Abstract

Wiskott-Aldrich syndrome (WAS) is a rare X-linked recessive primary immunodeficiency characterised by immune dysregulation, microthrombocytopaenia, eczema and lymphoid malignancies. Mutations in the WAS gene can lead to distinct syndrome variations which largely, although not exclusively, depend upon the mutation. Premature termination and deletions abrogate Wiskott-Aldrich syndrome protein (WASp) expression and lead to severe disease (WAS). Missense mutations usually result in reduced protein expression and the phenotypically milder X-linked thrombocytopenia (XLT) or attenuated WAS [1-3]. More recently however novel activating mutations have been described that give rise to X-linked neutropenia (XLN), a third syndrome defined by neutropenia with variable myelodysplasia [4-6]. WASP is key in transducing signals from the cell surface to the actin cytoskeleton, and a lack of WASp results in cytoskeletal defects that compromise multiple aspects of normal cellular activity including proliferation, phagocytosis, immune synapse formation, adhesion and directed migration.

Highlights

  • Wiskott-Aldrich syndrome (WAS) is a rare Xlinked recessive primary immunodeficiency characterised by immune dysregulation, microthrombocytopaenia, eczema and lymphoid malignancies

  • The other mammalian members (Fig. 1) that share expression of the VCA domain include neural WASp (N-WASp), WASp family verprolin-homologous protein (WAVE) 1–3 and the more recently discovered Wiskott-Aldrich syndrome protein and SCAR homolog (WASH) and WASP homolog associated with actin, membranes, and microtubules (WHAMM) [7,8,9]

  • WASp function is regulated at several levels including release and stabilisation of an autoinhibitory conformation, oligomerisation and proteasomal degradation

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Summary

Introduction

Wiskott-Aldrich syndrome (WAS) is a rare Xlinked recessive primary immunodeficiency characterised by immune dysregulation, microthrombocytopaenia, eczema and lymphoid malignancies. M.P. Blundell et al / The Wiskott-Aldrich syndrome: The actin cytoskeleton and immune cell function tion and deletions abrogate Wiskott-Aldrich syndrome protein (WASp) expression and lead to severe disease (WAS). Missense mutations usually result in reduced protein expression and the phenotypically milder Xlinked thrombocytopenia (XLT) or attenuated WAS [1,2,3]. More recently novel activating mutations have been described that give rise to X-linked neutropenia (XLN), a third syndrome defined by neutropenia with variable myelodysplasia [4,5,6]. WASP is key in transducing signals from the cell surface to the actin cytoskeleton, and a lack of WASp results in cytoskeletal defects that compromise multiple aspects of normal cellular activity including proliferation, phagocytosis, immune synapse formation, adhesion and directed migration

Molecular structure
EVH1 and WIP
Basic domain and PIP2
GBD and activation by Cdc42 and phosphorylation
VCA domain
Cellular function
WASp in the Haematopoietic system
10. T cell defects
11. B cell defects
12. NK Cell defects
13. Invariant NKT cells
14. Myeloid defects
15. Platelet defects
16. Autoimmunity and malignancy
17. Treatment
Findings
18. Concluding remarks
Full Text
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