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Published online before print October 23, 2003
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Departments of
* Pediatrics and
Laboratory Medicine and
Division of Blood Transfusion, Shinshu University School of Medicine, Matsumoto, Japan; and
Division of Hematology/Oncology, Cedars-Sinai Medical Center, Los Angeles, California
1 Correspondence: Department of Pediatrics, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621 Japan. E-mail: mjshio{at}poa.matsumoto.ne.jp
Neutrophil-specific granule deficiency (SGD) is a rare, congenital disease characterized by atypical neutrophil structure and function, resulting in recurrent bacterial infections from early infancy. Homozygous recessive mutations in the CCAAT/enhancer-binding protein 
(C/EBP) gene were described in two of five SGD patients, indicating loss of C/EBP function as the primary genetic defect in this disease. C/EBP is expressed in murine and human macrophages. Macrophages from the C/EBP-deficient mice show impaired differentiation, phagocytic activity, and transcription of macrophage-specific genes. To determine if monocyte/macrophage cells are impacted in SGD, we analyzed phenotypic features of peripheral blood (PB) monocytes in a SGD individual lacking functional C/EBP. Flow cytometric analysis of PB leukocytes revealed aberrant expression of CD45, CD11b, CD14, CD15, and CD16 on cells from the SGD individual. Also, the PB CD14+ cells from this individual, weakly stained for the monocyte-specific enzyme, nonspecific esterase, and electron microscopic examination, indicated morphologic differences between the SGD cells and those from normal controls. Serum interleukin (IL)-6 levels in the SGD individual during a severe bacterial infection were lower compared with levels in other non-SGD individuals with sepsis. In contrast, serum IL-8 levels were markedly elevated in the SGD individual compared with those of non-SGD individuals in sepsis. PB CD14+ cells from the SGD individual expressed higher IL-8 mRNA levels compared with normal controls in response to lipopolysaccharide and interferon-
. These phenotypic and functional alterations of PB monocytes in the SGD individual suggest that C/EBP plays a critical role in monocyte/macrophage development of humans and is consistent with observations in the murine system. This study implicates abnormalities in monocytes/macrophages and neutrophils in the onset and development of SGD.
Key Words: immunodeficiency • C/EBP • CD14 • esterase • IL-8
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