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Abstract
Incontinentia pigmenti is a rare X-linked genodermatosis, often associated with male lethality in utero. Occurrences of this disease in boys have been reported, however, its clinical phenotype has not been well characterized. The purpose of this study was to report on additional instances of incontinentia pigmenti in boys and to review the clinical, laboratory, and molecular characteristics of all published such patients. A retrospective chart review and Medline search using the keywords incontinentia pigmenti, males, and NEMO gene was undertaken. Six new boys with incontinentia pigmenti were found in our database and 36 more were previously reported in the literature. The vesiculo-bullous stage was the most frequent clinical presentation at diagnosis (80%). Fifteen percent of patients had an initial unilateral presentation. Recurrences of this stage were noted in 16%. Stages 2 and 3 of the disease were present in only 72.5% and 75% of patients, respectively. Only 15% of the boys had a documented stage 4. Extracutaneous manifestations were also documented (30% - central nervous system manifestations, 35% - eye involvement, 30% - alopecia, 40% - teeth anomalies). Thirty two percent of boys had peripheral eosinophilia. Only five had evidence of NEMO gene mutation. The male phenotype has clinical features similar to those of the female phenotype. Unilateral presentation is a distinct occurrence in boys, especially in early stages. Anomalies are the most common extracutaneous findings, followed by eye, hair, and central nervous system abnormalities.
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Affiliation(s)
- Daniela Ardelean
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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52
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Sebban H, Courtois G. NF-kappaB and inflammation in genetic disease. Biochem Pharmacol 2006; 72:1153-60. [PMID: 16965764 DOI: 10.1016/j.bcp.2006.08.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2006] [Revised: 07/06/2006] [Accepted: 08/01/2006] [Indexed: 11/20/2022]
Abstract
By responding to pro-inflammatory cytokines, such as IL-1beta and TNF-alpha, and controlling itself the expression of numerous mediators of inflammation, NF-kappaB plays a pivotal role in controlling the proper sequence of events characterizing the inflammation process. Although excessive NF-kappaB activation is often associated with inflammatory signs in many different tissues, impaired NF-kappaB activation can also generate inflammation. This is the case in humans suffering from the genetic disease incontinentia pigmenti that exhibit severe skin inflammation. Identifying the molecular basis of this pathology, mutations affecting the gene coding for NEMO, has allowed production of mouse models for investigating the disease. Their characterization supports the view that a very tight positive and negative regulation of the NF-kappaB signaling pathway is required in vivo to ensure not only a fine-tuned response to injury or infection but also to maintain tissue homeostasis.
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Affiliation(s)
- Hélène Sebban
- INSERM U697, Pavillon Bazin, Hôpital Saint-Louis, 1, Avenue Claude Vellefaux, 75010 Paris, France
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53
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Pacheco TR, Levy M, Collyer JC, de Parra NP, Parra CA, Garay M, Aprea G, Moreno S, Mancini AJ, Paller AS. Incontinentia pigmenti in male patients. J Am Acad Dermatol 2006; 55:251-5. [PMID: 16844507 DOI: 10.1016/j.jaad.2005.12.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2005] [Revised: 12/06/2005] [Accepted: 12/06/2005] [Indexed: 11/17/2022]
Abstract
BACKGROUND Incontinentia pigmenti (IP) is a rare X-linked dominant genodermatosis that is typified by distinctive cutaneous findings and often by abnormalities of teeth, hair, nails, eyes, musculoskeletal system, and central nervous system. The gene that is mutated in patients with IP has been mapped to Xq28 and encodes the NF-kappaB essential modulator, NEMO. Female patients with IP show functional mosaicism and cutaneous manifestations follow Blaschko's lines of ectodermal embryologic development. The condition is generally considered to be lethal in utero in male fetuses, suggesting that having some normal gene expression is critical for survival. OBSERVATIONS We observed 9 boys with IP. All had normal karotypes and no apparent family history of IP. In 8 of these 9 patients, lesions were localized to one extremity at presentation. The diagnosis was confirmed by histopathologic examination that showed eosinophils within intraepidermal, multiloculated vesicles. One of the boys later developed dental and neurologic abnormalities. LIMITATIONS The case series was small and the workup for these patients from different sites was not uniform. CONCLUSIONS Male individuals may show cutaneous and noncutaneous features of IP in a limited distribution that allows survival. Postzygotic mutation/somatic mosaicism is the likely mechanism. Given the potential sequelae associated with this condition, continuing follow-up of these patients is recommended.
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Affiliation(s)
- Theresa R Pacheco
- Department of Dermatology, University of Colorado Health Sciences Center, USA
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54
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Filipe-Santos O, Bustamante J, Haverkamp MH, Vinolo E, Ku CL, Puel A, Frucht DM, Christel K, von Bernuth H, Jouanguy E, Feinberg J, Durandy A, Senechal B, Chapgier A, Vogt G, de Beaucoudrey L, Fieschi C, Picard C, Garfa M, Chemli J, Bejaoui M, Tsolia MN, Kutukculer N, Plebani A, Notarangelo L, Bodemer C, Geissmann F, Israël A, Véron M, Knackstedt M, Barbouche R, Abel L, Magdorf K, Gendrel D, Agou F, Holland SM, Casanova JL. X-linked susceptibility to mycobacteria is caused by mutations in NEMO impairing CD40-dependent IL-12 production. ACTA ACUST UNITED AC 2006; 203:1745-59. [PMID: 16818673 PMCID: PMC2118353 DOI: 10.1084/jem.20060085] [Citation(s) in RCA: 226] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Germline mutations in five autosomal genes involved in interleukin (IL)-12–dependent, interferon (IFN)-γ–mediated immunity cause Mendelian susceptibility to mycobacterial diseases (MSMD). The molecular basis of X-linked recessive (XR)–MSMD remains unknown. We report here mutations in the leucine zipper (LZ) domain of the NF-κB essential modulator (NEMO) gene in three unrelated kindreds with XR-MSMD. The mutant proteins were produced in normal amounts in blood and fibroblastic cells. However, the patients' monocytes presented an intrinsic defect in T cell–dependent IL-12 production, resulting in defective IFN-γ secretion by T cells. IL-12 production was also impaired as the result of a specific defect in NEMO- and NF-κB/c-Rel–mediated CD40 signaling after the stimulation of monocytes and dendritic cells by CD40L-expressing T cells and fibroblasts, respectively. However, the CD40-dependent up-regulation of costimulatory molecules of dendritic cells and the proliferation and immunoglobulin class switch of B cells were normal. Moreover, the patients' blood and fibroblastic cells responded to other NF-κB activators, such as tumor necrosis factor-α, IL-1β, and lipopolysaccharide. These two mutations in the NEMO LZ domain provide the first genetic etiology of XR-MSMD. They also demonstrate the importance of the T cell– and CD40L-triggered, CD40-, and NEMO/NF-κB/c-Rel–mediated induction of IL-12 by monocyte-derived cells for protective immunity to mycobacteria in humans.
