1
|
Bondarenko AV, Boyarchuk OR, Sakovich IS, Polyakova EA, Migas AA, Kupchinskaya AN, Opalinska A, Reich A, Volianska L, Hilfanova AM, Lapiy FI, Chernyshova LI, Volokha AP, Zabara DV, Belevtsev MV, Shman TV, Kukharenko LV, Goltsev MV, Dubouskaya TG, Hancharou AY, Ji W, Lakhani S, Lucas CL, Aleinikova OV, Sharapova SO. Variable CD18 expression in a 22-year-old female with leukocyte adhesion deficiency I: Clinical case and literature review. Clin Case Rep 2023; 11:e7791. [PMID: 37601427 PMCID: PMC10432584 DOI: 10.1002/ccr3.7791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Key Clinical Message Partial leukocyte adhesion deficiency type 1 (LAD-1) deficiency is extremely rare condition with milder infectious manifestation and immune system imbalance leads to increased risks of autoinflammatory complications, such as pyoderma gangrenosum, that can be triggered by trauma or pregnancy. In patients with spice-site ITGB2 variants, partial expression can occur due to different β2 integrin isophorms expression. Abstract LAD-1, OMIM ID #116920 is a rare, autosomal recessive disorder that results from mutations in the ITGB2 gene that encodes the CD18 β2 integrin subunit. According to the CD18 expression, LAD-1 is categorized as severe (<2%), moderate (2%-30%), or mild (>30%). Here, we describe a 22-year-old female, who presented with inflammatory skin disease and oral cavity, as well as respiratory tract infections during the first year of life. LAD-1 was diagnosed at the age of 2 years by low expression of CD18 (1%). Whole-exome sequencing identified homozygous c. 59-10C>A variant in the ITGB2 gene. Despite severe phenotype, the patient survived to adulthood without hematopoietic stem cell transplantation and became pregnant at the age of 20 years, with pregnancy complicated by a pyoderma gangrenosum-like lesion. During her life, CD18 expression increased from 1% to 9%; at 22 years of age, 5% of neutrophils and 9% of lymphocytes were CD18+. All CD18+-lymphocytes were predominantly memory/effector cytotoxic T cells. However, revertant mosaicism was not being established suggesting that CD18 expression variability may be mediated by other mechanisms such as different β2 integrin isophorms expression.
Collapse
Affiliation(s)
- Anastasiia V Bondarenko
- Department of Pediatrics, Immunology, Infectious and Rare Diseases, European Medical School International European University Kyiv Ukraine
| | - Oksana R Boyarchuk
- Department of Children's Diseases and Pediatric Surgery I. Horbachevsky Ternopil National Medical University Ternopil Ukraine
| | - Inga S Sakovich
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Ekaterina A Polyakova
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Alexander A Migas
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Aleksandra N Kupchinskaya
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Aleksandra Opalinska
- Department of Dermatology, Institute of Medical Sciences Medical College of Rzeszow University Rzeszow Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences Medical College of Rzeszow University Rzeszow Poland
| | - Liubov Volianska
- Department of Children's Diseases and Pediatric Surgery I. Horbachevsky Ternopil National Medical University Ternopil Ukraine
| | - Anna M Hilfanova
- Department of Pediatrics, Immunology, Infectious and Rare Diseases, European Medical School International European University Kyiv Ukraine
| | - Fedir I Lapiy
- Department of Pediatrics, Immunology, Infectious and Rare Diseases, European Medical School International European University Kyiv Ukraine
| | | | - Alla P Volokha
- Shupyk National Healthcare University of Ukraine Kyiv Ukraine
| | - Dariia V Zabara
- Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova of the NAMS of Ukraine Kyiv Ukraine
| | - Mikhail V Belevtsev
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Tatsiana V Shman
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Lyudmila V Kukharenko
- Department of Medical and Biological Physics Belarusian State Medical University Minsk Belarus
| | - Mikhail V Goltsev
- Department of Medical and Biological Physics Belarusian State Medical University Minsk Belarus
| | | | - Andrei Y Hancharou
- Institute of Biophysics and Cell Engineering NAS of Belarus Minsk Belarus
| | - Weizhen Ji
- Department of Pediatrics Yale University New Haven Connecticut USA
- Yale University Pediatric Genomics Discovery Program New Haven Connecticut USA
| | - Saquib Lakhani
- Department of Pediatrics Yale University New Haven Connecticut USA
- Yale University Pediatric Genomics Discovery Program New Haven Connecticut USA
| | - Carrie L Lucas
- Yale University Pediatric Genomics Discovery Program New Haven Connecticut USA
- Department of Immunobiology Yale University New Haven Connecticut USA
| | - Olga V Aleinikova
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| | - Svetlana O Sharapova
- Research Department Belarusian Research Center for Pediatric Oncology, Hematology and Immunology Minsk Belarus
| |
Collapse
|
2
|
Krzyzanowski D, Oszer A, Madzio J, Zdunek M, Kolodrubiec J, Urbanski B, Mlynarski W, Janczar S. The paradox of autoimmunity and autoinflammation in inherited neutrophil disorders - in search of common patterns. Front Immunol 2023; 14:1128581. [PMID: 37350970 PMCID: PMC10283154 DOI: 10.3389/fimmu.2023.1128581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023] Open
Abstract
Congenital defects of neutrophil number or function are associated with a severe infectious phenotype that may require intensive medical attention and interventions to be controlled. While the infectious complications in inherited neutrophil disorders are easily understood much less clear and explained are autoimmune and autoinflammatory phenomena. We survey the clinical burden of autoimmunity/autoinflammation in this setting, search for common patterns, discuss potential mechanisms and emerging treatments.
