity for the X boxes of HLA-DR, -DP, and -DQ promoters. RF-X mRNA is present in the regulatory mutants, indicating a defect in the synthesis of a functional form of the RF-X protein.

Bare lymphocyte syndrome: altered HLA class II expression in B cell lines derived from two patients

Types II and III bare lymphocyte syndrome (BLS) are severe or lethal congenital immunodeficiencies characterized by defective cell surface expression of HLA class II antigens. We have analyzed by Southern and Northern blotting B-lymphoblastoid cell lines derived by Epstein-Barr virus (EBV) transformation from peripheral blood lymphocytes of two unrelated BLS patients and their families. While DNA analyses of both families showed no indication of rearrangement or alteration of HLA region genes, class II mRNAs were virtually absent in the patients' cell lines (BLS-1 and BLS-2). This is consistent with previous observations of different BLS patients and their families. An exception to the absence of class II mRNAs in BLS was the detection of low quantities of HLA-DQ alpha transcripts in the cell lines BLS-1. This finding provides further evidence that factors regulating HLA-DQ expression may differ from those governing expression of the other class II genes.

Inherited immunodeficiency with a defect in a major histocompatibility complex class II promoter-binding protein differs in the chromatin structure of the HLA-DRA gene

A defect in a trans-regulatory factor which controls major histocompatibility complex class II gene expression is responsible for an inherited form of immunodeficiency with a lack of expression of human leukocyte antigen (HLA) class II antigens. We have recently described and cloned an HLA class II promoter DNA-binding protein, RF-X, present in normal B cells and absent in these class II-deficient regulatory mutants. Here we report that these in vitro results correlate with a specific change in the chromatin structure of the class II promoter: two prominent DNase I-hypersensitive sites were identified in the promoter of the HLA-DRA gene in normal B lymphocytes and found to be absent in the class II-deficient mutant cells. The same two prominent DNase I-hypersensitive sites were observed in normal fibroblastic cells induced by gamma interferon to express class II genes. Interestingly, they were also observed in the uninduced class II-negative fibroblastic cells, which have also been shown to have a normal RF-X binding pattern. We conclude that the two DNase I-hypersensitive sites in the HLA-DRA promoter reflect features in chromatin structure which correlate with the binding of the trans-acting factor RF-X and which are necessary but not sufficient for the expression of class II genes.

Ovarian hormones, antiestrogen and pregnancy effects on the expression of class II histocompatibility antigens by N-nitroso-N-methylurea-induced rat mammary carcinomas

Hormonal modulation of Class II histocompatibility antigen expression was studied in female Sprague-Dawley rats with N-nitroso-N-methylurea-induced mammary tumors. The effects of ovarian hormones, pregnancy and lactation were examined when cancers appeared. At this time, rats with tumors were divided into several groups. Different groups received respectively 17 beta-estradiol alone, 17 beta-estradiol in association with progesterone, and tamoxifen alone. Other groups were selected to undergo pregnancy. The control group received carcinogenic treatment only. For all removed tumors, Class II histocompatibility antigens were radiolabeled, specifically immunoprecipitated with monoclonal antibody and quantified by chromatofocusing. The amount of Class II histocompatibility antigens measured in NMU-induced rat mammary tumors without any hormonal treatment decreased significantly after treatment with estrogen alone or in association with antiestrogen and during the pregnancy. Nevertheless, Class II histocompatibility antigen expression was not changed in mammary carcinoma from rats receiving progesterone, but increased significantly during the lactation. These results demonstrated clearly that ovarian hormones change the Class II histocompatibility antigen expression of NMU-induced mammary tumors in female Sprague-Dawley rats.

Inherited immunodeficiency with a defect in a major histocompatibility complex class II promoter-binding protein differs in the chromatin structure of the HLA-DRA gene

A defect in a trans-regulatory factor which controls major histocompatibility complex class II gene expression is responsible for an inherited form of immunodeficiency with a lack of expression of human leukocyte antigen (HLA) class II antigens. We have recently described and cloned an HLA class II promoter DNA-binding protein, RF-X, present in normal B cells and absent in these class II-deficient regulatory mutants. Here we report that these in vitro results correlate with a specific change in the chromatin structure of the class II promoter: two prominent DNase I-hypersensitive sites were identified in the promoter of the HLA-DRA gene in normal B lymphocytes and found to be absent in the class II-deficient mutant cells. The same two prominent DNase I-hypersensitive sites were observed in normal fibroblastic cells induced by gamma interferon to express class II genes. Interestingly, they were also observed in the uninduced class II-negative fibroblastic cells, which have also been shown to have a normal RF-X binding pattern. We conclude that the two DNase I-hypersensitive sites in the HLA-DRA promoter reflect features in chromatin structure which correlate with the binding of the trans-acting factor RF-X and which are necessary but not sufficient for the expression of class II genes.