Skip to main content
Erschienen in: Journal of Clinical Immunology 6/2016

24.05.2016 | Original Article

Role of Flow Cytometry in the Diagnosis of Chronic Granulomatous Disease: the Egyptian Experience

verfasst von: Rabab El Hawary, Safa Meshaal, Caroline Deswarte, Nermeen Galal, Mahitab Abdelkawy, Radwa Alkady, Dalia Abd Elaziz, Tomas Freiberger, Barbora Ravcukova, Jiri Litzman, Jacinta Bustamante, Jeannette Boutros, Taghrid Gaafar, Aisha Elmarsafy

Erschienen in: Journal of Clinical Immunology | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Chronic granulomatous disease (CGD) is an inherited mutational defect in any of the NADPH oxidase complex, CYBB (gp91-phox), NCF1 (p47-phox), CYBA (p22-phox), NCF2 (p67-phox), or NCF4 (p40-phox) leading to inability of phagocytes to perform effective respiratory burst and thus diminished killing of bacteria and fungi. The identification of defective proteins aids in establishing a diagnosis prior to genetic analysis, which is rather labor-intensive, expensive, and time-consuming.

Aim

The present study aims at assessing the NADPH proteins by performing the intracellular staining with specific monoclonal antibodies and their assessment on flow cytometry. The use of flow cytometry is less laborious and faster to perform than western blot. It also confirms the diagnosis of CGD and detects the affected components allowing proper management of patients.

Materials and Methods

Twenty-eight patients from 25 different kindred, clinically suspected as CGD were recruited in Egypt. Dihydrorhodamine test was performed to confirm the diagnosis of the patients. Intracellular staining of NADPH components using specific monoclonal antibodies was performed followed by flow cytometric analysis.

Results

The present study revealed that the most common defective protein in our cohort is p22-phox, found in 13 patients (46.4 % of cases) followed by p47-phox in 8 patients (28.6 %), gp91-phox in 5 patients (17.9 %), and finally p67-phox in 2 patients (7.1 %).

