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Application of extensively targeted next-generation sequencing for the diagnosis of primary immunodeficiencies. J Allergy Clin Immunol 2016; 138:303-305.e3. [DOI: 10.1016/j.jaci.2016.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 11/26/2015] [Accepted: 01/20/2016] [Indexed: 01/03/2023]
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Al-Mousa H, Abouelhoda M, Monies DM, Al-Tassan N, Al-Ghonaium A, Al-Saud B, Al-Dhekri H, Arnaout R, Al-Muhsen S, Ades N, Elshorbagi S, Al Gazlan S, Sheikh F, Dasouki M, El-Baik L, Elamin T, Jaber A, Kheir O, El-Kalioby M, Subhani S, Al Idrissi E, Al-Zahrani M, Alhelale M, Alnader N, Al-Otaibi A, Kattan R, Al Abdelrahman K, Al Breacan MM, Bin Humaid FS, Wakil SM, Alzayer F, Al-Dusery H, Faquih T, Al-Hissi S, Meyer BF, Hawwari A. Unbiased targeted next-generation sequencing molecular approach for primary immunodeficiency diseases. J Allergy Clin Immunol 2016; 137:1780-1787. [PMID: 26915675 DOI: 10.1016/j.jaci.2015.12.1310] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 11/11/2015] [Accepted: 12/02/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Molecular genetics techniques are an essential diagnostic tool for primary immunodeficiency diseases (PIDs). The use of next-generation sequencing (NGS) provides a comprehensive way of concurrently screening a large number of PID genes. However, its validity and cost-effectiveness require verification. OBJECTIVES We sought to identify and overcome complications associated with the use of NGS in a comprehensive gene panel incorporating 162 PID genes. We aimed to ascertain the specificity, sensitivity, and clinical sensitivity of the gene panel and its utility as a diagnostic tool for PIDs. METHODS A total of 162 PID genes were screened in 261 patients by using the Ion Torrent Proton NGS sequencing platform. Of the 261 patients, 122 had at least 1 known causal mutation at the onset of the study and were used to assess the specificity and sensitivity of the assay. The remaining samples were from unsolved cases that were biased toward more phenotypically and genotypically complicated cases. RESULTS The assay was able to detect the mutation in 117 (96%) of 122 positive control subjects with known causal mutations. For the unsolved cases, our assay resulted in a molecular genetic diagnosis for 35 of 139 patients. Interestingly, most of these cases represented atypical clinical presentations of known PIDs. CONCLUSIONS The targeted NGS PID gene panel is a sensitive and cost-effective diagnostic tool that can be used as a first-line molecular assay in patients with PIDs. The assay is an alternative choice to the complex and costly candidate gene approach, particularly for patients with atypical presentation of known PID genes.
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Affiliation(s)
- Hamoud Al-Mousa
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Mohamed Abouelhoda
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Dorota M Monies
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Nada Al-Tassan
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Abdulaziz Al-Ghonaium
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Bandar Al-Saud
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Hasan Al-Dhekri
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Rand Arnaout
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Saleh Al-Muhsen
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
| | - Nazema Ades
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Sahar Elshorbagi
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Sulaiman Al Gazlan
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Farrukh Sheikh
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Majed Dasouki
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Lina El-Baik
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Tanzeil Elamin
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Amal Jaber
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Omnia Kheir
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed El-Kalioby
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Shazia Subhani
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Eman Al Idrissi
- Department of Pediatrics, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Maryam Alhelale
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Noukha Alnader
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Afaf Al-Otaibi
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Rana Kattan
- Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Khalid Al Abdelrahman
- Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Muna M Al Breacan
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Faisal S Bin Humaid
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Salma Majid Wakil
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Fadi Alzayer
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Haya Al-Dusery
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Tariq Faquih
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Safa Al-Hissi
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Brian F Meyer
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi Human Genome Project, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Abbas Hawwari
- Department of Genetics (Research Center), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