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Affiliation(s)
- Orchidée Filipe-Santos
- Laboratory of Human Genetics of Infectious Diseases, University of Paris René Descartes-Institut National de la Santé et de la Recherche Médicale (INSERM) U 550, Necker Medical School, Paris, France
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55
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Dupuis-Girod S, Cancrini C, Le Deist F, Palma P, Bodemer C, Puel A, Livadiotti S, Picard C, Bossuyt X, Rossi P, Fischer A, Casanova JL. Successful allogeneic hemopoietic stem cell transplantation in a child who had anhidrotic ectodermal dysplasia with immunodeficiency. Pediatrics 2006; 118:e205-11. [PMID: 16769798 DOI: 10.1542/peds.2005-2661] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Anhidrotic ectodermal dysplasia with immunodeficiency is associated with multiple infections and a poor clinical outcome. Hypomorphic mutations in nuclear factor kappaB essential modulator (NEMO)/IkappaB kinase complex and a hypermorphic mutation in inhibitor alpha of nuclear factor kappaB (IkappaBalpha) both result in impaired nuclear factor kappaB activation and are associated with X-recessive and autosomal-dominant forms of anhidrotic ectodermal dysplasia with immunodeficiency, respectively. Autosomal-dominant anhidrotic ectodermal dysplasia with immunodeficiency is also associated with a severe T-cell phenotype. It is not known whether hematopoietic stem cell transplantation can cure immune deficiency in children with anhidrotic ectodermal dysplasia with immunodeficiency. A boy with autosomal-dominant anhidrotic ectodermal dysplasia with immunodeficiency and a severe T-cell immunodeficiency underwent transplantation at 1 year of age with haploidentical T-cell-depleted bone marrow after myeloablative conditioning. Engraftment occurred, with full hematopoietic chimerism. Seven years after transplantation, clinical outcome is favorable, with normal T-cell development. As expected, the developmental features of the anhidrotic ectodermal dysplasia syndrome have appeared and persisted. This is the first report of successful hematopoietic stem cell transplantation in a child with anhidrotic ectodermal dysplasia with immunodeficiency. Hematopoietic stem cell transplantation is well tolerated and efficiently cures the profound immunodeficiency associated with autosomal-dominant anhidrotic ectodermal dysplasia with immunodeficiency.
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Affiliation(s)
- Sophie Dupuis-Girod
- Unité d'Immunologie et d'Hématologie Pédiatriques, Institut National de la Santé et de la Recherche Médicale U429, Hôpital Necker-Enfants Malades, Paris, France
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56
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Franco LM, Goldstein J, Prose NS, Selim MA, Tirado CA, Coale MM, McDonald MT. Incontinentia pigmenti in a boy with XXY mosaicism detected by fluorescence in situ hybridization. J Am Acad Dermatol 2006; 55:136-8. [PMID: 16781308 DOI: 10.1016/j.jaad.2005.11.1068] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Revised: 11/09/2005] [Accepted: 11/18/2005] [Indexed: 11/30/2022]
Abstract
We report the case of a male infant with incontinentia pigmenti (MIM 308310) and low-grade XXY mosaicism. Fluorescence in situ hybridization may reveal the underlying genetic alteration in male patients with incontinentia pigmenti and a normal karyotype.
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Affiliation(s)
- Luis M Franco
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA
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57
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Nelson DL. NEMO, NFkappaB signaling and incontinentia pigmenti. Curr Opin Genet Dev 2006; 16:282-8. [PMID: 16647846 DOI: 10.1016/j.gde.2006.04.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Accepted: 04/18/2006] [Indexed: 11/22/2022]
Abstract
The identification of mutations in the NEMO gene in humans with incontinentia pigmenti and several other genetic conditions has led to an appreciation of the multiple roles of signaling through the NFkappaB pathway, and how erroneous signalling contributes to disease. The finding that the disease results from a common, recurrent mutation was surprising given the high variability in patients' phenotypes and illustrates the role of X inactivation and selection in females. Recent advances in mouse models and in understanding the multiple roles of NEMO in the cell provide additional avenues to define the various roles of NEMO in NFkappaB signaling.
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Affiliation(s)
- David L Nelson
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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58
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Puel A, Reichenbach J, Bustamante J, Ku CL, Feinberg J, Döffinger R, Bonnet M, Filipe-Santos O, Beaucoudrey LD, Durandy A, Horneff G, Novelli F, Wahn V, Smahi A, Israel A, Niehues T, Casanova JL. The NEMO mutation creating the most-upstream premature stop codon is hypomorphic because of a reinitiation of translation. Am J Hum Genet 2006; 78:691-701. [PMID: 16532398 PMCID: PMC1424680 DOI: 10.1086/501532] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Accepted: 01/13/2006] [Indexed: 11/04/2022] Open
Abstract
Amorphic mutations in the NF- kappa B essential modulator (NEMO) cause X-dominant incontinentia pigmenti, which is lethal in males in utero, whereas hypomorphic mutations cause X-recessive anhidrotic ectodermal dysplasia with immunodeficiency, a complex developmental disorder and life-threatening primary immunodeficiency. We characterized the NEMO mutation 110_111insC, which creates the most-upstream premature translation termination codon (at codon position 49) of any known NEMO mutation. Surprisingly, this mutation is associated with a pure immunodeficiency. We solve this paradox by showing that a Kozakian methionine codon located immediately downstream from the insertion allows the reinitiation of translation. The residual production of an NH(2)-truncated NEMO protein was sufficient for normal fetal development and for the subsequent normal development of skin appendages but was insufficient for the development of protective immune responses.
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Affiliation(s)
- Anne Puel
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Janine Reichenbach
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Jacinta Bustamante
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Cheng-Lung Ku
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Jacqueline Feinberg
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Rainer Döffinger
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Marion Bonnet
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Orchidée Filipe-Santos
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Ludovic de Beaucoudrey
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Anne Durandy
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Gerd Horneff
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Francesco Novelli
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Volker Wahn
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Asma Smahi
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Alain Israel
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Tim Niehues
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
| | - Jean-Laurent Casanova
- Laboratoire de Génétique Humaine des Maladies Infectieuses, INSERM U550, Faculté de Médecine Necker-Enfants Malades, Développement Normal et Pathologique du Système Immunitaire, INSERM U429, Unité de Recherches sur les Handicaps Génétiques de l’Enfant, INSERM U393, and Unité d’Immunologie et d’Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Unité de Signalisation Moléculaire et Activation Cellulaire, URA 2582 Centre National de la Recherche Scientifique, Institut Pasteur, Paris; and Pädiatrische Immunologie und Rheumatologie, Zentrum für Kinderheilkunde, Heinrich Heine Universität, Düsseldorf, Germany
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59
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Ørstavik KH, Kristiansen M, Knudsen GP, Storhaug K, Vege A, Eiklid K, Abrahamsen TG, Smahi A, Steen-Johnsen J. Novel splicing mutation in the NEMO (IKK-gamma) gene with severe immunodeficiency and heterogeneity of X-chromosome inactivation. Am J Med Genet A 2006; 140:31-9. [PMID: 16333836 DOI: 10.1002/ajmg.a.31026] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report on a family with three stillborn males, three affected males who were small for gestational age and died within 8 months, and one male who died at age 5 years. This boy had cone-shaped teeth and oligoodontia. He had serious bacterial infections and inflammatory bowel disease. Mutations in the NF-kappaB essential modulator (NEMO) gene have recently been shown to be the cause of a group of ectodermal dysplasia and immunodeficiency disorders (EDA-ID). Analysis of the NEMO gene revealed a nucleotide change in the consensus sequence of the splicing donor site of exon 6 IVS6 + 5G --> A(1027 + 5G --> A), which has not previously been described in EDA-ID. RT-PCR analysis of fibroblast RNA from an aborted affected male fetus demonstrated a skipping of exons 4, 5, and 6 which resulted in a truncated protein of about 35 kDa revealed by NEMO antibody. The skipping of exons 4, 5, and 6 did not affect the ORF of the C-terminal of NEMO encoded by exons 7, 8, 9, and 10, which contains a coiled-coil motif (CC2), a leucin-zipper (LZ), and a zinc finger motif (ZF) sub-domains of NEMO. IkappaBalpha degradation was strongly impaired in the fetal fibroblasts, suggesting an impaired NF-kappaB signaling. One healthy carrier had a completely skewed X-inactivation pattern with the normal X active, whereas the two other carriers had a random X-inactivation pattern. This family may represent a new phenotype within the EDA-ID disorders. From the heterogeneity in X-inactivation phenotype, we conclude that this mutation is not deleterious enough to be lethal for peripheral blood cells.
