Mutations in Btk, μ heavy chain, or the surrogate light chain account for 85–90% of patients with early onset hypogammaglobulinemia and absent B cells. The nature of the defect in the remaining patients is unknown. We screened 25 such patients for mutations in genes encoding components of the pre–B-cell receptor (pre-BCR) complex. A 2-year-old girl was found to have a homozygous splice defect in Igα, a transmembrane protein that forms part of the Igα/Igβ signal-transduction module of the pre-BCR. Studies in mice suggest that the Igβ component of the pre-BCR influences V-DJ rearrangement before cell-surface expression of μ heavy chain. To determine whether Igα plays a similar role, we compared B-cell development in an Igα-deficient patient with that seen in a μ heavy chain–deficient patient. By immunofluorescence, both patients had a complete block in B-cell development at the pro-B to pre-B transition; both patients also had an equivalent number and diversity of rearranged V-DJ sequences. These results indicate that mutations in Igα can be a cause of agammaglobulinemia. Furthermore, they suggest that Igα does not play a critical role in B-cell development until it is expressed, along with μ heavy chain, as part of the pre-BCR.
Yoshiyuki Minegishi, Elaine Coustan-Smith, Lisa Rapalus, Fügen Ersoy, Dario Campana, Mary Ellen Conley
The Editorial Board will only consider comments that are deemed relevant and of interest to readers. The Journal will not post data that have not been subjected to peer review; or a comment that is essentially a reiteration of another comment.