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Tesi B, Lagerstedt-Robinson K, Chiang SCC, Ben Bdira E, Abboud M, Belen B, Devecioglu O, Fadoo Z, Yeoh AEJ, Erichsen HC, Möttönen M, Akar HH, Hästbacka J, Kaya Z, Nunes S, Patiroglu T, Sabel M, Saribeyoglu ET, Tvedt TH, Unal E, Unal S, Unuvar A, Meeths M, Henter JI, Nordenskjöld M, Bryceson YT. Targeted high-throughput sequencing for genetic diagnostics of hemophagocytic lymphohistiocytosis. Genome Med 2015; 7:130. [PMID: 26684649 PMCID: PMC4684627 DOI: 10.1186/s13073-015-0244-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/11/2015] [Indexed: 01/06/2023] Open
Abstract
Background Hemophagocytic lymphohistiocytosis (HLH) is a rapid-onset, potentially fatal hyperinflammatory syndrome. A prompt molecular diagnosis is crucial for appropriate clinical management. Here, we validated and prospectively evaluated a targeted high-throughput sequencing approach for HLH diagnostics. Methods A high-throughput sequencing strategy of 12 genes linked to HLH was validated in 13 patients with previously identified HLH-associated mutations and prospectively evaluated in 58 HLH patients. Moreover, 2504 healthy individuals from the 1000 Genomes project were analyzed in silico for variants in the same genes. Results Analyses revealed a mutation detection sensitivity of 97.3 %, an average coverage per gene of 98.0 %, and adequate coverage over 98.6 % of sites previously reported as mutated in these genes. In the prospective cohort, we achieved a diagnosis in 22 out of 58 patients (38 %). Genetically undiagnosed HLH patients had a later age at onset and manifested higher frequencies of known secondary HLH triggers. Rare, putatively pathogenic monoallelic variants were identified in nine patients. However, such monoallelic variants were not enriched compared with healthy individuals. Conclusions We have established a comprehensive high-throughput platform for genetic screening of patients with HLH. Almost all cases with reduced natural killer cell function received a diagnosis, but the majority of the prospective cases remain genetically unexplained, highlighting genetic heterogeneity and environmental impact within HLH. Moreover, in silico analyses of the genetic variation affecting HLH-related genes in the general population suggest caution with respect to interpreting causality between monoallelic mutations and HLH. A complete understanding of the genetic susceptibility to HLH thus requires further in-depth investigations, including genome sequencing and detailed immunological characterization. Electronic supplementary material The online version of this article (doi:10.1186/s13073-015-0244-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bianca Tesi
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden. .,Clinical Genetics Unit, Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
| | - Kristina Lagerstedt-Robinson
- Clinical Genetics Unit, Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Samuel C C Chiang
- Centre for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-14186, Stockholm, Sweden
| | - Eya Ben Bdira
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden.,Clinical Genetics Unit, Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Miguel Abboud
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Burcu Belen
- Department of Pediatric Hematology, Izmir Katip Celebi University Medical Faculty, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Omer Devecioglu
- Department of Pediatric Hematology Oncology, Istanbul Medical School, Istanbul, Turkey
| | - Zehra Fadoo
- Department of Oncology and Pediatrics, Aga Khan University, Karachi, Pakistan
| | - Allen E J Yeoh
- Viva-University Children's Cancer Centre, Department of Paediatric, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Merja Möttönen
- Department of Pediatrics and Adolescence, PEDEGO Research Unit, Oulu University Hospital, Oulu, Finland
| | - Himmet Haluk Akar
- Department of Pediatric Immunology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Johanna Hästbacka
- Department of Perioperative and Intensive Care, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Zuhre Kaya
- Pediatric Hematology Unit of the Department of Pediatrics, Medical School of Gazi University, Ankara, Turkey
| | - Susana Nunes
- Hematology-Oncology Unit, Department of Pediatrics, São João Hospital Center, Oporto, Portugal
| | - Turkan Patiroglu
- Department of Pediatric Immunology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Magnus Sabel
- Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Ebru Tugrul Saribeyoglu
- Department of Pediatric Hematology and Oncology and Bone Marrow Transplantation Unit, Medipol School of Medicine, Medipol University, Istanbul, Turkey
| | - Tor Henrik Tvedt
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ekrem Unal
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sule Unal
- Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Aysegul Unuvar
- Division of Pediatric Hematology and Oncology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Marie Meeths
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden.,Clinical Genetics Unit, Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jan-Inge Henter
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden
| | - Magnus Nordenskjöld
- Clinical Genetics Unit, Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Yenan T Bryceson
- Centre for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-14186, Stockholm, Sweden. .,Broegelmann Research Laboratory, The Gades Institute, University of Bergen, Bergen, Norway.
