TREC/KREC Newborn Screening followed by Next-Generation Sequencing for Severe Combined Immunodeficiency in Japan

Manabu Wakamatsu, Daiei Kojima, Hideki Muramatsu, Yusuke Okuno, Shinsuke Kataoka, Fumiko Nakamura, Yoshimi Sakai, Ikuya Tsuge, Tsuyoshi Ito, Kazuto Ueda, Akiko Saito, Eiji Morihana, Yasuhiko Ito, Naoki Ohashi, Makito Tanaka, Taihei Tanaka, Seiji Kojima, Yoko Nakajima, Tetsuya Ito, Yoshiyuki Takahashi

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Purpose: The aim of this study is to evaluate the usefulness of T cell receptor excision circle (TREC) and/or kappa-deleting recombination excision circle (KREC) measurements integrated with diagnostic next-generation sequencing (NGS) analysis using a severe combined immunodeficiency (SCID) newborn screening (NBS) program. Methods: TREC and/or KREC values were measured in 137,484 newborns between April 2017 and December 2021 using EnLite TREC (n = 80,791) or TREC/KREC kits (n = 56,693). For newborns with positive screening results, diagnostic NGS analysis was performed with a 349-gene panel to detect genetic mutations associated with primary immunodeficiencies (PIDs). Results: A total of 145 newborns (0.11%) had abnormal TREC and/or KREC values, and a genetic diagnosis was established in 2 patients with SCID (1 in 68,742 newborns) (IL2RG-SCID and reticular dysgenesis) and 10 with non-SCID PIDs with T and/or B cell deficiencies (1 in 13,748 newborns) using NGS analysis. Furthermore, TREC values of 2849 newborns were measured and confirmed the significant correlation between the results of both TREC and TREC/KREC kits (P < 0.001) and naïve T cell counts. Conclusions: We performed the first large-scale TREC and TREC/KREC NBS programs in Japan. Our NBS programs followed by the diagnostic NGS analysis for newborns with abnormal TREC and/or KREC values are useful for the early identification and rapid molecular evaluation of not only SCID but also different non-SCID PIDs.

Original languageEnglish
Pages (from-to)1696-1707
Number of pages12
JournalJournal of Clinical Immunology
Issue number8
Publication statusPublished - 11-2022

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology


Dive into the research topics of 'TREC/KREC Newborn Screening followed by Next-Generation Sequencing for Severe Combined Immunodeficiency in Japan'. Together they form a unique fingerprint.

Cite this