Collapse
Affiliation(s)
- Damian Krzyzanowski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
- Laboratory of Epigenetics, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
| | - Aleksandra Oszer
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Joanna Madzio
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Maciej Zdunek
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Julia Kolodrubiec
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Bartosz Urbanski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Wojciech Mlynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Szymon Janczar
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
3
|
Joshi TP, Wang HY, Athukuri P, Bohac S, Farr MA, Hinson D, Kahla JA, Khalfe N, McBee DB, Stroh R, Walters N, Ren V. Biologic Therapies for the Management of Cutaneous Findings in Genodermatoses: A Review. Am J Clin Dermatol 2022; 23:673-688. [PMID: 35606649 DOI: 10.1007/s40257-022-00700-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 01/17/2023]
Abstract
Genodermatoses are genetically inherited dermatologic conditions. The management of cutaneous findings in genodermatoses is challenging, and first-line therapies, such as steroids and/or retinoids, are often inadequate. In recent years, research on the molecular basis of genodermatoses has led to the use of biologic therapies for intractable disease. Here, we review the evidence regarding the use of available biologic therapies for the management of dermatologic findings in genodermatoses. Biologic therapies appear to be promising therapeutic options for several recalcitrant genodermatoses, especially those with underlying immune dysregulation. However, not all genodermatoses are amenable to biologic therapies, and some have been shown to paradoxically worsen under treatment. Biologic therapies offer a novel avenue to target refractory genodermatoses. However, evidence supporting the use of biologic therapies in the management of genodermatoses is mostly limited to case reports and case series. Further studies are warranted to determine the safety and efficacy of biologic therapies for the management of cutaneous findings in genodermatoses.
Collapse
|
4
|
Understanding the Role of LFA-1 in Leukocyte Adhesion Deficiency Type I (LAD I): Moving towards Inflammation? Int J Mol Sci 2022; 23:ijms23073578. [PMID: 35408940 PMCID: PMC8998723 DOI: 10.3390/ijms23073578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
LFA-1 (Lymphocyte function-associated antigen-1) is a heterodimeric integrin (CD11a/CD18) present on the surface of all leukocytes; it is essential for leukocyte recruitment to the site of tissue inflammation, but also for other immunological processes such as T cell activation and formation of the immunological synapse. Absent or dysfunctional expression of LFA-1, caused by mutations in the ITGB2 (integrin subunit beta 2) gene, results in a rare immunodeficiency syndrome known as Leukocyte adhesion deficiency type I (LAD I). Patients suffering from severe LAD I present with recurrent infections of the skin and mucosa, as well as inflammatory symptoms complicating the clinical course of the disease before and after allogeneic hematopoietic stem cell transplantation (alloHSCT); alloHSCT is currently the only established curative treatment option. With this review, we aim to provide an overview of the intrinsic role of inflammation in LAD I.