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Ashoori A, Eagleman DM, Jankovic J. Effects of Auditory Rhythm and Music on Gait Disturbances in Parkinson's Disease. Front Neurol 2015; 6:234. [PMID: 26617566 PMCID: PMC4641247 DOI: 10.3389/fneur.2015.00234] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 10/22/2015] [Indexed: 12/05/2022] Open
Abstract
Gait abnormalities, such as shuffling steps, start hesitation, and freezing, are common and often incapacitating symptoms of Parkinson’s disease (PD) and other parkinsonian disorders. Pharmacological and surgical approaches have only limited efficacy in treating these gait disorders. Rhythmic auditory stimulation (RAS), such as playing marching music and dance therapy, has been shown to be a safe, inexpensive, and an effective method in improving gait in PD patients. However, RAS that adapts to patients’ movements may be more effective than rigid, fixed-tempo RAS used in most studies. In addition to auditory cueing, immersive virtual reality technologies that utilize interactive computer-generated systems through wearable devices are increasingly used for improving brain–body interaction and sensory–motor integration. Using multisensory cues, these therapies may be particularly suitable for the treatment of parkinsonian freezing and other gait disorders. In this review, we examine the affected neurological circuits underlying gait and temporal processing in PD patients and summarize the current studies demonstrating the effects of RAS on improving these gait deficits.
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Affiliation(s)
- Aidin Ashoori
- Columbia University College of Physicians & Surgeons , New York, NY , USA
| | - David M Eagleman
- Department of Neuroscience, Baylor College of Medicine , Houston, TX , USA
| | - Joseph Jankovic
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine , Houston, TX , USA
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55
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Lundin KE, Hamasy A, Backe PH, Moens LN, Falk-Sörqvist E, Elgstøen KB, Mørkrid L, Bjørås M, Granert C, Norlin AC, Nilsson M, Christensson B, Stenmark S, Smith CIE. Susceptibility to infections, without concomitant hyper-IgE, reported in 1976, is caused by hypomorphic mutation in the phosphoglucomutase 3 (PGM3) gene. Clin Immunol 2015; 161:366-72. [PMID: 26482871 PMCID: PMC4695917 DOI: 10.1016/j.clim.2015.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/17/2015] [Accepted: 10/13/2015] [Indexed: 10/28/2022]
Abstract
Phosphoglucomutase 3 (PGM3) is an enzyme converting N-acetyl-glucosamine-6-phosphate to N-acetyl-glucosamine-1-phosphate, a precursor important for glycosylation. Mutations in the PGM3 gene have recently been identified as the cause of novel primary immunodeficiency with a hyper-IgE like syndrome. Here we report the occurrence of a homozygous mutation in the PGM3 gene in a family with immunodeficient children, described already in 1976. DNA from two of the immunodeficient siblings was sequenced and shown to encode the same homozygous missense mutation, causing a destabilized protein with reduced enzymatic capacity. Affected individuals were highly prone to infections, but lack the developmental defects in the nervous and skeletal systems, reported in other families. Moreover, normal IgE levels were found. Thus, belonging to the expanding group of congenital glycosylation defects, PGM3 deficiency is characterized by immunodeficiency, with or without increased IgE levels, and with variable forms of developmental defects affecting other organ systems.
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Affiliation(s)
- Karin E Lundin
- Clinical Research Center, Karolinska Institutet, Department of Laboratory Medicine, Karolinska University Hospital, S-141 86 Huddinge, Sweden.
