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Guo ZF, Tongmuang N, Li C, Zhang C, Hu L, Capreri D, Zuo MX, Summer R, Sun J. Inhibiting endothelial cell Mst1 attenuates acute lung injury in mice. JCI Insight 2024; 9:e178208. [PMID: 39253972 PMCID: PMC11385092 DOI: 10.1172/jci.insight.178208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 07/25/2024] [Indexed: 09/11/2024] Open
Abstract
Lung endothelium plays a pivotal role in the orchestration of inflammatory responses to acute pulmonary insults. Mammalian sterile 20-like kinase 1 (Mst1) is a serine/threonine kinase that has been shown to play an important role in the regulation of apoptosis, stress responses, and organ growth. This study investigated the role of Mst1 in lung endothelial activation and acute lung injury (ALI). We found that Mst1 was significantly activated in inflamed lung endothelial cells (ECs) and mouse lung tissues. Overexpression of Mst1 promoted nuclear factor κ-B (NF-κB) activation through promoting JNK and p38 activation in lung ECs. Inhibition of Mst1 by either its dominant negative form (DN-Mst1) or its pharmacological inhibitor markedly attenuated cytokine-induced expression of cytokines, chemokines, and adhesion molecules in lung ECs. Importantly, in a mouse model of lipopolysaccharide-induced (LPS-induced) ALI, both deletion of Mst1 in lung endothelium and treatment of WT mice with a pharmacological Mst1 inhibitor significantly protected mice from LPS-induced ALI. Together, our findings identified Mst1 kinase as a key regulator in controlling lung EC activation and suggest that therapeutic strategies aimed at inhibiting Mst1 activation might be effective in the prevention and treatment of inflammatory lung diseases.
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Affiliation(s)
- Zhi-Fu Guo
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Department of Cardiology, Changhai Hospital, Naval Medical University, Shanghai
| | - Nopprarat Tongmuang
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Chao Li
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Chen Zhang
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Louis Hu
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Daniel Capreri
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mei-Xing Zuo
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ross Summer
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jianxin Sun
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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2
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El Kettani A, Ouair H, Marnissi F, El Bakkouri J, Chevalier R, Lorenzo L, Kholaiq H, Béziat V, Jouanguy E, Casanova JL, Bousfiha AA. Case Report of Two Independent Moroccan Families with Syndromic Epidermodysplasia Verruciformis and STK4 Deficiency. Viruses 2024; 16:1415. [PMID: 39339890 PMCID: PMC11437448 DOI: 10.3390/v16091415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/30/2024] Open
Abstract
Epidermodysplasia verruciformis (EV) is a rare genodermatosis caused by β-human papillomaviruses (HPV) in immunodeficient patients. EV is characterized by flat warts and pityriasis-like lesions and might be isolated or syndromic, associated with some other infectious manifestations. We report here three patients from two independent families, with syndromic EV for both of them. By whole exome sequencing, we found that the patients carry new homozygous variants in STK4, both leading to a premature stop codon. STK4 deficiency causes a combined immunodeficiency characterized by a broad infectious susceptibility to bacteria, viruses, and fungi. Auto-immune manifestations were also reported. Deep immunophenotyping revealed multiple cytopenia in the three affected patients, in particular deep CD4+ T cells deficiency. We report here the fourth and the fifth cases of the syndromic EV due to STK4 deficiency.
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Affiliation(s)
- Assiya El Kettani
- Laboratory of Clinical Immunology-Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca 20250, Morocco; (J.E.B.); (H.K.); (A.A.B.)
- Laboratory of Bacteriology, Virology and Hospital Hygiene, Ibn Rochd University Hospital, Casablanca 20250, Morocco
- Laboratory of Bacteriology and Virology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca 20250, Morocco;
| | - Hind Ouair
- Laboratory of Bacteriology and Virology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca 20250, Morocco;
| | - Farida Marnissi
- Laboratory of Pathological Anatomy, Ibn Rochd University Hospital, Hassan II University, Casablanca 20250, Morocco;
| | - Jalila El Bakkouri
- Laboratory of Clinical Immunology-Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca 20250, Morocco; (J.E.B.); (H.K.); (A.A.B.)
