The molecular basis of chronic granulomatous disease

Springer Semin Immunopathol. 1998;19(4):417-34. doi: 10.1007/BF00792600.

Abstract

CGD is a rare inherited immunodeficiency syndrome, caused by the phagocytes' inability to produce (sufficient) reactive oxygen metabolites. This dysfunction is due to a defect in the NADPH oxidase, the enzyme responsible for the production of superoxide. It is composed of several subunits, two of which, gp91phox and p22phox, form the membrane-bound cytochrome b558, while its three cytosolic components, p47phox, p67phox and p40phox, have to translocate to the membrane upon activation. This is a tightly and intricately controlled process that involves, among others, several low-molecular weight GTP-binding proteins. Gp91phox is encoded on the X-chromosome and p22phox, p47phox and p67phox on different autosomal chromosomes, and a defect in one of these components leads to CGD. This explains the variable mode of inheritance seen in this syndrome. Clinically CGD manifests itself typically already at a very young age with recurrent and serious infections, most often caused by catalase-positive pathogens. Modern treatment options, including prophylaxis with trimethoprim-sulfamethoxazole and rIFN-gamma as well as early and aggressive anti-infection therapy, have improved the prognosis of this disease dramatically. CGD, as a very well-characterized inherited affection of the hematopoietic stem cells, is predestined to be among the first diseases to profit from the advances in cutting-edge therapeutics, such as gene therapy and in utero stem cell transplantation.

Publication types

  • Review

MeSH terms

  • Animals
  • Disease Models, Animal
  • Enzyme Activation
  • Female
  • Granulomatous Disease, Chronic / diagnosis
  • Granulomatous Disease, Chronic / enzymology
  • Granulomatous Disease, Chronic / genetics*
  • Granulomatous Disease, Chronic / immunology
  • Granulomatous Disease, Chronic / therapy
  • Heterozygote
  • Humans
  • Interferon-gamma / therapeutic use
  • Membrane Glycoproteins / chemistry
  • Membrane Glycoproteins / genetics
  • Membrane Glycoproteins / metabolism
  • Membrane Transport Proteins*
  • Mice
  • Mice, Knockout
  • NADPH Dehydrogenase / chemistry
  • NADPH Dehydrogenase / genetics
  • NADPH Dehydrogenase / metabolism
  • NADPH Oxidase 2
  • NADPH Oxidases / chemistry
  • NADPH Oxidases / metabolism
  • Phagocytes / enzymology
  • Phagocytes / immunology*
  • Phosphoproteins / genetics
  • Phosphoproteins / metabolism
  • Pregnancy
  • Prenatal Diagnosis
  • Recombinant Proteins

Substances

  • Membrane Glycoproteins
  • Membrane Transport Proteins
  • Phosphoproteins
  • Recombinant Proteins
  • Interferon-gamma
  • CYBB protein, human
  • NADPH Oxidase 2
  • NADPH Oxidases
  • CYBA protein, human
  • neutrophil cytosolic factor 1
  • NADPH Dehydrogenase