Case report: Sideroblastic anemia with B-cell immunodeficiency, periodic fevers, and developmental delay: Three cases and a literature review.

Sideroblastic anemia with B-cell immunodeficiency, periodic fevers, and developmental delay (SIFD) is a serious autosomal recessive syndrome caused by biallelic mutations in cytosine-cytosine-adenosine tRNA nucleotidyltransferase 1 (TRNT1). The main clinical features of SIFD are periodic fevers, developmental delay, sideroblastic or microcytic anemia, and immunodeficiency. Herein, we report three cases of SIFD with compound heterozygous variants of TRNT1. Patients 1 and 2 were siblings; they presented with periodic fevers, arthritis, low immunoglobulin A, bilateral cataracts, anemia, and neurodevelopmental and developmental delay. Patient 3 had severed clinical features with recurrent fever and infections. She was treated with infliximab and symptomatic treatments but without therapeutic effect. She received a stem cell transplantation of umbilical cord blood but died of posttransplant infection and posttransplant graft-vs.-host disease 17 days after transplantation. Finally, a literature review revealed that TRNT1 variants differed among SIFD patients. Our cases and literature review further expand existing knowledge on the phenotype and TRNT1 variations of SIFD and suggest that the early genomic diagnosis of TRNT1 is valuable to promptly assess bone marrow transplantation and tumor necrosis factor inhibitor treatments, which might be effective for the immunodeficiency and inflammation caused by SIFD.

Oral administration of submerged cultivated Grifola frondosa enhances phagocytic activity in normal mice.

Grifola frondosa fruiting body (Maitake) has been used as a dietary supplement due to its antitumour and immunomodulatory properties. The aim of this study was to evaluate the immunomodulatory effects of orally administered submerged cultivated G. frondosa mixture, including both mycelium and culture broth, in a healthy murine model. Composition analyses showed that submerged cultivated G. frondosa mixture contained only 32.48% carbohydrate, which was less than half of fruiting bodies. The content of adenosine, a potential immunomodulatory agent in medicinal mushrooms, was 2.8 mg g(-1). After feeding 8-week-old female BALB/cByJ mice with AIN-93G diet containing 0% (C), 1% (G1), 3% (G3) or 5% (G5) (wt/wt) G. frondosa mixture for 31 days, neither body weight nor the outward appearance of organs showed any significant difference among different diet groups. Splenocyte subpopulation, mitogen-activated cytokine release and splenic NK activity were not affected by G. frondosa administration, either. On the other hand, the phagocytic activity was enhanced in leucocytes of groups G3 and G5, without exerting detectable levels of serum proinflammatory cytokines. These results suggested that oral administration of submerged cultivated G. frondosa mixture may enhance host innate immunity against foreign pathogens without eliciting adverse inflammatory response.

Immunomodulatory properties of Grifola frondosa in submerged culture.

Maitake (Grifola frondosa) is a popular mushroom in Asia for its tasty flavor and immune-stimulating property. The aim of the study is to investigate the innate immunity augmentation effects of different extracts of mycelia and culture filtrate from G. frondosa in submerged cultures. The hot water extract of mycelia showed the strongest cytokine induction effect as a function of its concentration in human whole blood culture. The most potent fractions of hot water extract, Fr. I and II, were mainly composed of polysaccharides with molecular masses of 43-140 and 13-38 kDa, respectively. These fractions (0.025 mg/mL) showed marked activity in enhancing phagocytosis of human polymorphonuclear neutrophils (PMN). In parallel, the expression of CD11b, an early marker of PMN activation, was also up-regulated dose dependently. This result suggested that complement receptor 3 was primed by these fractions. In addition to activation of phagocytes, these bioactive fractions also increased human peripheral blood natural killer cell cytotoxicity. These results imply that the relatively low molecular mass polysaccharides isolated from mycelia of G. frondosa can enhance innate immunity in vitro and therefore may serve as biological response modifiers.