VDJ rearrangement

Last updated: June 19, 2025

VDJ rearrangement

year 1

year 1

Introduction to the immune system
Cytokines
Innate immune system
Complement system
T-cell development
B-cell development
MHC class I and MHC class II molecules
T-cell activation
B-cell activation, differentiation, and contraction
Cell-mediated immunity of CD4 cells
Cell-mediated immunity of natural killer and CD8 cells
Antibody classes
Somatic hypermutation and affinity maturation
VDJ rearrangement
Contracting the immune response and peripheral tolerance
B- and T-cell memory
Anergy, exhaustion, and clonal deletion
Vaccinations
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
Sepsis
Neonatal sepsis
Abscesses
Food allergy
Anaphylaxis
Asthma
Immune thrombocytopenia
Autoimmune hemolytic anemia
Hemolytic disease of the newborn
Rheumatic heart disease
Myasthenia gravis
Graves disease
Pemphigus vulgaris
Serum sickness
Systemic lupus erythematosus
Poststreptococcal glomerulonephritis
Graft-versus-host disease
Contact dermatitis
X-linked agammaglobulinemia
Selective immunoglobulin A deficiency
Common variable immunodeficiency
IgG subclass deficiency
Hyperimmunoglobulin E syndrome
Isolated primary immunoglobulin M deficiency
Thymic aplasia
DiGeorge syndrome
Severe combined immunodeficiency
Adenosine deaminase deficiency
Ataxia-telangiectasia
Hyper IgM syndrome
Wiskott-Aldrich syndrome
Leukocyte adhesion deficiency
Chediak-Higashi syndrome
Chronic granulomatous disease
Complement deficiency
Hereditary angioedema
Asplenia
Thymoma
Ruptured spleen
Immunodeficiencies: T-cell and B-cell disorders: Pathology review
Immunodeficiencies: Combined T-cell and B-cell disorders: Pathology review
Immunodeficiencies: Phagocyte and complement dysfunction: Pathology review
Glucocorticoids
Non-corticosteroid immunosuppressants and immunotherapies
Skin histology
Skin anatomy and physiology
Hair, skin and nails
Wound healing
Introduction to the skeletal system
Introduction to the muscular system
Bones of the neck
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Bones of the vertebral column
Joints of the vertebral column
Vessels and nerves of the vertebral column
Muscles of the back
Anatomy of the suboccipital region
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy of the muscles and nerves of the posterior abdominal wall
Bones of the upper limb
Fascia, vessels and nerves of the upper limb
Anatomy of the brachial plexus
Anatomy of the pectoral and scapular regions
Anatomy of the arm
Muscles of the forearm
Vessels and nerves of the forearm
Muscles of the hand
Anatomy of the sternoclavicular and acromioclavicular joints
Anatomy of the glenohumeral joint
Anatomy of the elbow joint
Anatomy of the radioulnar joints
Joints of the wrist and hand
Anatomy of the axilla
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Bones of the lower limb
Fascia, vessels and nerves of the lower limb
Anatomy of the anterior and medial thigh
Muscles of the gluteal region and posterior thigh
Vessels and nerves of the gluteal region and posterior thigh
Anatomy of the popliteal fossa
Anatomy of the leg
Anatomy of the foot
Anatomy of the hip joint
Anatomy of the knee joint
Anatomy of the tibiofibular joints
Joints of the ankle and foot
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Development of the axial skeleton
Development of the limbs
Development of the muscular system
Bone histology
Cartilage histology
Skeletal muscle histology
Skeletal system anatomy and physiology
Bone remodeling and repair
Cartilage structure and growth
Fibrous, cartilage, and synovial joints
Muscular system anatomy and physiology
Brachial plexus
Neuromuscular junction and motor unit
Sliding filament model of muscle contraction
Slow twitch and fast twitch muscle fibers
Muscle contraction
Muscle spindles and golgi tendon organs
Radial head subluxation (Nursemaid elbow)
Developmental dysplasia of the hip
Legg-Calve-Perthes disease
Slipped capital femoral epiphysis
Transient synovitis
Osgood-Schlatter disease (traction apophysitis)
Rotator cuff tear
Dislocated shoulder
Winged scapula
Thoracic outlet syndrome
Carpal tunnel syndrome
Ulnar claw
Erb-Duchenne palsy
Klumpke paralysis
Iliotibial band syndrome