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Affiliation(s)
- Karen Helene Ørstavik
- Department of Medical Genetics, Forskningsveien 2B, Rikshospitalet, 0027 Oslo, Norway.
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60
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Doffinger R, Patel SY, Kumararatne DS. Host genetic factors and mycobacterial infections: lessons from single gene disorders affecting innate and adaptive immunity. Microbes Infect 2006; 8:1141-50. [PMID: 16520078 DOI: 10.1016/j.micinf.2005.10.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2005] [Accepted: 10/19/2005] [Indexed: 12/21/2022]
Abstract
This review summarizes the association of increased susceptibility to mycobacterial disease in patients with genetic defects affecting innate and adaptive immunity. The optimum function of CD4 T-cell and macrophage function is critically important for immunity against mycobacteria. Antibody, complement and neutrophil function is not required for effective anti-mycobacterial immunity.
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Affiliation(s)
- Rainer Doffinger
- Department of Clinical Biochemistry and Immunology, Box 109, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK
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61
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Abstract
The recent identification of genetic diseases (incontinentia pigmenti, anhidrotic ectodermal dysplasia with immunodeficiency and cylindromatosis) resulting from mutations affecting components of the nuclear factor-kappaB (NF-kappaB) signaling pathway provides a unique opportunity to understand the function of NF-kappaB in vivo. Besides confirming the importance of NF-kappaB in innate and acquired immunity or bone mass control, analysis of these diseases has uncovered new critical roles played by this transcription factor in the development and homeostasis of the epidermis and the proper function of lymphatic vessels. In addition, the identified mutations will help understanding at the molecular level how NF-kappaB is activated in response to cell stimulation.
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Affiliation(s)
- G Courtois
- INSERM U697, Pavillon Bazin, Hôpital Saint-Louis, Paris, France.
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62
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Morlon A, Munnich A, Smahi A. TAB2, TRAF6 and TAK1 are involved in NF-κB activation induced by the TNF-receptor, Edar and its adaptator Edaradd. Hum Mol Genet 2005; 14:3751-7. [PMID: 16251197 DOI: 10.1093/hmg/ddi405] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Activation of the NF-kappaB pathway by the TNF-receptor Edar (Ectodysplasin receptor) and its downstream adaptator Edaradd (Edar-associated death domain) is essential for the development of hair follicles, teeth, exocrine glands and other ectodermal derivatives. Dysfunction of Edar signalling causes hypohidrotic/anhidrotic ectodermal dysplasia (ED), a disorder characterized by sparse hair, lack of sweat glands and malformation of teeth. The Edar signalling pathway stimulates NF-kappaB transcription factors via an activation of the IkappaB kinase (IKK) complex. To gain further insight into the mechanism of IKK activation by Edar and Edaradd, we performed a yeast two-hybrid screen and isolated TAB2 (TAK1-binding protein 2) as a binding partner of Edaradd. TAB2 is an adaptator protein that brigdes TRAF6 (TNF-receptor-associated factor 6) to TAK1 (TGFbeta-activated kinase 1), allowing TAK1 activation and subsequent IKK activation. Here, we show that endogenous and overexpressed TAB2, TRAF6 and TAK1 co-immunoprecipitated with Edaradd in 293 cells. Moreover, we show that dominant negative forms of TAB2, TRAF6 and TAK1 blocked the NF-kappaB activation induced by Edaradd. These results support the involvement of the TAB2/TRAF6/TAK1 signalling complex in the Edar signal transduction pathway and have important implications for our understanding of NF-kappaB activation and EDs in human.
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Affiliation(s)
- Aurore Morlon
- Unité de Recherche sur les Handicaps Génétiques de l'Enfant INSERM U-393, Hôpital Necker-Enfants Malades, 149 rue de sèvres 75015 Paris, France.
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63
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Martinez-Pomar N, Munoz-Saa I, Heine-Suner D, Martin A, Smahi A, Matamoros N. A new mutation in exon 7 of NEMO gene: late skewed X-chromosome inactivation in an incontinentia pigmenti female patient with immunodeficiency. Hum Genet 2005; 118:458-65. [PMID: 16228229 DOI: 10.1007/s00439-005-0068-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2005] [Accepted: 08/01/2005] [Indexed: 01/12/2023]
Abstract
Incontinentia pigmenti is an X-linked genodermatosis, lethal in males. Affected females survive because of X-chromosome dizygosity and negative selection of cells carrying the mutant X-chromosome, and for this reason the skewed X inactivation pattern is often used to confirm the diagnosis. The most frequent mutation is a deletion of part of the NEMO gene (NEMODelta4-10), although other mutations have been reported. Mutations of NEMO which do not abolish NF-kappaB activity totally permit male survival, causing an allelic variant of IP called hypohidrotic ectodermal dysplasia and immunodeficiency (HED-ID). We present a non-classical IP female patient who also suffered transient immunodeficiency because of a late and progressive selection against peripheral blood cells carrying an active mutated X-chromosome. This finding suggests that in the absence of known mutation the X-inactivation studies used in genetic counselling can induce mistakes with some female patients. At the age of 3 years and 6 months, all immunodeficiency signs disappeared, and the X-chromosome inactivation pattern was completely skewed. The low T cell proliferation and CD40L expression corroborate the important role of NEMO/ NF-kappaB pathway in T cell homeostasis. The decreased NEMO protein amount and the impaired IkBalpha degradation suggest that this new mutation, NM_003639: c.1049dupA, causes RNA or protein instability. To our knowledge, this is the first time that selection against the mutated X-chromosome in X-linked disease has been documented in vivo.
