Discordance between IgA switching at the DNA level and IgA expression at the mRNA level in IgA-deficient patients

IgA deficiency is a common immune disorder in Caucasians and is associated with certain MHC conserved extended haplotypes, such as [HLA-B8, SC01, DR3], which presumably carry a susceptibility gene(s). We applied a competitive digestion-circularization PCR method to quantitate the number of switch (S) μ to Sα rearrangements in peripheral B cells from IgA-deficient subjects homozygous for this haplotype and compared their number with the productive Cα mRNA level to determine Cα gene expression in IgA-switched B cells. Two types of defects, low expression of both secreted and membrane forms of productive Cα mRNA in IgA-switched B cells and impaired IgA switching, were characterized in IgA-deficient subjects homozygous for [HLA- B8, SC01, DR3]. The former defect was also found in another noncarrier subject. It may directly cause low IgA secretion and reflects a blockade in post-IgA switch differentiation of B cells. These results suggest that the heterogeneity of defects in IgA deficiency is not simply ascribable to MHC susceptibility genes.