- Immunology Laboratory, Ibn Rochd University Hospital, Casablanca 20250, Morocco
| | - Rémi Chevalier
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France; (R.C.); (L.L.); (V.B.); (E.J.); (J.-L.C.)
- Imagine Institute, Paris Cité University, 75015 Paris, France
| | - Lazaro Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France; (R.C.); (L.L.); (V.B.); (E.J.); (J.-L.C.)
- Imagine Institute, Paris Cité University, 75015 Paris, France
| | - Halima Kholaiq
- Laboratory of Clinical Immunology-Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca 20250, Morocco; (J.E.B.); (H.K.); (A.A.B.)
| | - Vivien Béziat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France; (R.C.); (L.L.); (V.B.); (E.J.); (J.-L.C.)
- Imagine Institute, Paris Cité University, 75015 Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France; (R.C.); (L.L.); (V.B.); (E.J.); (J.-L.C.)
- Imagine Institute, Paris Cité University, 75015 Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France; (R.C.); (L.L.); (V.B.); (E.J.); (J.-L.C.)
- Imagine Institute, Paris Cité University, 75015 Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
- Howard Hughes Medical Institute, Chevy Chase, MD 20815-6789, USA
| | - Ahmed Aziz Bousfiha
- Laboratory of Clinical Immunology-Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca 20250, Morocco; (J.E.B.); (H.K.); (A.A.B.)
- Clinical Immunology and Infectious Pediatrics Department, Abderrahim Harouchi Hospital-Ibn Rochd University Hospital, Casablanca 20250, Morocco
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3
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Bildik HN, Esenboga S, Halaclı SO, Karaatmaca B, Aytekin ES, Nabiyeva N, Akarsu A, Ocak M, Erman B, Tan C, Arikoglu T, Yaz I, Cicek B, Tezcan I, Cagdas D. A single center experience on PI3K/AKT/MTOR signaling defects: Towards pathogenicity assessment for four novel defects. Pediatr Allergy Immunol 2024; 35:e14245. [PMID: 39312287 DOI: 10.1111/pai.14245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Phosphoinositide 3 kinases (PI3K) are lipid kinases expressed in lymphocytes/myeloid cells. PI3K/AKT/mTOR signaling defects present with recurrent infections, autoimmunity, lymphoproliferation, and agammaglobulinemia. OBJECTIVE To characterize the PI3K/AKT/mTOR pathway defects and perform pathway analyses to assess novel variant pathogenicity. METHODS We included 12 patients (heterozygous PIK3CD (n = 9) and PIK3R1 (n = 1) (activated PI3K delta syndrome (APDS) with gain-of-function mutations) and homozygous PIK3R1 variant (n = 2)), performed clinical/laboratory/genetic evaluation, and flow cytometric PI3K/AKT/mTOR pathway analyses. RESULTS Median age at onset of complaints was 17.5 months (3 months to 12 years) and at diagnosis was 15.7 years (2.5-37) in APDS. Median diagnostic delay was 12.9 years (1.6-27). Recurrent respiratory tract infections (90%), lymphoproliferation (70%), autoimmune/inflammatory findings (60%), and allergy (40%) were common in APDS. Recurrent viral infections were present in 4/10 and malignancy (non-Hodgkin lymphoma and testicular yolk sac tumor) was present in 2/10 in APDS. Low CD4+ T cells(5/8) with increased CD4+ effector memory (8/8) and CD4+ TEMRA cells (6/8) were present in the given number of APDS patients. We diagnosed tubulointerstitial nephritis, Langerhans cell histiocytosis, and late-onset congenital adrenal hyperplasia in APDS. Allergic findings, lymphoproliferation/malignancy, and high IgM were present in the APDS but not in PIK3R1 deficiency. Low IgM/IgG/CD19+ B cell counts were characteristic in patients with PIK3R1 homozygous loss-of function mutations. CONCLUSION Differential diagnosis with combined immunodeficiency and diseases of immune dysregulation make molecular genetic analysis crucial for diagnosing mTOR pathway defects. It is easy to differentiate APDS and homozygous PIK3R1 defects with specific laboratory features. Additionally, mTOR pathway functional analysis is a definitive diagnostic and pathogenicity assessment tool for novel APDS mutations.