| | - Abdulrahman Hamasy
- Clinical Research Center, Karolinska Institutet, Department of Laboratory Medicine, Karolinska University Hospital, S-141 86 Huddinge, Sweden
| | - Paul Hoff Backe
- Department of Microbiology, Clinic for Diagnostics and Intervention, Oslo University Hospital, Rikshospitalet, Box 4950, Nydalen, N-0424 Oslo, Norway; Department of Medical Biochemistry, Institute for Clinical Medicine, University of Oslo, Box 4950, Nydalen, N-0424 Oslo, Norway
| | - Lotte N Moens
- Department of Immunology, Genetics and Pathology, Uppsala University, S-751 85 Uppsala, Sweden
| | - Elin Falk-Sörqvist
- Department of Immunology, Genetics and Pathology, Uppsala University, S-751 85 Uppsala, Sweden
| | - Katja B Elgstøen
- Department of Medical Biochemistry, Institute for Clinical Medicine, University of Oslo, Box 4950, Nydalen, N-0424 Oslo, Norway
| | - Lars Mørkrid
- Department of Medical Biochemistry, Institute for Clinical Medicine, University of Oslo, Box 4950, Nydalen, N-0424 Oslo, Norway
| | - Magnar Bjørås
- Department of Microbiology, Clinic for Diagnostics and Intervention, Oslo University Hospital, Rikshospitalet, Box 4950, Nydalen, N-0424 Oslo, Norway; Institute for Cancer Research and Molecular Medicine, NTNU, 8905, N-7491 Trondheim, Norway
| | - Carl Granert
- Immunodeficiency Unit, Section of Clinical Immunology, Karolinska University Hospital, S-14186, Stockholm, Sweden
| | - Anna-Carin Norlin
- Immunodeficiency Unit, Section of Clinical Immunology, Karolinska University Hospital, S-14186, Stockholm, Sweden; Clinical Immunology and Transfusion Medicine, Karolinska University Laboratory, Karolinska University Hospital, S-14186, Stockholm, Sweden
| | - Mats Nilsson
- Department of Immunology, Genetics and Pathology, Uppsala University, S-751 85 Uppsala, Sweden; Science for Life Laboratory, Department of Biochemistry and Biophysics, Stockholm University, S-171 21, Stockholm, Sweden
| | - Birger Christensson
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, S-141 86, Stockholm, Sweden
| | | | - C I Edvard Smith
- Clinical Research Center, Karolinska Institutet, Department of Laboratory Medicine, Karolinska University Hospital, S-141 86 Huddinge, Sweden; Immunodeficiency Unit, Section of Clinical Immunology, Karolinska University Hospital, S-14186, Stockholm, Sweden.
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56
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Frans G, Moens L, Schrijvers R, Wuyts G, Bouckaert B, Schaballie H, Dupont L, Bossuyt X, Corveleyn A, Meyts I. PID in Disguise: Molecular Diagnosis of IRAK-4 Deficiency in an Adult Previously Misdiagnosed With Autosomal Dominant Hyper IgE Syndrome. J Clin Immunol 2015; 35:739-44. [PMID: 26472314 DOI: 10.1007/s10875-015-0205-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
Abstract
Autosomal recessive IL-1R-associated kinase 4 (IRAK-4) deficiency is a rare cause of recurrent pyogenic infections with limited inflammatory responses. We describe an adult female patient with severe lung disease who was phenotypically diagnosed as suffering from autosomal dominant Hyper IgE syndrome (AD HIES) because of recurrent skin infections with Staphylococcus aureus, recurrent pneumonia and elevated serum IgE levels. In contrast to findings in AD HIES patients, no abnormalities were found in the Th17 and circulating follicular helper T cell subsets. A panel-based sequencing approach led to the identification of a homozygous IRAK4 stop mutation (c.877C > T, p.Gln293*).
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Affiliation(s)
- Glynis Frans
- Department of Microbiology and Immunology, Experimental Laboratory Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Leen Moens
- Department of Microbiology and Immunology, Experimental Laboratory Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Rik Schrijvers
- Department of Microbiology and Immunology, Laboratory of Clinical Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Greet Wuyts
- Department of Microbiology and Immunology, Experimental Laboratory Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Bernard Bouckaert
- Department of Respiratory Disease, AZ Delta Roeselare, Wilgenstraat 2, 8800, Roeselare, Belgium
| | - Heidi Schaballie
- Department of Microbiology and Immunology, Childhood Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Pediatrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Lieven Dupont
- Department of Respiratory Disease, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Xavier Bossuyt
- Department of Microbiology and Immunology, Experimental Laboratory Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Laboratory Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Anniek Corveleyn
- Department of Human Genetics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Isabelle Meyts
- Department of Microbiology and Immunology, Childhood Immunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Pediatrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Precision Medicine for Continuing Phenotype Expansion of Human Genetic Diseases. BIOMED RESEARCH INTERNATIONAL 2015; 2015:745043. [PMID: 26137492 PMCID: PMC4475565 DOI: 10.1155/2015/745043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/12/2015] [Indexed: 12/20/2022]
Abstract
Determining the exact genetic causes for a patient and providing definite molecular diagnoses are core elements of precision medicine. Individualized patient care is often limited by our current knowledge of disease etiologies and commonly used phenotypic-based diagnostic approach. The broad and incompletely understood phenotypic spectrum of a disease and various underlying genetic heterogeneity also present extra challenges to our clinical practice. With the rapid adaptation of new sequence technology in clinical setting for diagnostic purpose, phenotypic expansions of disease spectrum are becoming increasingly common. Understanding the underlying molecular mechanisms will help us to integrate genomic information into the workup of individualized patient care and make better clinical decisions.
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