Conclusion

In countries with limited resources and yet large number of CGD patients, the analysis of the defective proteins by flow cytometry is an optimum solution for confirming the diagnosis and is a step for targeted sequencing in families seeking prenatal diagnosis.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Suliaman F, Amra N, Sheikh S, Almuhsen S, Alsmadi O. Epidemiology of chronic granulomatous disease of childhood in Eastern Province, Saudi Arabia. Pediat asthma, Allergy immunol. 2009;22(1):21–6.CrossRef Suliaman F, Amra N, Sheikh S, Almuhsen S, Alsmadi O. Epidemiology of chronic granulomatous disease of childhood in Eastern Province, Saudi Arabia. Pediat asthma, Allergy immunol. 2009;22(1):21–6.CrossRef
2.
Zurück zum Zitat Roos D, De Boer M, Yavuz Koker M, Dekker J, Singh-Gupta V, Ahlin A, et al. Chronic granulomatous disease caused by mutations other than the common GT deletion in NCF1, the gene encoding the p47phox component of the phagocyte NADPH oxidase. Hum Mutat. 2006;27(12):1218–29.CrossRefPubMed Roos D, De Boer M, Yavuz Koker M, Dekker J, Singh-Gupta V, Ahlin A, et al. Chronic granulomatous disease caused by mutations other than the common GT deletion in NCF1, the gene encoding the p47phox component of the phagocyte NADPH oxidase. Hum Mutat. 2006;27(12):1218–29.CrossRefPubMed
3.
Zurück zum Zitat Ben-Ari J, Wolach O, Gavrieli R, Wolach B. Chronic granulomatous disease: linking genetics to phenotypic expression. Expert Rev Anti Infect Ther. 2012;10(8):881–94.CrossRefPubMed Ben-Ari J, Wolach O, Gavrieli R, Wolach B. Chronic granulomatous disease: linking genetics to phenotypic expression. Expert Rev Anti Infect Ther. 2012;10(8):881–94.CrossRefPubMed
4.
Zurück zum Zitat Koker MY, Metin A, Özgür TT, De Boer M, Roos D. Prenatal diagnosis of chronic granulomatous disease in a male fetus. Iran J Allergy Asthma Immunol. 2009;8(1):57–61. Koker MY, Metin A, Özgür TT, De Boer M, Roos D. Prenatal diagnosis of chronic granulomatous disease in a male fetus. Iran J Allergy Asthma Immunol. 2009;8(1):57–61.
5.
Zurück zum Zitat Rezvani Z, Mohammadzadeh I, Pourpak Z, Moin M, Teimourian S. CYBB gene mutation detection in an Iranian patient with chronic granulomatous disease. Iranian J aller, asthma Immunol. 2005;4(2):103–6. Rezvani Z, Mohammadzadeh I, Pourpak Z, Moin M, Teimourian S. CYBB gene mutation detection in an Iranian patient with chronic granulomatous disease. Iranian J aller, asthma Immunol. 2005;4(2):103–6.
6.
Zurück zum Zitat Battersby AC, Cale CM, Goldblatt D, Gennery AR. Clinical manifestations of disease in X-linked carriers of chronic granulomatous disease. J Clin Immunol. 2013;33(8):1276–84.CrossRefPubMed Battersby AC, Cale CM, Goldblatt D, Gennery AR. Clinical manifestations of disease in X-linked carriers of chronic granulomatous disease. J Clin Immunol. 2013;33(8):1276–84.CrossRefPubMed
7.
Zurück zum Zitat Meshaal S, El Hawary R, Abd Elaziz D, Alkady R, Galal N, Boutros J, et al. Chronic granulomatous disease: review of a cohort of Egyptian patients. Allergol Immunopathol. 2015;43(3):279–85.CrossRef Meshaal S, El Hawary R, Abd Elaziz D, Alkady R, Galal N, Boutros J, et al. Chronic granulomatous disease: review of a cohort of Egyptian patients. Allergol Immunopathol. 2015;43(3):279–85.CrossRef
8.
Zurück zum Zitat Yu G, Hong DK, Dionis KY, Rae J, Heyworth PG, Curnutte JT, et al. Focus on FOCIS: the continuing diagnostic challenge of autosomal recessive chronic granulomatous disease. Clin Immunol. 2008;128(2):117–26.CrossRefPubMed Yu G, Hong DK, Dionis KY, Rae J, Heyworth PG, Curnutte JT, et al. Focus on FOCIS: the continuing diagnostic challenge of autosomal recessive chronic granulomatous disease. Clin Immunol. 2008;128(2):117–26.CrossRefPubMed
9.
Zurück zum Zitat Baba LA, Ailal F, El Hafidi N, Hubeau M, Jabot-Hanin F, Benajiba N, et al. Chronic granulomatous disease in Morocco: genetic, immunological, and clinical features of 12 patients from 10 kindred. J Clin Immunol. 2014;34(4):452–8.PubMed Baba LA, Ailal F, El Hafidi N, Hubeau M, Jabot-Hanin F, Benajiba N, et al. Chronic granulomatous disease in Morocco: genetic, immunological, and clinical features of 12 patients from 10 kindred. J Clin Immunol. 2014;34(4):452–8.PubMed
10.