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Affiliation(s)
- Natalia Martinez-Pomar
- Immunology Service, Hospital Universitari Son Dureta, Andrea Doria, 55, 07014, Palma de Mallorca, Balearic Islands, Spain
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64
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Phan TA, Wargon O, Turner AM. Incontinentia pigmenti case series: clinical spectrum of incontinentia pigmenti in 53 female patients and their relatives. Clin Exp Dermatol 2005; 30:474-80. [PMID: 16045670 DOI: 10.1111/j.1365-2230.2005.01848.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A retrospective case series of 53 female patients with incontinentia pigmenti (IP) including 28 secondary cases (female relatives of probands) was reviewed and compared with other series in an attempt to estimate more accurately the true disease burden of patients with IP. We found that, while the frequency of the first three cutaneous stages of IP was comparable with previous studies, none of the secondary cases manifested any serious neurological complications but all displayed stage IV pale anhidrotic reticulate lines on their posterior calves. This important clinical feature of IP in secondary cases has previously been under-represented in studies that often involved only paediatric probands. Hence, mildly affected cases of IP are often undiagnosed and under-represented in case series to date, possibly leading to inappropriately high estimates of neurological and eye involvement. With the availability of genetic testing, it is now feasible to confirm the variability of the phenotype and the risk of complications in IP.
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Affiliation(s)
- T A Phan
- Department of Dermatology, Sydney Children's Hospital, Randwick, NSW, Australia
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65
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Ku CL, Yang K, Bustamante J, Puel A, von Bernuth H, Santos OF, Lawrence T, Chang HH, Al-Mousa H, Picard C, Casanova JL. Inherited disorders of human Toll-like receptor signaling: immunological implications. Immunol Rev 2005; 203:10-20. [PMID: 15661018 DOI: 10.1111/j.0105-2896.2005.00235.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In vitro nine of 10 known human Toll-like receptors (TLRs) are engaged by well-defined chemical agonists that mimic microbial compounds, raising the possibility that human TLRs play a critical role in protective immunity in vivo. We thus review here the recently described human primary immunodeficiencies caused by germline mutations in genes encoding molecules involved in cell signaling downstream from TLRs. Subjects with anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID) carry either X-linked recessive hypomorphic mutations in NEMO or autosomal dominant hypermorphic mutations in IKBA. Their cells show a broad defect in nuclear factor-kappaB (NF-kappaB) activation, with an impaired, but not abolished response to a large variety of stimuli including TLR agonists. EDA-ID patients show developmental anomalies of skin appendages and a broad spectrum of infectious diseases. Patients with autosomal recessive amorphic mutations in IRAK4 present a purely immunological syndrome and more restricted defects, with specific impairment of the Toll and interleukin-1 receptor (TIR)-interleukin-1 receptor-associated kinase (IRAK) signaling pathway. In these subjects, the NF-kappaB- and mitogen-activated protein kinase-mediated induction of inflammatory cytokines in response to TIR agonists is impaired. The patients present a narrow range of pyogenic bacterial infections that become increasingly rare with age. Altogether, these data suggest that human TLRs play a critical role in host defense. However, they do not provide compelling evidence, as even the infectious phenotype of patients with mutations in IRAK4 may result from impaired signaling via receptors other than TLRs. Paradoxically, these experiments of nature raise the possibility that the entire set of human TLRs is largely redundant in protective immunity in vivo.
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Affiliation(s)
- Cheng-Lung Ku
- Laboratory of Human Genetics of Infectious Diseases, University of Paris René Descartes, INSERM U550, Necker Medical School, Paris, France
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66
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Orange JS, Levy O, Geha RS. Human disease resulting from gene mutations that interfere with appropriate nuclear factor-kappaB activation. Immunol Rev 2005; 203:21-37. [PMID: 15661019 DOI: 10.1111/j.0105-2896.2005.00221.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The nuclear factor (NF)-kappaB family of transcription factors serves vital roles in a wide array of cell functions. An increasing number of human genetic lesions that result in defined disease entities are linked to inappropriate activation of NF-kappaB. The resulting aberrant NF-kappaB function can lead to cellular defects that ultimately impair normal developmental processes, host immune defenses, or both. Molecular defects that lie upstream in cell-signaling pathways and rely upon NF-kappaB activation tend to give a more specific phenotype, whereas those closer to the actual NF-kappaB proteins have broader defects. A detailed study of these diseases can provide insight into the biochemistry of NF-kappaB activation as well as the role of NF-kappaB in human health.
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Affiliation(s)
- Jordan S Orange
- Division of Immunology, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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67
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Bonilla FA, Bernstein IL, Khan DA, Ballas ZK, Chinen J, Frank MM, Kobrynski LJ, Levinson AI, Mazer B, Nelson RP, Orange JS, Routes JM, Shearer WT, Sorensen RU. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma Immunol 2005; 94:S1-63. [PMID: 15945566 DOI: 10.1016/s1081-1206(10)61142-8] [Citation(s) in RCA: 311] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Francisco A Bonilla
- Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA
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68
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Ku CL, Dupuis-Girod S, Dittrich AM, Bustamante J, Santos OF, Schulze I, Bertrand Y, Couly G, Bodemer C, Bossuyt X, Picard C, Casanova JL. NEMO mutations in 2 unrelated boys with severe infections and conical teeth. Pediatrics 2005; 115:e615-9. [PMID: 15833888 DOI: 10.1542/peds.2004-1754] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
X-linked recessive anhidrotic ectodermal dysplasia with immunodeficiency is a developmental and immunologic disorder caused by mutations in nuclear factor-kappaB essential modulator (NEMO), which is essential for nuclear factor-kappaB activation. Early in life, affected boys present a typical appearance, with hypotrichosis or atrichosis, hypohidrosis or anhidrosis, and hypodontia or anodontia with conical incisors. They are also susceptible to various microorganisms, mostly pyogenic bacteria and mycobacteria. Here we report 2 unrelated boys, aged 6 and 11 years, who have novel mutations in NEMO and present conical incisors and hypodontia as their sole and long-unrecognized developmental anomaly. One child had isolated recurrent pneumococcal disease, whereas the other had multiple infections. Our observations indicate that conical incisors should prompt the search for NEMO mutations in boys with unusual infectious diseases.
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Affiliation(s)
- Cheng-Lung Ku
- Laboratory of Human Genetics of Infectious Diseases, University of Paris René Descartes-Institut National de la Santé et de la Recherche Médicale U550, Necker Medical School, Paris, France
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69
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Abstract
PURPOSE OF REVIEW Cytokines are soluble mediators involved in the development or function of the immune system. This paper reviews the literature on childhood-onset inherited disorders associated with impaired cytokine-mediated immunity. RECENT FINDINGS Cytokine-mediated immunity defects can be classified into seven different groups: defects in the interleukin (IL)-7 receptor (IL7RA), in the common cytokine receptor gamma chain (gammac) of the IL-2, -4, -7, -15, and -21, and in Jak3 (JAK3) downstream of the gamma chain; mutation in the IL-2 receptor alpha (IL-2RA) and defective expression of the IL-2Rbeta chain; mutations in the gene encoding for a chemokine receptor, CXCR4; mutations in five genes involved in the IL-12/23-interferon-gamma axis (IL12B, IL12RB1, IFNGR1, IFNGR2, STAT1); mutations in three genes involved in the nuclear factor-kappaB signaling pathway (IRAK4, NEMO, IkappaBA); mutations in the tumor necrosis factor receptor signaling pathway (TNFRSF1A); and mutations in the transforming growth factor-1 gene (TGFB1). SUMMARY Genetic cytokine-mediated immunity defects are associated with a highly heterogeneous group of clinical features, ranging from susceptibility to infections to developmental defects. This heterogeneity highlights the diversity and pleiotropy of cytokines. It is likely that many more cytokine defects and their responsive pathways will be discovered in the coming years, expanding further the heterogeneity associated with this group of childhood-onset illnesses.
