Deficiencies in a tyrosine kinase, designated Btk, cause X-linked agam
maglobulinemia (XLA) in man, a hereditary defect of B-cell differentia
tion. Mutations in the newly found PH domain located at the N-terminus
of Btk have been shown to be the direct cause of XLA, and here two ne
w mutations, T33P and V64F, are presented. Btk is thus far the only pr
otein in which mutations of the PH domain have been found to cause a d
isease. The three-dimensional structure of the Btk PH domain was model
ed on the basis of the dynamin PH structure. Despite a relatively low
sequence similarity the Btk PH domain seems to have the same two P-she
et structure observed in the known structures. The model was used to i
nterpret the structural basis for disease in five independent point mu
tations and in an insertion in patients with XLA. The mutated residues
F25, V64, and V113, and possibly residue(s) around Q103, could form a
binding site, since these amino acids are located close to each other
on the surface of the molecule.