PMC7099040_01
(A) Numerous, confluent cutaneous warts on palmar surface of hand. (B) CT sinuses showing turbinate edema and maxillary sinus mucosal thickening with layering fluid.
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F1
He developed cutaneous, oropharyngeal, and genital warts that relapsed and remitted but had worsened in recent years (Figure 1A). In the prior 5 years, he had three pneumonias, chronic sinusitis (Figure 1B), and a skin infection due to MRSA.
(A) IL-2, IL-4, and IL-21 stimulation in CD4+ T cells in control, sister (donor) and patient, as measured by pSTAT5, pSTAT6, and pSTAT3, respectively. (B) IL-4 and IL-21 stimulation of B cells in control, sister (donor), and patient as measured by pSTAT6 and pSTAT3. (C) IL-2 and IL-15 stimulation in NK cells in control and patient as measured by pSTAT5. (D) IL-4 stimulation in CD14+ monocytes in control and patient as measured by pSTAT6.
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F2
To better delineate our patient's B-cell function, we studied the response of his lymphocytes to cytokines that signal through the gammac receptor (Figure 2). We found our patient's T cells showed normal gammac signaling (Figure 2A). When we tested B-cell responses to gammac-dependent cytokines, we found that B cells stimulated with IL-21 showed normal phosphorylation of STAT3 (Figure 2B). Most NK cells showed normal gammac signaling (Figure 2C), corresponding to the degree of chimerism.