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Affiliation(s)
- Capucine Picard
- Unité d'Immunologie et d'Hématologie Pédiatriques, Hôpital Necker-Enfants Malades, and Laboratoire de Génétique Humaine des Maladies Infectieuses, Université de Paris René Descartes-INSERM U550, Faculté de Médecine Necker, Paris, France.
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70
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Abstract
Incontinentia pigmenti is an uncommon X-linked dominant genodermatosis primarily affecting females. Its hallmark is a unique skin eruption that presents in infancy along the lines of Blaschko and evolves through four stages: inflammatory, verrucous, hyperpigmented, and atrophic. Other persistent findings of the disease include alopecia and dental anomalies. In a minority of cases, serious ophthalmologic and neurological alterations may occur. Mutations in the NF-kappaB essential modulator (NEMO) that lead to an inability to activate the NF-kappaB pathway produce IP. Less deleterious mutations in NF-kappaB essential modulator give rise to hypohidrotic ectodermal dysplasia with immune deficiency in affected males, a related but distinct phenotype. These recent discoveries provide insight into the crucial role of NF-kappaB function in regulating the developmental, inflammatory, immune, and anti-apoptotic responses of the skin and other organs.
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Affiliation(s)
- Anna L Bruckner
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94143-0316, USA
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71
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Puel A, Picard C, Ku CL, Smahi A, Casanova JL. Inherited disorders of NF-kappaB-mediated immunity in man. Curr Opin Immunol 2004; 16:34-41. [PMID: 14734108 DOI: 10.1016/j.coi.2003.11.013] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The transcription factors of the NF-kappaB family play an important role in immunity to infection in animal models. Three human primary immunodeficiencies associated with impaired NF-kappaB signaling were recently described. X-linked recessive anhidrotic ectodermal dysplasia with immunodeficiency (XL-EDA-ID) is caused by hypomorphic mutations in the gene encoding NEMO/IKKgamma, the regulatory subunit of the IkappaB-kinase (IKK) complex. Autosomal dominant EDA-ID (AD-EDA-ID) is caused by a hypermorphic mutation in the gene encoding the inhibitory protein IkappaBalpha. Autosomal recessive immunodeficiency without EDA is caused by mutations in the gene encoding IRAK-4, a kinase acting upstream from the IKK complex in the TIR signaling pathway. The description of the infectious phenotypes associated with these genetic defects has initiated the forward genetic dissection of NF-kappaB-mediated immunity in man.
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Affiliation(s)
- Anne Puel
- Université de Paris René Descartes, Institut National de la Santé et de la Recherche Médicale U550, Faculté de Médecine Necker, 75015 Paris, France
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72
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Abstract
This article outlines the clinical, central nervous system, and neuropathologic features,pathogenesis, genetics, molecular biology, and neuroimaging characteristics of the rare vascular phakomatoses, melanophakomatoses, and organoid phakomatoses.
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Affiliation(s)
- Simon Edelstein
- Department of Radiology, MIA Group Limited Box Hill Hospital, Melbourne, Australia
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73
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Nishikomori R, Akutagawa H, Maruyama K, Nakata-Hizume M, Ohmori K, Mizuno K, Yachie A, Yasumi T, Kusunoki T, Heike T, Nakahata T. X-linked ectodermal dysplasia and immunodeficiency caused by reversion mosaicism of NEMO reveals a critical role for NEMO in human T-cell development and/or survival. Blood 2004; 103:4565-72. [PMID: 14726382 DOI: 10.1182/blood-2003-10-3655] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
X-linked ectodermal dysplasia and immunodeficiency (XL-EDA-ID) is an X-linked recessive disease caused by a mutation in the nuclear factor-kappaB (NF-kappaB) essential modulator (NEMO). Here we report an XL-EDA-ID patient with atypical features of very few naive-phenotype T cells and defective mitogen-induced proliferation of peripheral blood mononuclear cells (PBMCs). The patient's NEMO defect was diagnosed by flow cytometric analysis of intracellular NEMO staining. Specific cell lineages (monocytes and neutrophils) expressed reduced levels of NEMO, but 2 populations of T, B, and NK cells were detected with normal and reduced expression of NEMO. Genomic analysis revealed that duplication of a 4.4-kb sequence ranging from intron 3 to exon 6 caused the reduced expression of NEMO. Polymorphism analysis showed that the patient's B- and T-cell lines with reduced and normal expression of NEMO had the same X chromosome, indicating that the somatic mosaicism was not due to fetomaternal transfusion but was most likely due to postzygotic reversion. This XLEDA-ID case adds to our understanding of NEMO biology, indicating that NEMO is critical for T-cell development and/or survival in humans as well as in mice.
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Affiliation(s)
- Ryuta Nishikomori
- Department of Pediatrics and Laboratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto 606-8507, Japan
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74
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Abstract
Incontinentia pigmenti, or Block-Sulzberger Syndrome, is an X-linked dominant disorder with characteristic skin, hair, eye and tooth abnormalities. It is classically considered a male-lethal disorder with recurrent miscarriages of male foetuses. A few cases of surviving males with incontinentia pigmenti have been reported in the medical literature. This article reports the medical and dental findings of a boy diagnosed with incontinentia pigmenti.
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Affiliation(s)
- S Y Cho
- School Dental Care Service, Department of Health, Hong Kong.
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75
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Courtois G, Smahi A, Reichenbach J, Döffinger R, Cancrini C, Bonnet M, Puel A, Chable-Bessia C, Yamaoka S, Feinberg J, Dupuis-Girod S, Bodemer C, Livadiotti S, Novelli F, Rossi P, Fischer A, Israël A, Munnich A, Le Deist F, Casanova JL. A hypermorphic IkappaBalpha mutation is associated with autosomal dominant anhidrotic ectodermal dysplasia and T cell immunodeficiency. J Clin Invest 2003; 112:1108-15. [PMID: 14523047 PMCID: PMC198529 DOI: 10.1172/jci18714] [Citation(s) in RCA: 252] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
X-linked anhidrotic ectodermal dysplasia with immunodeficiency (XL-EDA-ID) is caused by hypomorphic mutations in the gene encoding NEMO/IKKgamma, the regulatory subunit of the IkappaB kinase (IKK) complex. IKK normally phosphorylates the IkappaB-inhibitors of NF-kappaB at specific serine residues, thereby promoting their ubiquitination and degradation by the proteasome. This allows NF-kappaB complexes to translocate into the nucleus where they activate their target genes. Here, we describe an autosomal-dominant (AD) form of EDA-ID associated with a heterozygous missense mutation at serine 32 of IkappaBalpha. This mutation is gain-of-function, as it enhances the inhibitory capacity of IkappaBalpha by preventing its phosphorylation and degradation, and results in impaired NF-kappaB activation. The developmental, immunologic, and infectious phenotypes associated with hypomorphic NEMO and hypermorphic IKBA mutations largely overlap and include EDA, impaired cellular responses to ligands of TIR (TLR-ligands, IL-1beta, and IL-18), and TNFR (TNF-alpha, LTalpha1/beta2, and CD154) superfamily members and severe bacterial diseases. However, AD-EDA-ID but not XL-EDA-ID is associated with a severe and unique T cell immunodeficiency. Despite a marked blood lymphocytosis, there are no detectable memory T cells in vivo, and naive T cells do not respond to CD3-TCR activation in vitro. Our report highlights both the diversity of genotypes associated with EDA-ID and the diversity of immunologic phenotypes associated with mutations in different components of the NF-kappaB signaling pathway.