Collapse
|
5
|
Miyazawa H, Wada T. Reversion Mosaicism in Primary Immunodeficiency Diseases. Front Immunol 2021; 12:783022. [PMID: 34868061 PMCID: PMC8635092 DOI: 10.3389/fimmu.2021.783022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Reversion mosaicism has been reported in an increasing number of genetic disorders including primary immunodeficiency diseases. Several mechanisms can mediate somatic reversion of inherited mutations. Back mutations restore wild-type sequences, whereas second-site mutations result in compensatory changes. In addition, intragenic recombination, chromosomal deletions, and copy-neutral loss of heterozygosity have been demonstrated in mosaic individuals. Revertant cells that have regained wild-type function may be associated with milder disease phenotypes in some immunodeficient patients with reversion mosaicism. Revertant cells can also be responsible for immune dysregulation. Studies identifying a large variety of genetic changes in the same individual further support a frequent occurrence of reversion mosaicism in primary immunodeficiency diseases. This phenomenon also provides unique opportunities to evaluate the biological effects of restored gene expression in different cell lineages. In this paper, we review the recent findings of reversion mosaicism in primary immunodeficiency diseases and discuss its clinical implications.
Collapse
Affiliation(s)
- Hanae Miyazawa
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Taizo Wada
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| |
Collapse
|
6
|
Both T, Dalm VASH, Richardson SA, van Schie N, van den Broek LM, de Vries AC, van Hagen PM, Rombach SM. Inflammatory bowel disease in primary immunodeficiency disorders is a heterogeneous clinical entity requiring an individualized treatment strategy: A systematic review. Autoimmun Rev 2021; 20:102872. [PMID: 34118459 DOI: 10.1016/j.autrev.2021.102872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/17/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To describe the prevalence, clinical presentation and current treatment regimens of inflammatory bowel disease (IBD) in patients with primary immunodeficiency disorders (PIDs). METHODS A systematic review was conducted. The following databases were searched: MEDLINE, Embase, Web of Science, the Cochrane Library and Google Scholar. RESULTS A total of 838 articles were identified, of which 36 were included in this review. The prevalence of IBD in PIDs ranges between 3.4% and 61.2%, depending on the underlying PID. Diarrhea and abdominal pain were reported in 64.3% and 52.4% of the patients, respectively. Colon ulceration was the most frequent finding on endoscopic evaluation, while cryptitis, granulomas, ulcerations and neutrophilic/lymphocytic infiltrates were the most frequently reported histopathological abnormalities. Described treatment regimens included oral corticosteroids and other oral immunosuppressive agents, including mesalazine, azathioprine and cyclosporin, leading to clinical improvement in the majority of patients. In case of treatment failure, biological therapies including TNF- α blocking agents, are considered. CONCLUSIONS The overall prevalence of IBD in patients with PID is high, but varies between different PIDs. Physicians should be aware of these complications and focus on characteristic symptoms to reduce diagnostic delay and delay in initiation of treatment. Treatment of IBD in PIDs depends on severity of symptoms and may differ between various PIDs based on distinct underlying pathogenesis. An individualized diagnostic and therapeutic approach is therefore warranted.
Collapse
Affiliation(s)
- Tim Both
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Virgil A S H Dalm
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Savannah A Richardson
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Naïma van Schie
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Luuk M van den Broek
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annemarie C de Vries
- Department of Gastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - P Martin van Hagen
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Saskia M Rombach
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
7
|
Vrachnis N, Zygouris D, Vrachnis D, Roussos N, Loukas N, Antonakopoulos N, Paltoglou G, Barbounaki S, Valsamakis G, Iliodromiti Z. Perinatal Inflammation: Could Partial Blocking of Cell Adhesion Molecule Function Be a Solution? CHILDREN-BASEL 2021; 8:children8050380. [PMID: 34065912 PMCID: PMC8150343 DOI: 10.3390/children8050380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 11/16/2022]
Abstract
In spite of the great advances made in recent years in prenatal and perinatal medicine, inflammation can still frequently result in injury to vital organs and often constitutes a major cause of morbidity. It is today well established that in neonates—though vulnerability to infection among neonates is triggered by functional impairments in leukocyte adhesion—the decreased expression of cell adhesion molecules also decreases the inflammatory response. It is also clear that the cell adhesion molecules, namely, the integrins, selectins, and the immunoglobulin (Ig) gene super family, all play a crucial role in the inflammatory cascade. Thus, by consolidating our knowledge concerning the actions of these vital cell adhesion molecules during the prenatal period as well as regarding the genetic deficiencies of these molecules, notably leukocyte adhesion deficiency (LAD) I, II, and III, which can provoke severe clinical symptoms throughout the first year of life, it is anticipated that intervention involving blocking the function of cell adhesion molecules in neonatal leukocytes has the potential to constitute an effective therapeutic approach for inflammation. A promising perspective is the potential use of antibody therapy in preterm and term infants with perinatal inflammation and infection focusing on cases in which LAD is involved, while a further important scientific advance related to this issue could be the combination of small peptides aimed at the inhibition of cellular adhesion.
