Ligase IV syndrome.

Ligase IV (LIG4) syndrome belongs to the group of hereditary disorders associated with impaired DNA damage response mechanisms. Subjects affected with this rare autosomal recessive disease exhibit microcephaly, unusual facial features, growth retardation, developmental delay, skin anomalies, and are typically pancytopenic. The disease is characterized by pronounced radiosensitivity, genome instability, malignancy, immunodeficiency, and bone marrow abnormalities. LIG4 syndrome results from mutations in the DNA ligase IV gene encoding an enzyme that plays a pivotal role in repairing double strand DNA breaks and V(D)J recombination. Since LIG4 null-mutant mice are embryonic lethal and biallelic null mutations have not been described to date in LIG4-deficient patients, viability of the DNA ligase IV deficiency syndrome appears to require at least one allele with a hypomorphic mutation. Mutations R278H, Q280R, H282L, M249E located in the vicinity of the active site are typical hypomorphic because they do not affect ligase expression and retain residual albeit reduced activity of the enzyme at levels of 5-10% of that for the wild-type ligase. Carriers heterozygous for those mutations usually develop moderate defects in V(D)J recombination, mild immune abnormalities and malignancy. In contrast, mutations resided in OBD, i.e. in the C-terminal subdomain of the catalytic domain, and in XRCC4-binding domain more dramatically inhibit the ligase function and also greatly decrease its expression. A truncating mutation R580X and a frameshift mutation K424FS resulting in loss of the C-terminal XRCC4-binding domain have deleterious effect on both expression and function of LIG4 and represent a null allele.