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Affiliation(s)
- Gilles Courtois
- Unité de Biologie Moléculaire de l'Expression Génique, Centre National de la Recherche Scientifique URA 2582, Institut Pasteur, Paris, France
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76
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Shah SN, Gibbs S, Upton CJ, Pickworth FE, Garioch JJ. Incontinentia pigmenti associated with cerebral palsy and cerebral leukomalacia: a case report and literature review. Pediatr Dermatol 2003; 20:491-4. [PMID: 14651567 DOI: 10.1111/j.1525-1470.2003.20607.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Incontinentia pigmenti (IP) is a multisystem disorder with characteristic cutaneous signs. After the skin, the central nervous system is the next most affected system. We report a child with IP and left-sided hemiparesis and cerebral periventricular leukomalacia on magnetic resonance imaging (MRI). The MRI findings would support ischemia sustained perinatally.
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Affiliation(s)
- Syed N Shah
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom
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77
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Andrews T, Sullivan KE. Infections in patients with inherited defects in phagocytic function. Clin Microbiol Rev 2003; 16:597-621. [PMID: 14557288 PMCID: PMC207096 DOI: 10.1128/cmr.16.4.597-621.2003] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Patients with defects in phagocytic function are predisposed to intracellular microorganisms and typically have early dissemination of the infection. Recognition of the underlying disorder and aggressive antimicrobial therapy has been beneficial for the patients. Improved understanding of the pathophysiology has also affected patient management by allowing specific, targeted immunomodulatory intervention. The disorders described in this review are not common but have had a significant impact on our understanding of the role of phagocytic cells in host defense. Conversely, understanding the role of the neutrophil and macrophage in infection has benefited not just the patients described in this review but also other patients with similar disease processes.
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Affiliation(s)
- Timothy Andrews
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
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78
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Tang ED, Wang CY, Xiong Y, Guan KL. A role for NF-kappaB essential modifier/IkappaB kinase-gamma (NEMO/IKKgamma) ubiquitination in the activation of the IkappaB kinase complex by tumor necrosis factor-alpha. J Biol Chem 2003; 278:37297-305. [PMID: 12867425 DOI: 10.1074/jbc.m303389200] [Citation(s) in RCA: 179] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
NEMO (NF-kappaB essential modifier)/IKKgamma (IkappaB kinase-gamma) is required for the activation of the IkappaB kinase complex (IKK) by inflammatory stimuli such as tumor necrosis factor (TNF-alpha). Here we show that TNF-alpha stimulates the ubiquitination of NEMO in a manner that does not appear to target it for degradation and that is impaired by mutations in the NEMO zinc finger. Mutations of the zinc finger are found in patients with hypohidrotic ectodermal dysplasia with immunodeficiency (HED-ID) and lead to the impairment of TNF-alpha-stimulated IKK phosphorylation and activation. In addition, the ubiquitination of NEMO is mediated by c-IAP1, an inhibitor of apoptosis protein that is a component of the TNF receptor signaling complex. Thus, the ubiquitination of NEMO mediated by c-IAP1 likely plays an important role in the activation of IKK by TNF-alpha. Also, defective NEMO ubiquitination may be responsible for the impaired cellular NF-kappaB signaling found in patients with HED-ID.
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Affiliation(s)
- Eric D Tang
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA.
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79
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Berlin AL, Paller AS, Chan LS. Incontinentia pigmenti: a review and update on the molecular basis of pathophysiology. J Am Acad Dermatol 2002; 47:169-87; quiz 188-90. [PMID: 12140463 DOI: 10.1067/mjd.2002.125949] [Citation(s) in RCA: 154] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UNLABELLED Incontinentia pigmenti is an uncommon X-linked dominant disorder, lethal in the majority of affected males in utero and variably expressed in females. Cutaneous manifestations are classically subdivided into 4 stages: vesicular, verrucous, hyperpigmented, and atrophic. Various hair and nail abnormalities, dental anomalies, and ophthalmologic and neurologic deficits are associated with the disorder. The gene for incontinentia pigmenti has been mapped to Xq28. Recently, mutations in the NEMO/IKKgamma gene located at Xq28 have been found to cause expression of the disease. Knockout mice heterozygous for NEMO/IKKgamma gene deficiency develop a clinical phenotype very similar to that of incontinentia pigmenti. NEMO/IKKgamma is an essential component of the newly discovered nuclear factor kappaB (NF-kappaB) signaling pathway. When activated, NF-kappaB controls the expression of multiple genes, including cytokines and chemokines, and protects cells against apoptosis. The mechanism by which NEMO/IKKgamma deficiency causes, via the NF-kappaB pathway, the phenotypical expression of the disease has recently been elucidated. In addition, the newest research findings on eosinophil recruitment through eotaxin release by activated keratinocytes are described in the review. Finally, anhidrotic ectodermal dysplasia with immunodeficiency, a disorder allelic to incontinentia pigmenti, is discussed together with implications on the current understanding of NF-kappaB function. (J Am Acad Dermatol 2002;47:169-87.) LEARNING OBJECTIVE At the completion of this learning activity, participants will have a comprehensive and current understanding of incontinentia pigmenti, including its typical and uncommon clinical and histopathologic characteristics, diagnostic assessment, and current management strategies. Additionally, participants will gain the most current knowledge of the genetic and molecular basis of cutaneous pathomechanism.
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Affiliation(s)
- Alexander L Berlin
- Department of Dermatology, University of Illinois College of Medicine, 60612, USA
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80
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Caamaño J, Hunter CA. NF-kappaB family of transcription factors: central regulators of innate and adaptive immune functions. Clin Microbiol Rev 2002; 15:414-29. [PMID: 12097249 PMCID: PMC118079 DOI: 10.1128/cmr.15.3.414-429.2002] [Citation(s) in RCA: 387] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Transcription factors of the Rel/NF-kappaB family are activated in response to signals that lead to cell growth, differentiation, and apoptosis, and these proteins are critical elements involved in the regulation of immune responses. The conservation of this family of transcription factors in many phyla and their association with antimicrobial responses indicate their central role in the regulation of innate immunity. This is illustrated by the association of homologues of NF-kappaB, and their regulatory proteins, with resistance to infection in insects and plants (M. S. Dushay, B. Asling, and D. Hultmark, Proc. Natl. Acad. Sci. USA 93:10343-10347, 1996; D. Hultmark, Trends Genet. 9:178-183, 1993; J. Ryals et al., Plant Cell 9:425-439, 1997). The aim of this review is to provide a background on the biology of NF-kappaB and to highlight areas of the innate and adaptive immune response in which these transcription factors have a key regulatory function and to review what is currently known about their roles in resistance to infection, the host-pathogen interaction, and development of human disease.
