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Two populations of human natural killer (NK) cells can be identified in peripheral blood. The majority are CD3 − CD56 dim  cells while the minority exhibits a CD3 − CD56 bright  phenotype.  In vitro  evidence indicates that CD56 bright  cells are precursors of CD56 dim  cells, but  in vivo  evidence is lacking. Here, we studied NK cells from a patient that suffered from a melanoma and opportunistic fungal infection during childhood. The patient exhibited a stable phenotype characterized by a reduction in the frequency of peripheral blood CD3 − CD56 dim  NK cells, accompanied by an overt increase in the frequency and absolute number of CD3 − CD56 bright  cells. These NK cells exhibited similar expression of perforin, CD57 and CD158, the major activating receptors CD16, NKp46, NKG2D, DNAM-1, and 2B4, as well as the inhibitory receptor CD94/NKG2A, on both CD56 bright  and CD56 dim  NK cells as healthy controls. Also, both NK cell subpopulations produced IFN-γ upon stimulation with cytokines, and CD3 − CD56 dim  NK cells degranulated in response to cytokines or K562 cells. However, upon stimulation with cytokines, a substantial fraction of CD56 dim  cells failed to up-regulate CD57 and CD158, showed a reduction in the percentage of CD16 +  cells, and CD56 bright  cells did not down-regulate CD62L, suggesting that CD56 dim  cells could not acquire a terminally differentiated phenotype and that CD56 bright  cells exhibit a maturation defect that might result in a potential altered migration pattern. These observations, support the notion that NK cells of this patient display a maturation/activation defect that precludes the generation of mature NK cells at a normal rate accompanied by CD56 dim  NK cells that cannot completely acquire a terminally differentiated phenotype. Thus, our results provide evidence that support the concept that  in vivo  CD56 bright  NK cells differentiate into CD56 dim  NK cells, and contribute to further understand human NK cell ontogeny.

Human Natural Killer Cell Maturation Defect Supports In Vivo CD56bright to CD56dim Lineage Development