Collapse
Affiliation(s)
- Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 11526 Athens, Greece;
- Vascular Biology, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
- Research Centre in Obstetrics and Gynecology, Hellenic Society of Obstetric and Gynecologic Emergency, 11526 Athens, Greece; (D.Z.); (N.R.)
- Correspondence: ; Tel.: +30-2107777442
| | - Dimitrios Zygouris
- Research Centre in Obstetrics and Gynecology, Hellenic Society of Obstetric and Gynecologic Emergency, 11526 Athens, Greece; (D.Z.); (N.R.)
| | - Dionysios Vrachnis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, 11526 Athens, Greece;
| | - Nikolaos Roussos
- Research Centre in Obstetrics and Gynecology, Hellenic Society of Obstetric and Gynecologic Emergency, 11526 Athens, Greece; (D.Z.); (N.R.)
| | - Nikolaos Loukas
- Department of Gynecology, General Hospital of Athens “G. Gennimatas”, 11527 Athens, Greece;
| | - Nikolaos Antonakopoulos
- Third Department of Obstetrics and Gynecology, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 11526 Athens, Greece;
| | - Georgios Paltoglou
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 11526 Athens, Greece; (G.P.); (G.V.)
| | | | - Georgios Valsamakis
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 11526 Athens, Greece; (G.P.); (G.V.)
| | - Zoi Iliodromiti
- Department of Neonatology, School of Medicine, National and Kapodistrian University of Athens, Aretaieio Hospital, 11526 Athens, Greece;
| |
Collapse
|
8
|
Pyoderma Gangrenosum with an Underlying Leukocyte Adhesion Deficiency Type 1 (LAD-1) and Pregnancy in the Shade of COVID-19 Epidemic: A Patient and Physician Experience. Dermatol Ther (Heidelb) 2021; 11:643-653. [PMID: 33686591 PMCID: PMC7939102 DOI: 10.1007/s13555-021-00507-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Indexed: 11/06/2022] Open
Abstract
In the first part of this article, the anonymous patient diagnosed with leukocyte adhesion deficiency type 1 (LAD-1) and pyoderma gangrenosum (PG) discusses her experience of her medical history and treatment in a foreign country during her pregnancy and the coronavirus disease-19 (COVID-19) pandemic. The patient’s dermatologists, immunologist, and diagnostician refer to the epidemiology, genetics, diagnosis, morphologic manifestations, including skin lesions, treatment, and prognosis in LAD-1. The patient’s diagnostic and therapeutic process was discussed in the last part of this paper.
Collapse
|
9
|
Leukocyte adhesion defect: Where do we stand circa 2019? Genes Dis 2019; 7:107-114. [PMID: 32181281 PMCID: PMC7063431 DOI: 10.1016/j.gendis.2019.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/21/2019] [Accepted: 07/30/2019] [Indexed: 01/13/2023] Open
Abstract
Migration of polymorphonuclear leukocytes from bloodstream to the site of inflammation is an important event required for surveillance of foreign antigens. This trafficking of leukocytes from bloodstream to the tissue occurs in several distinct steps and involves several adhesion molecules. Defect in adhesion of leukocytes to vascular endothelium affecting their subsequent migration to extravascular space gives rise to a group of rare primary immunodeficiency diseases (PIDs) known as Leukocyte Adhesion Defects (LAD). Till date, four classes of LAD are discovered with LAD I being the most common form. LAD I is caused by loss of function of common chain, cluster of differentiation (CD)18 of β2 integrin family. These patients suffer from life-threatening bacterial infections and in its severe form death usually occurs in childhood without bone marrow transplantation. LAD II results from a general defect in fucose metabolism. These patients suffer from less severe bacterial infections and have growth and mental retardation. Bombay blood group phenotype is also observed in these patients. LAD III is caused by abnormal integrin activation. LAD III patients suffer from severe bacterial and fungal infections. Patients frequently show delayed detachment of umbilical cord, impaired wound healing and increased tendency to bleed. LAD IV is the most recently described class. It is caused by defects in β2 and α4β1 integrins which impairs lymphocyte adhesion. LAD IV patients have monogenic defect in cystic-fibrosis-transmembrane-conductance-regulator (CFTR) gene, resulting in cystic fibrosis. Pathophysiology and genetic etiology of all LAD syndromes are discussed in detail in this paper.