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Affiliation(s)
- Jorge Caamaño
- Department of Pathobiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6008, USA
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81
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Abstract
Humans are exposed to a variety of environmental mycobacteria (EM), and most children are inoculated with live Bacille Calmette-Guérin (BCG) vaccine. In addition, most of the world's population is occasionally exposed to human-borne mycobacterial species, which are less abundant but more virulent. Although rarely pathogenic, mildly virulent mycobacteria, including BCG and most EM, may cause a variety of clinical diseases. Mycobacterium tuberculosis, M. leprae, and EM M. ulcerans are more virulent, causing tuberculosis, leprosy, and Buruli ulcer, respectively. Remarkably, only a minority of individuals develop clinical disease, even if infected with virulent mycobacteria. The interindividual variability of clinical outcome is thought to result in part from variability in the human genes that control host defense. In this well-defined microbiological and clinical context, the principles of mouse immunology and the methods of human genetics can be combined to facilitate the genetic dissection of immunity to mycobacteria. The natural infections are unique to the human model, not being found in any of the animal models of experimental infection. We review current genetic knowledge concerning the simple and complex inheritance of predisposition to mycobacterial diseases in humans. Rare patients with Mendelian disorders have been found to be vulnerable to BCG, a few EM, and M. tuberculosis. Most cases of presumed Mendelian susceptibility to these and other mycobacterial species remain unexplained. In the general population leprosy and tuberculosis have been shown to be associated with certain human genetic polymorphisms and linked to certain chromosomal regions. The causal vulnerability genes themselves have yet to be identified and their pathogenic alleles immunologically validated. The studies carried out to date have been fruitful, initiating the genetic dissection of protective immunity against a variety of mycobacterial species in natural conditions of infection. The human model has potential uses beyond the study of mycobacterial infections and may well become a model of choice for the investigation of immunity to infectious agents.
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Affiliation(s)
- Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Université René Descartes-INSERM U550, Necker Medical School, 156 rue de Vaugirard, 75015 Paris, France.
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82
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Orange JS, Brodeur SR, Jain A, Bonilla FA, Schneider LC, Kretschmer R, Nurko S, Rasmussen WL, Köhler JR, Gellis SE, Ferguson BM, Strominger JL, Zonana J, Ramesh N, Ballas ZK, Geha RS. Deficient natural killer cell cytotoxicity in patients with IKK-γ/NEMO mutations. J Clin Invest 2002. [DOI: 10.1172/jci0214858] [Citation(s) in RCA: 152] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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83
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Orange JS, Brodeur SR, Jain A, Bonilla FA, Schneider LC, Kretschmer R, Nurko S, Rasmussen WL, Köhler JR, Gellis SE, Ferguson BM, Strominger JL, Zonana J, Ramesh N, Ballas ZK, Geha RS. Deficient natural killer cell cytotoxicity in patients with IKK-gamma/NEMO mutations. J Clin Invest 2002; 109:1501-9. [PMID: 12045264 PMCID: PMC150995 DOI: 10.1172/jci14858] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
NF-kappaB essential modifier (NEMO), also known as IKK-gamma, is a member of the I-kappaB kinase complex responsible for phosphorylating I-kappaB, allowing the release and activation of NF-kappaB. Boys with an expressed NEMO mutation have an X-linked syndrome characterized by hypohidrotic ectodermal dysplasia with immune deficiency (HED-ID). The immunophenotype resulting from NEMO mutation is highly variable, with deficits in both T and B cell responses. We evaluated three patients with NEMO mutations (L153R, Q403X, and C417R) and HED-ID who had evidence of defective CD40 signaling. All three patients had normal percentages of peripheral blood NK cells, but impaired NK cell cytotoxic activity. This was not due to a generalized defect in cytotoxicity because antibody-dependent cellular cytotoxicity was intact. This abnormality was partially reversed by in vitro addition of IL-2, which was also able to induce NF-kappaB activation. In one patient with recurrent cytomegalovirus infections, administration of IL-2 partially corrected the NK cell killing deficit. These data suggest that NEMO participates in signaling pathways leading to NK cell cytotoxicity and that IL-2 can activate NF-kappaB and partially overcome the NK cell defect in patients with NEMO mutations.
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Affiliation(s)
- Jordan S Orange
- Division of Immunology, Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115, USA
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84
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Dupuis-Girod S, Corradini N, Hadj-Rabia S, Fournet JC, Faivre L, Le Deist F, Durand P, Döffinger R, Smahi A, Israel A, Courtois G, Brousse N, Blanche S, Munnich A, Fischer A, Casanova JL, Bodemer C. Osteopetrosis, lymphedema, anhidrotic ectodermal dysplasia, and immunodeficiency in a boy and incontinentia pigmenti in his mother. Pediatrics 2002; 109:e97. [PMID: 12042591 DOI: 10.1542/peds.109.6.e97] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A child with X-linked osteopetrosis, lymphedema, anhidrotic ectodermal dysplasia, and immunodeficiency (OL-EDA-ID) was recently reported. We report the clinical features of a second boy with this novel syndrome and his mother, who presented with signs of incontinentia pigmenti (IP). The child had mild osteopetrosis without neurosensory complications, unilateral lymphedema of the left leg, and characteristic features of anhidrotic ectodermal dysplasia with sparse hair, facial dysmorphy, delayed eruption of teeth, and sweat gland abnormalities. He died at 18 months of severe immunodeficiency with multiple infections caused by Gram-negative (Salmonella enteritidis) and Gram-positive (Streptococcus pneumoniae) bacteria, nontuberculous mycobacteria (Mycobacterium kansasii), and fungi (Pneumocystis carinii). His 30-year-old mother's medical history, together with residual cutaneous lesions, was highly suggestive of IP without neurologic impairment. In this patient with OL-EDA-ID, we detected the same NF-kappaB essential modulator stop codon hypomorphic mutation identified in the previous patient. The occurrence of the same clinical features in 2 unrelated patients with the same genotype demonstrates that OL-EDA-ID is a genuine clinical syndrome. The clinical and biological descriptions of the proband and his mother further corroborate the relationship between IP and EDA. Both syndromes are allelic and are associated with mutations in NF-kappaB essential modulator, with a genotype-phenotype correlation in hemizygous males. In contrast, loss-of-function mutations and hypomorphic mutations may cause IP in females.
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Affiliation(s)
- Sophie Dupuis-Girod
- Unité d'Immunologie et d'Hé matologie pédiatriques, Hôpital Necker-Enfants Malades, Paris, France
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85
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86
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Thesleff I, Mikkola ML. Death receptor signaling giving life to ectodermal organs. SCIENCE'S STKE : SIGNAL TRANSDUCTION KNOWLEDGE ENVIRONMENT 2002; 2002:pe22. [PMID: 11997580 DOI: 10.1126/stke.2002.131.pe22] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A new tumor necrosis factor (TNF) pathway has been identified that has an important function in the regulation of embryonic development. Three key components of this pathway are previously unknown proteins: the TNF ligand ectodysplasin (also known as EDA), its death domain-containing receptor EDAR, and the death domain adapter molecule EDARADD. This pathway was discovered and delineated through the cloning of genes that cause human hypohidrotic ectodermal dysplasia (HED) syndromes and by analysis of the corresponding mouse mutants (Tabby, downless, and crinkled) showing defects in hair, teeth, and several exocrine glands. EDAR signaling is mediated by the activation of nuclear factor kappa B, but other downstream targets are not known. Ectodysplasin-EDAR signaling mediates cell interactions within the ectoderm and regulates the initiation and morphogenesis of hair and teeth. It is also necessary for the development of fish scales, indicating that this pathway and its function have been conserved during the evolution of ectodermal organs.