Zurück zum Zitat Dimitrova G, Bunkall C, Lim D, Kendrick C. Comparison of two methods for the diagnosis of chronic granulomatous disease – neutrophil oxidative burst measured by the nitro blue tetrazolium slide test versus the dihydrorhodamine 123 flow cytometric assay. N Z J Med Lab Sci. 2013;67:45–51. Dimitrova G, Bunkall C, Lim D, Kendrick C. Comparison of two methods for the diagnosis of chronic granulomatous disease – neutrophil oxidative burst measured by the nitro blue tetrazolium slide test versus the dihydrorhodamine 123 flow cytometric assay. N Z J Med Lab Sci. 2013;67:45–51.
11.
Zurück zum Zitat Van Pelt LJ, Van Zwieten R, Weening RS, Roos D, Verhoeven J, Bolscher BG. Limitations on the use of dihydrorhodamine 123 for flow cytometric analysis of the neutrophil respiratory burst. J Immunol Methods. 1996;191(2):187–96.CrossRefPubMed Van Pelt LJ, Van Zwieten R, Weening RS, Roos D, Verhoeven J, Bolscher BG. Limitations on the use of dihydrorhodamine 123 for flow cytometric analysis of the neutrophil respiratory burst. J Immunol Methods. 1996;191(2):187–96.CrossRefPubMed
12.
Zurück zum Zitat Holland SM. Chronic Granulomatous Disease. Clinic Rev Allerg Immunol. 2010;38:3–10.CrossRef Holland SM. Chronic Granulomatous Disease. Clinic Rev Allerg Immunol. 2010;38:3–10.CrossRef
13.
Zurück zum Zitat Mauch L, Lun A, O’Gorman MR, Harris JS, Schulze I, Zychlinsky A, et al. Chronic granulomatous disease (CGD) and complete myeloperoxidase deficiency both yield strongly reduced dihydrorhodamine 123 test signals but can be easily discerned in routine testing for CGD. Clin Chem. 2007;53:890–6.CrossRefPubMed Mauch L, Lun A, O’Gorman MR, Harris JS, Schulze I, Zychlinsky A, et al. Chronic granulomatous disease (CGD) and complete myeloperoxidase deficiency both yield strongly reduced dihydrorhodamine 123 test signals but can be easily discerned in routine testing for CGD. Clin Chem. 2007;53:890–6.CrossRefPubMed
14.
Zurück zum Zitat Bakri FG, Martel C, Khuri-Bulos N, Mahafzah A, El-Khateeb MS, Al-Wahadneh AM, et al. First report of clinical, functional, and molecular investigation of chronic granulomatous disease in nine Jordanian families. J Clin Immunol. 2009;29:215–30.CrossRefPubMed Bakri FG, Martel C, Khuri-Bulos N, Mahafzah A, El-Khateeb MS, Al-Wahadneh AM, et al. First report of clinical, functional, and molecular investigation of chronic granulomatous disease in nine Jordanian families. J Clin Immunol. 2009;29:215–30.CrossRefPubMed
15.
Zurück zum Zitat Cross AR, Noak D, Rae J, Curnutte JT, PG H. Hematologically important mutations: the autosomal recessive forms of chronic granulomatous disease (first update). Blood Cells Mol Dis. 2000;26(5):561–5.CrossRefPubMed Cross AR, Noak D, Rae J, Curnutte JT, PG H. Hematologically important mutations: the autosomal recessive forms of chronic granulomatous disease (first update). Blood Cells Mol Dis. 2000;26(5):561–5.CrossRefPubMed
16.
Zurück zum Zitat El Kares R, Barbouche MR, Elloumi-Zghal H, Bejaoui M, Chemli J, Mellouli F, et al. Genetics and mutational heterogeneity of autosomal recessive chronic granulomatous in Tunisia. J Hum Genet. 2006;51:887–95.CrossRefPubMed El Kares R, Barbouche MR, Elloumi-Zghal H, Bejaoui M, Chemli J, Mellouli F, et al. Genetics and mutational heterogeneity of autosomal recessive chronic granulomatous in Tunisia. J Hum Genet. 2006;51:887–95.CrossRefPubMed
17.
Zurück zum Zitat Koker MY, Camcioglu Y, Van Leeuwen K, Sebnem Kılıc S, Barlan I, Yılmaz M, et al. Clinical, functional, and genetic characterization of chronic granulomatous disease in 89 Turkish patients. J Allergy Clin Immunol. 2013;132(5):1156–63.CrossRefPubMed Koker MY, Camcioglu Y, Van Leeuwen K, Sebnem Kılıc S, Barlan I, Yılmaz M, et al. Clinical, functional, and genetic characterization of chronic granulomatous disease in 89 Turkish patients. J Allergy Clin Immunol. 2013;132(5):1156–63.CrossRefPubMed
18.
Zurück zum Zitat Kannengiesser C, Gérard B, El Benna J, Henri D, Kroviarski Y, Chollet-Martin S, et al. Molecular epidemiology of chronic granulomatous disease in a series of 80 kindreds: identification of 31 novel mutations. HUMAN MUTATION. 2008;29:E132–49.CrossRefPubMed Kannengiesser C, Gérard B, El Benna J, Henri D, Kroviarski Y, Chollet-Martin S, et al. Molecular epidemiology of chronic granulomatous disease in a series of 80 kindreds: identification of 31 novel mutations. HUMAN MUTATION. 2008;29:E132–49.CrossRefPubMed
19.