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Affiliation(s)
- Hacer Neslihan Bildik
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Saliha Esenboga
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sevil Oskay Halaclı
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Betül Karaatmaca
- Pediatric Allergy and Immunology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Elif Soyak Aytekin
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nadira Nabiyeva
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayşegul Akarsu
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Melike Ocak
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Baran Erman
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Can Sucak Research Laboratory for Translational Immunology, Hacettepe University, Ankara, Turkey
| | - Cagman Tan
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tugba Arikoglu
- Department of Pediatrics, Division of Allergy and Immunology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ismail Yaz
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Begum Cicek
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilhan Tezcan
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Deniz Cagdas
- Institute of Child Health, Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Ihsan Dogramaci Childrens' Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Division of Immunology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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4
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Ying W, Long X, Vandergriff T, Karnati H, Heberton M, Chen M, Wang X, Wysocki C, Kong XF. Epidermodysplasia Verruciformis and Vδ2 γδ T-cell Expansion in STK4 Deficiency. J Clin Immunol 2024; 44:172. [PMID: 39110273 PMCID: PMC11306306 DOI: 10.1007/s10875-024-01780-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024]
Abstract
The clinical penetrance of infectious diseases varies considerably among patients with inborn errors of immunity (IEI), even for identical genetic defects. This variability is influenced by pathogen exposure, healthcare access and host-environment interactions. We describe here a patient in his thirties who presented with epidermodysplasia verruciformis (EV) due to infection with a weakly virulent beta-papillomavirus (HPV38) and CD4+ T-cell lymphopenia. The patient was born to consanguineous parents living in the United States. Exome sequencing identified a previously unknown biallelic STK4 stop-gain mutation (p.Trp425X). The patient had no relevant history of infectious disease during childhood other than mild wart-like lesion on the skin, but he developed diffuse large B-cell lymphoma (DLBCL) and EBV viremia with a low viral load in his thirties. Despite his low CD4+ T-cell count, the patient had normal counts of CD3+ cells, predominantly double-negative T cells (67.4%), which turned out to be Vδ2+ γδ T cells. γδ T-cell expansion has frequently been observed in the 33 reported cases with STK4 deficiency. The Vδ2 γδ T cells of this STK4-deficient patient are mostly CD45RA-CD27+CCR7+ central memory γδT cells, and their ability to proliferate in response to T-cell activation was impaired, as was that of CD4+ T cells. In conclusion, γδ T-cell expansion may act as a compensatory mechanism to combat viral infection, providing immune protection in immunocompromised individuals.
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MESH Headings
- Humans
- Epidermodysplasia Verruciformis/genetics
- Epidermodysplasia Verruciformis/diagnosis
- Male
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/deficiency
- Adult
- Receptors, Antigen, T-Cell, gamma-delta/genetics
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/deficiency
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Mutation/genetics
- Epstein-Barr Virus Infections/immunology
- Epstein-Barr Virus Infections/genetics
- Epstein-Barr Virus Infections/complications
- Intraepithelial Lymphocytes/immunology
- Consanguinity
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Affiliation(s)
- Wenjing Ying
- Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite J5.136, Dallas, TX, 75390-9151, USA
- Department of Clinical Immunology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China
| | - Xin Long
- Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite J5.136, Dallas, TX, 75390-9151, USA
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Travis Vandergriff
- Departments of Dermatology and Pathology, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Hemanth Karnati
- Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite J5.136, Dallas, TX, 75390-9151, USA
| | - Meghan Heberton
- Department of Dermatology and Dermatopathology, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Mingyi Chen
- Department of Pathology, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Xiaochuan Wang
- Department of Clinical Immunology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China
| | - Christian Wysocki
- Division of Allergy and Immunology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Xiao-Fei Kong
- Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite J5.136, Dallas, TX, 75390-9151, USA.
- McDermott Center for Human Growth and Development, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite J5.136, Dallas, TX, 75390-9151, USA.