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Affiliation(s)
- Irma Thesleff
- Developmental Biology Program, Insitute of Biotechnology, Viikki Biocenter, PO Box 56, University of Helsinki, 00014 Helsinki, Finland.
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Reichenbach J, Rosenzweig S, Döffinger R, Dupuis S, Holland SM, Casanova JL. Mycobacterial diseases in primary immunodeficiencies. Curr Opin Allergy Clin Immunol 2001; 1:503-11. [PMID: 11964733 DOI: 10.1097/00130832-200112000-00003] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Primary immunodeficiency diseases comprise over 100 conditions, each associated with a variety of viral, bacterial, fungal and protozoan infections. M. tuberculosis and less virulent mycobacteria, such as bacille Calmette-Guérin vaccines and environmental non-tuberculous mycobacteria, may cause severe disease in patients with primary immunodeficiency diseases. However, no previous review has dealt with the issue of which primary immunodeficiency diseases predispose affected individuals to mycobacterial disease. This information is very useful, not only increasing our understanding of human immunity to mycobacteria, but also for the diagnostic investigation of patients with mycobacteriosis. We review here the medical literature on cases of mycobacterial disease in patients with primary immunodeficiency diseases.
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Affiliation(s)
- J Reichenbach
- Laboratoire de Génétique Humaine des Maladies Infectieuses, Université René Descartes, Faculté de Médecine Necker Enfants Malades, Paris, France
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88
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Kenwrick S, Woffendin H, Jakins T, Shuttleworth SG, Mayer E, Greenhalgh L, Whittaker J, Rugolotto S, Bardaro T, Esposito T, D'Urso M, Soli F, Turco A, Smahi A, Hamel-Teillac D, Lyonnet S, Bonnefont JP, Munnich A, Aradhya S, Kashork CD, Shaffer LG, Nelson DL, Levy M, Lewis RA. Survival of male patients with incontinentia pigmenti carrying a lethal mutation can be explained by somatic mosaicism or Klinefelter syndrome. Am J Hum Genet 2001; 69:1210-7. [PMID: 11673821 PMCID: PMC1235532 DOI: 10.1086/324591] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2001] [Accepted: 09/26/2001] [Indexed: 11/03/2022] Open
Abstract
Incontinentia pigmenti (IP), or "Bloch-Sulzberger syndrome," is an X-linked dominant disorder characterized by abnormalities of skin, teeth, hair, and eyes; skewed X-inactivation; and recurrent miscarriages of male fetuses. IP results from mutations in the gene for NF-kappaB essential modulator (NEMO), with deletion of exons 4-10 of NEMO accounting for >80% of new mutations. Male fetuses inheriting this mutation and other "null" mutations of NEMO usually die in utero. Less deleterious mutations can result in survival of males subjects, but with ectodermal dysplasia and immunodeficiency. Male patients with skin, dental, and ocular abnormalities typical of those seen in female patients with IP (without immunodeficiency) are rare. We investigated four male patients with clinical hallmarks of IP. All four were found to carry the deletion normally associated with male lethality in utero. Survival in one patient is explained by a 47,XXY karyotype and skewed X inactivation. Three other patients possess a normal 46,XY karyotype. We demonstrate that these patients have both wild-type and deleted copies of the NEMO gene and are therefore mosaic for the common mutation. Therefore, the repeat-mediated rearrangement leading to the common deletion does not require meiotic division. Hypomorphic alleles, a 47,XXY karyotype, and somatic mosaicism therefore represent three mechanisms for survival of males carrying a NEMO mutation.
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89
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Abstract
Despite substantial progress in understanding the NF-kappaB signaling pathway, the connections between this pathway and human disease are only now being elucidated. Genes that function within or upstream of the NF-kappaB pathway have been found to cause four distinct disorders and two allelic conditions. Investigation of these genes and disorders has brought significant insight into the role of NF-kappaB in various aspects of physiological development.
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Affiliation(s)
- S Aradhya
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030, USA
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90
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Schmidt-Ullrich R, Aebischer T, Hülsken J, Birchmeier W, Klemm U, Scheidereit C. Requirement of NF-κB/Rel for the development of hair follicles and other epidermal appendices. Development 2001; 128:3843-53. [PMID: 11585809 DOI: 10.1242/dev.128.19.3843] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
NF-κB/Rel transcription factors and IκB kinases (IKK) are essential for inflammation and immune responses, but also for bone-morphogenesis, skin proliferation and differentiation. Determining their other functions has previously been impossible, owing to embryonic lethality of NF-κB/Rel or IKK-deficient animals. Using a gene targeting approach we have ubiquitously expressed an NF-κB super-repressor to investigate NF-κB functions in the adult. Mice with suppressed NF-κB revealed defective early morphogenesis of hair follicles, exocrine glands and teeth, identical to Eda (tabby) and Edar (downless) mutant mice. These affected epithelial appendices normally display high NF-κB activity, suppression of which resulted in increased apoptosis, indicating that NF-κB acts as a survival factor downstream of the tumor necrosis factor receptor family member EDAR. Furthermore, NF-κB is required for peripheral lymph node formation and macrophage function.
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Affiliation(s)
- R Schmidt-Ullrich
- Max-Delbrück-Center of Molecular Medicine, Robert-Rössle Strasse 10, 13092 Berlin, Germany.
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91
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92
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Zonana J, Ferguson B. Reply to Kosaki et al. Am J Hum Genet 2001. [DOI: 10.1086/323002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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93
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Kosaki K, Shimasaki N, Fukushima H, Hara M, Ogata T, Matsuo N. Female patient showing hypohidrotic ectodermal dysplasia and immunodeficiency (HED-ID). Am J Hum Genet 2001; 69:664-6. [PMID: 11484156 PMCID: PMC1235496 DOI: 10.1086/323003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Kenjiro Kosaki
- Department of Pediatrics and Pharmacia Fund for Growth & Development Research, Keio University School of Medicine, Tokyo; and Shimizu City Hospital, Shimizu, Japan
| | - Noriko Shimasaki
- Department of Pediatrics and Pharmacia Fund for Growth & Development Research, Keio University School of Medicine, Tokyo; and Shimizu City Hospital, Shimizu, Japan
| | - Hiroyuki Fukushima
- Department of Pediatrics and Pharmacia Fund for Growth & Development Research, Keio University School of Medicine, Tokyo; and Shimizu City Hospital, Shimizu, Japan
| | - Mitsuhiro Hara
- Department of Pediatrics and Pharmacia Fund for Growth & Development Research, Keio University School of Medicine, Tokyo; and Shimizu City Hospital, Shimizu, Japan
| | - Tsutomu Ogata
- Department of Pediatrics and Pharmacia Fund for Growth & Development Research, Keio University School of Medicine, Tokyo; and Shimizu City Hospital, Shimizu, Japan
| | - Nobutake Matsuo
- Department of Pediatrics and Pharmacia Fund for Growth & Development Research, Keio University School of Medicine, Tokyo; and Shimizu City Hospital, Shimizu, Japan
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