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Restoring balance to B cells in ADA deficiency
Eline T. Luning Prak
Eline T. Luning Prak
Published May 24, 2012
Citation Information: J Clin Invest. 2012;122(6):1960-1962. https://doi.org/10.1172/JCI63782.
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Commentary

Restoring balance to B cells in ADA deficiency

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Abstract

It is paradoxical that immunodeficiency disorders are associated with autoimmunity. Adenosine deaminase (ADA) deficiency, a cause of X-linked severe combined immunodeficiency (SCID), is a case in point. In this issue of the JCI, Sauer and colleagues investigate the B cell defects in ADA-deficient patients. They demonstrate that ADA patients receiving enzyme replacement therapy had B cell tolerance checkpoint defects. Remarkably, gene therapy with a retrovirus that expresses ADA resulted in the apparent correction of these defects, with normalization of peripheral B cell autoantibody frequencies. In vitro, agents that either block ADA or overexpress adenosine resulted in altered B cell receptor and TLR signaling. Collectively, these data implicate a B cell–intrinsic mechanism for alterations in B cell tolerance in the setting of partial ADA deficiency that is corrected by gene therapy.

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Eline T. Luning Prak

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