Unhappy triad
Anterior cruciate ligament injury
Patellar tendon rupture
Meniscus tear
Patellofemoral pain syndrome
Sprained ankle
Achilles tendon rupture
Spondylolysis
Spondylolisthesis
Degenerative disc disease
Spinal disc herniation
Sciatica
Compartment syndrome
Rhabdomyolysis
Osteogenesis imperfecta
Craniosynostosis
Pectus excavatum
Arthrogryposis
Genu valgum
Genu varum
Pigeon toe
Flat feet
Club foot
Cleidocranial dysplasia
Achondroplasia
Osteomyelitis
Bone tumors
Osteochondroma
Chondrosarcoma
Osteoporosis
Osteomalacia and rickets
Osteopetrosis
Paget disease of bone
Osteosclerosis
Lordosis, kyphosis, and scoliosis
Osteoarthritis
Spondylosis
Spinal stenosis
Rheumatoid arthritis
Juvenile idiopathic arthritis
Gout
Calcium pyrophosphate deposition disease (pseudogout)
Psoriatic arthritis
Ankylosing spondylitis
Reactive arthritis
Spondylitis
Septic arthritis
Bursitis
Baker cyst
Muscular dystrophy
Polymyositis
Dermatomyositis
Inclusion body myopathy
Polymyalgia rheumatica
Fibromyalgia
Rhabdomyosarcoma
Lambert-Eaton myasthenic syndrome
Sjogren syndrome
Mixed connective tissue disease
Antiphospholipid syndrome
Raynaud phenomenon
Scleroderma
Back pain: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Gout and pseudogout: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Scleroderma: Pathology review
Sjogren syndrome: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Osteoporosis medications
Fever of unknown origin: Clinical
Infective endocarditis: Clinical
Pneumonia: Clinical
Tuberculosis: Pathology review
Diarrhea: Clinical
Urinary tract infections: Clinical
Meningitis, encephalitis and brain abscesses: Clinical
Bites and stings: Clinical
Skin and soft tissue infections: Clinical
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Antituberculosis medications
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anthelmintic medications
Antimalarials
Anti-mite and louse medications
Joint pain: Clinical
Pediatric orthopedic conditions: Clinical
Rheumatoid arthritis: Clinical
Lower back pain: Clinical
Immunodeficiencies: Clinical
Fat-soluble vitamin deficiency and toxicity: Pathology review
Water-soluble vitamin deficiency and toxicity: B1-B7: Pathology review
Zinc deficiency and protein-energy malnutrition: Pathology review
Viral hepatitis: Clinical
HIV and AIDS: Pathology review
Integrase and entry inhibitors
Nucleoside reverse transcriptase inhibitors (NRTIs)
Protease inhibitors
Hepatitis medications
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Neuraminidase inhibitors
Seronegative arthritis: Clinical
Systemic lupus erythematosus (SLE): Clinical
Sjogren syndrome: Clinical
Inflammatory myopathies: Clinical
Vasculitis: Clinical
Preoperative evaluation: Clinical
Postoperative evaluation: Clinical
General anesthetics
Local anesthetics
Neuromuscular blockers
Laxatives and cathartics
Anticoagulants: Heparin
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Insulins
Traumatic brain injury: Clinical
Neck trauma: Clinical
Chest trauma: Clinical
Abdominal trauma: Clinical
Anatomy of the vertebral canal
Anatomy of the descending spinal cord pathways
Anatomy of the ascending spinal cord pathways
Anatomy clinical correlates: Vertebral canal
Anatomy clinical correlates: Spinal cord pathways
Superficial structures of the neck: Posterior triangle
Superficial structures of the neck: Cervical plexus
Superficial structures of the neck: Anterior triangle
Deep structures of the neck: Prevertebral muscles
Anatomy of the thyroid and parathyroid glands
Anatomy of the larynx and trachea
Anatomy of the pharynx and esophagus
Anatomy of the lymphatics of the neck
Deep structures of the neck: Root of the neck
Fascia and spaces of the neck
Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck
Anatomy clinical correlates: Viscera of the neck
Introduction to pharmacology
Enzyme function
Pharmacodynamics: Drug-receptor interactions
Pharmacodynamics: Agonist, partial agonist and antagonist
Pharmacodynamics: Desensitization and tolerance
Pharmacokinetics: Drug absorption and distribution
Pharmacokinetics: Drug metabolism
Pharmacokinetics: Drug elimination and clearance
Drug administration and dosing regimens
Mechanisms of antibiotic resistance