Collapse
|
10
|
De Rose DU, Giliani S, Notarangelo LD, Lougaris V, Lanfranchi A, Moratto D, Martire B, Specchia F, Tommasini A, Plebani A, Badolato R. Long term outcome of eight patients with type 1 Leukocyte Adhesion Deficiency (LAD-1): Not only infections, but high risk of autoimmune complications. Clin Immunol 2018; 191:75-80. [PMID: 29548898 DOI: 10.1016/j.clim.2018.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/09/2018] [Accepted: 03/11/2018] [Indexed: 11/16/2022]
Abstract
Leukocyte Adhesion Deficiency type 1 (LAD-1) is a rare primary immunodeficiency due to mutations in the gene encoding for the common β-chain of the β2 integrin family (CD18). Herein, we describe clinical manifestations and long-term complications of eight LAD-1 patients. Four LAD-1 patients were treated with hematopoietic stem cell transplantation (HSCT), while the remaining four, including two with moderate LAD-1 deficiency, received continuous antibiotic prophylaxis. Untreated patients presented numerous infections and autoimmune manifestations. In particular, two of them developed renal and intestinal autoimmune diseases, despite the expression of Beta-2 integrin was partially conserved. Other two LAD-1 patients developed type 1 diabetes and autoimmune cytopenia after HSCT, suggesting that HSCT is effective for preventing infections in LAD-1, but does not prevent the risk of the autoimmune complications.
Collapse
Affiliation(s)
- Domenico Umberto De Rose
- Clinica Pediatrica and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili Hospital, Brescia, Italy
| | - Silvia Giliani
- Cytogenetic and Medical Genetics Unit and "A. Nocivelli" Institute for Molecular Medicine, Spedali Civili Hospital, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | - Vassilios Lougaris
- Clinica Pediatrica and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili Hospital, Brescia, Italy; Cytogenetic and Medical Genetics Unit and "A. Nocivelli" Institute for Molecular Medicine, Spedali Civili Hospital, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Arnalda Lanfranchi
- Stem Cell Laboratory, Section of Hematology and Blood Coagulation, Spedali Civili Hospital, Brescia, Italy
| | - Daniele Moratto
- Cytogenetic and Medical Genetics Unit and "A. Nocivelli" Institute for Molecular Medicine, Spedali Civili Hospital, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Baldassarre Martire
- Pediatric Hematology and Oncology Unit, "Policlinico Giovanni XXIII" Hospital, University of Bari, Bari, Italy
| | | | - Alberto Tommasini
- Department of Pediatrics, Institute for Maternal and Child Health, IRCSS "Burlo Garofolo", Trieste, Italy
| | - Alessandro Plebani
- Clinica Pediatrica and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili Hospital, Brescia, Italy; Cytogenetic and Medical Genetics Unit and "A. Nocivelli" Institute for Molecular Medicine, Spedali Civili Hospital, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Raffaele Badolato
- Clinica Pediatrica and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili Hospital, Brescia, Italy; Cytogenetic and Medical Genetics Unit and "A. Nocivelli" Institute for Molecular Medicine, Spedali Civili Hospital, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| |
Collapse
|
11
|
Gerosa J, Lougaris V, Baronio M, Plebani A, Cicalese MP, Fousteri G. Beta2 integrins are required for follicular helper T cell differentiation in humans. Clin Immunol 2017; 180:60-62. [PMID: 28390967 DOI: 10.1016/j.clim.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Jolanda Gerosa
- Diabetes Research Institute, San Raffaele Hospital IRCCS, Milan, Italy
| | - Vassilios Lougaris
- Pediatrics Clinic and Institute for Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Manuela Baronio
- Pediatrics Clinic and Institute for Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Plebani
- Pediatrics Clinic and Institute for Molecular Medicine A. Novicelli, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Pia Cicalese
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy,; Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Georgia Fousteri
- Diabetes Research Institute, San Raffaele Hospital IRCCS, Milan, Italy.
| |
Collapse
|