Zurück zum Zitat Kim YM, Park JE, Kim JY, Lim HK, Nam JK, Cho M, et al. Genetic analysis of 10 unrelated Korean families with p22-phox-deficient chronic granulomatous disease: an unusually identical mutation of the CYBA gene on Jeju Island, Korea. J Korean Med Sci. 2009;24:1045–50.CrossRefPubMedPubMedCentral Kim YM, Park JE, Kim JY, Lim HK, Nam JK, Cho M, et al. Genetic analysis of 10 unrelated Korean families with p22-phox-deficient chronic granulomatous disease: an unusually identical mutation of the CYBA gene on Jeju Island, Korea. J Korean Med Sci. 2009;24:1045–50.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Kuhns DB, Alvord WG, Heller T, Feld JJ, Pike KM, Marciano BE, et al. Residual NADPH oxidase and survival in chronic granulomatous disease. N Engl J Med. 2010;363:2600–10.CrossRefPubMedPubMedCentral Kuhns DB, Alvord WG, Heller T, Feld JJ, Pike KM, Marciano BE, et al. Residual NADPH oxidase and survival in chronic granulomatous disease. N Engl J Med. 2010;363:2600–10.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Kannengiesser C, Gérard B, El Benna J, Henri D, Kroviarski Y, Chollet-Martin S, Gougerot-Pocidalo M A, Elbim C and Grandchamp B. Molecular epidemiology of chronic granulomatous disease in a series of 80 kindreds: identification of 31 novel mutations. HUMAN MUTATION. 2008 #1019, 29:E132-E149. Kannengiesser C, Gérard B, El Benna J, Henri D, Kroviarski Y, Chollet-Martin S, Gougerot-Pocidalo M A, Elbim C and Grandchamp B. Molecular epidemiology of chronic granulomatous disease in a series of 80 kindreds: identification of 31 novel mutations. HUMAN MUTATION. 2008 #1019, 29:E132-E149.
22.
Zurück zum Zitat Porter CD, Parkar MH, Verhoeven AJ, Levinsky RJ, Collins MK, Kinnon C. p22-phox-deficient chronic granulomatous disease: reconstitution by retrovirus-mediated expression and identification of a biosynthetic intermediate of gp91-phox. Blood. 1994;84:2767–75.PubMed Porter CD, Parkar MH, Verhoeven AJ, Levinsky RJ, Collins MK, Kinnon C. p22-phox-deficient chronic granulomatous disease: reconstitution by retrovirus-mediated expression and identification of a biosynthetic intermediate of gp91-phox. Blood. 1994;84:2767–75.PubMed
23.
Zurück zum Zitat Teimourian S, Zomorodian E, Badalzadeh M, Pouya A, Kannengiesser C, Mansouri D, et al. Characterization of six novel mutations in CYBA: the gene causing autosomal recessive chronic granulomatous disease. Br J Haematol. 2008;141:848–51.CrossRefPubMed Teimourian S, Zomorodian E, Badalzadeh M, Pouya A, Kannengiesser C, Mansouri D, et al. Characterization of six novel mutations in CYBA: the gene causing autosomal recessive chronic granulomatous disease. Br J Haematol. 2008;141:848–51.CrossRefPubMed
24.
Zurück zum Zitat Koker MY, Van Leeuwen K, de Boer M, Elmeli FC, Metin A, Ozgur TT, et al. Six different CYBA mutations including three novel mutations in ten families from Turkey, resulting in autosomal recessive chronic granulomatous disease. Eur J Clin Invest. 2009;39(4):311–9.CrossRefPubMed Koker MY, Van Leeuwen K, de Boer M, Elmeli FC, Metin A, Ozgur TT, et al. Six different CYBA mutations including three novel mutations in ten families from Turkey, resulting in autosomal recessive chronic granulomatous disease. Eur J Clin Invest. 2009;39(4):311–9.CrossRefPubMed
25.
Zurück zum Zitat Wolach B, Gavrieli R, de Boer M, Gottesman G, Ben-Ari J, Rottem M, et al. Chronic granulomatous disease in Israel: clinical, functional and molecular studies of 38 patients. Clin Immunol. 2008;129:103–14.CrossRefPubMed Wolach B, Gavrieli R, de Boer M, Gottesman G, Ben-Ari J, Rottem M, et al. Chronic granulomatous disease in Israel: clinical, functional and molecular studies of 38 patients. Clin Immunol. 2008;129:103–14.CrossRefPubMed
26.
Zurück zum Zitat Manea S-A, Constantin A, Manda G, Sasson S, Manea A. Regulation of Nox enzymes expression in vascular pathophysiology: focusing on transcription factors and epigenetic mechanisms. Redox Biol. 2015;5:358–66.CrossRefPubMedPubMedCentral Manea S-A, Constantin A, Manda G, Sasson S, Manea A. Regulation of Nox enzymes expression in vascular pathophysiology: focusing on transcription factors and epigenetic mechanisms. Redox Biol. 2015;5:358–66.CrossRefPubMedPubMedCentral
Metadaten
Titel
Role of Flow Cytometry in the Diagnosis of Chronic Granulomatous Disease: the Egyptian Experience
verfasst von
Rabab El Hawary
Safa Meshaal
Caroline Deswarte
Nermeen Galal
Mahitab Abdelkawy
Radwa Alkady
Dalia Abd Elaziz
Tomas Freiberger
Barbora Ravcukova
Jiri Litzman
Jacinta Bustamante
Jeannette Boutros
Taghrid Gaafar
Aisha Elmarsafy
Publikationsdatum
24.05.2016
Verlag
Springer US
Erschienen in
Journal of Clinical Immunology / Ausgabe 6/2016
Print ISSN: 0271-9142
Elektronische ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-016-0297-y

Weitere Artikel der Ausgabe 6/2016

Journal of Clinical Immunology 6/2016 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.