Transcript

Watch video only

The adaptive immune response is highly specific for each invader, and that’s because the cells of the adaptive immune response have receptors that differentiate friendly bacteria and potentially deadly pathogens from their unique parts - called antigens.

The key cells of the adaptive immune response are the lymphocytes- the B and T cells.

And the antigen receptors for T cells and B cells have a lot of things in common, one of which is that they share the same mechanism - called VDJ rearrangement - to generate a massively diverse set of receptors.

VDJ stands for variability, diversity, and joining, respectively, and VDJ rearrangement has 4 key characteristics that help ensure that each antigen receptor is unique.

First, each individual inherits multiple V, D, and J gene segments; second, the V, D, and J gene segments randomly recombine - meaning that any V can pair with any D and any J; third, there’s recombinational inaccuracy - meaning that this process is purposefully error prone - which leads to additional variation; and fourth, there’s random reassortment of two chains - meaning that this process involves two different chains that come together to make the receptor.

First, let’s look at our antigen receptors. The B cell receptor, or BCR, is essentially an antibody, except that it has a transmembrane part that goes through the membrane and attaches the receptor to the surface of a B cell.

Just like antibodies, the B cell receptor has a heavy chain and a light chain.

One region or fragment of the B cell receptor binds the antigen and it’s called the fragment - antigen binding or Fab region.

There are two Fab regions on every B cell receptor.

Then there’s the constant region or fragment called the fragment - constant or Fc region, which is the part that determines what class of B cell receptor it will be - for example, IgM or IgD, and whether or not it will remain a membrane bound B cell receptor or if it will get secreted as a free floating antibody.

The T cell receptor, or TCR, on the other hand looks quite different but still only has two chains.

In this case it has an alpha chain which is analogous to the B cell light chain, and a beta chain which is analogous to the B cell heavy chain.

Unlike the B cell receptor, the alpha and beta chains of the T cell receptor only form a transmembrane receptor - they don’t get secreted and there aren’t different classes. They also only have one antigen binding site.

So VDJ rearrangement, really only affects the portion of the protein that comes into contact with the antigen.

For both the BCR and TCR this is known as the variable region or V region.

This region is supported by a constant or C-region.

The variable regions of each of these receptors is highly diverse across the entire cell population -where no two T cells or B cells developed will recognize the same exact antigen.

This is accomplished by the significant variability in the genetic sequence that makes up the V region - but this variability is concentrated to certain segments of the V-region known as hypervariable regions or complementarity-determining regions.

These locations are brought together when the two chains of either the TCR or BCR are brought together to create one hypervariable site at the tip of each arm of the BCR or the tip of the TCR which is the antigen binding site.

So VDJ rearrangement is used to create the variability that is seen in these hypervariable regions which form the actual antigen binding site, and only that part of the protein.

The first step in VDJ rearrangement happens before we are born, in the sense that we inherit from each parent, multiple V, D, and J gene segments.

Each person has 44 V gene segments, 27 D segments, and 6 J segments and that is just for B cell heavy chains, there are more V, D, and J segments for the T cell receptor beta chain and of course there are more V and J segments for the B cell light chain and T cell alpha chain.

The various gene segments are all lined up on the DNA like box cars on a train.

The V gene segments are located furthest away from the genes that encode the constant gene segments, while the J segments are located fairly close to the constant gene segments.

And on the chromosomes that contain the genes for the heavy chain or beta chain the D gene segments sit between the V and J gene segments.

To generate diversity, these gene segments reassort randomly in both B cells and T cells.

A bit like how you might have several pairs of shoes, pants, and shirts and can mix and match them to create lots of different outfit combinations.

For B cell we’ll start with the heavy chain and for T cells we’ll start with the beta chain.

So let’s say for this heavy chain or beta chain rearranged to have V2-D2-J1, well this would be completely different and bind different antigens than a heavy chain or beta chain that rearranged to have V2-D3-J1.

So just by using a different D region, it completely changes what antigen these two cells might bind.

The rearrangement of these different exons is accomplished by having recombination signal sequences which are noncoding DNA sequences that flank the points where DNA needs to be cut and rearranged.

A recombination signal sequence has three parts to it.

First, there’s a 7 nucleotide sequence called a heptamer - 5’-CACAGTG-3’.

Key Takeaways

VDJ rearrangement is a process by which the genes responsible for encoding the variable region of the B-cell receptor and T-cell receptor are rearranged to create a diverse repertoire of receptors capable of recognizing a wide variety of antigens.

During VDJ rearrangement, DNA segments called V (variable), D (diversity), and J (joining) are rearranged to form the coding sequence for the receptor variable region. The process is mediated by recombination-activating genes (RAG1 and RAG2) and involves the introduction of double-strand breaks at specific recombination signal sequences (RSS) flanking the V, D, and J segments, followed by joining of the broken ends.

The resulting receptor variable region diversity is crucial for adaptive immunity, allowing the immune system to recognize and respond to a wide range of potential pathogens. However, errors in VDJ rearrangement can lead to autoimmune disease, immunodeficiency, or cancer.