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5
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St. Louis BM, Quagliato SM, Su YT, Dyson G, Lee PC. The Hippo kinases control inflammatory Hippo signaling and restrict bacterial infection in phagocytes. mBio 2024; 15:e0342923. [PMID: 38624208 PMCID: PMC11078001 DOI: 10.1128/mbio.03429-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
The Hippo kinases MST1 and MST2 initiate a highly conserved signaling cascade called the Hippo pathway that limits organ size and tumor formation in animals. Intriguingly, pathogens hijack this host pathway during infection, but the role of MST1/2 in innate immune cells against pathogens is unclear. In this report, we generated Mst1/2 knockout macrophages to investigate the regulatory activities of the Hippo kinases in immunity. Transcriptomic analyses identified differentially expressed genes (DEGs) regulated by MST1/2 that are enriched in biological pathways, such as systemic lupus erythematosus, tuberculosis, and apoptosis. Surprisingly, pharmacological inhibition of the downstream components LATS1/2 in the canonical Hippo pathway did not affect the expression of a set of immune DEGs, suggesting that MST1/2 control these genes via alternative inflammatory Hippo signaling. Moreover, MST1/2 may affect immune communication by influencing the release of cytokines, including TNFα, CXCL10, and IL-1ra. Comparative analyses of the single- and double-knockout macrophages revealed that MST1 and MST2 differentially regulate TNFα release and expression of the immune transcription factor MAF, indicating that the two homologous Hippo kinases individually play a unique role in innate immunity. Notably, both MST1 and MST2 can promote apoptotic cell death in macrophages upon stimulation. Lastly, we demonstrate that the Hippo kinases are critical factors in mammalian macrophages and single-cell amoebae to restrict infection by Legionella pneumophila, Escherichia coli, and Pseudomonas aeruginosa. Together, these results uncover non-canonical inflammatory Hippo signaling in macrophages and the evolutionarily conserved role of the Hippo kinases in the anti-microbial defense of eukaryotic hosts. IMPORTANCE Identifying host factors involved in susceptibility to infection is fundamental for understanding host-pathogen interactions. Clinically, individuals with mutations in the MST1 gene which encodes one of the Hippo kinases experience recurrent infection. However, the impact of the Hippo kinases on innate immunity remains largely undetermined. This study uses mammalian macrophages and free-living amoebae with single- and double-knockout in the Hippo kinase genes and reveals that the Hippo kinases are the evolutionarily conserved determinants of host defense against microbes. In macrophages, the Hippo kinases MST1 and MST2 control immune activities at multiple levels, including gene expression, immune cell communication, and programmed cell death. Importantly, these activities controlled by MST1 and MST2 in macrophages are independent of the canonical Hippo cascade that is known to limit tissue growth and tumor formation. Together, these findings unveil a unique inflammatory Hippo signaling pathway that plays an essential role in innate immunity.
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Affiliation(s)
- Brendyn M. St. Louis
- Department of Biological Sciences, College of Liberal Arts and Sciences, Wayne State University, Detroit, Michigan, USA
| | - Sydney M. Quagliato
- Department of Biological Sciences, College of Liberal Arts and Sciences, Wayne State University, Detroit, Michigan, USA
| | - Yu-Ting Su
- Department of Biological Sciences, College of Liberal Arts and Sciences, Wayne State University, Detroit, Michigan, USA
| | - Gregory Dyson
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Pei-Chung Lee
- Department of Biological Sciences, College of Liberal Arts and Sciences, Wayne State University, Detroit, Michigan, USA
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6
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Al-Saud B, Alajlan H, Alruwaili H, Almoaibed L, Al-Mazrou A, Ghebeh H, Al-Alwan M, Alazami AM. A unique STK4 mutation truncating only the C-terminal SARAH domain results in a mild clinical phenotype despite severe T cell lymphopenia: Case report. Front Immunol 2024; 15:1329610. [PMID: 38361950 PMCID: PMC10867200 DOI: 10.3389/fimmu.2024.1329610] [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: 10/29/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Mutations in STK4 (MST1) are implicated in a form of autosomal recessive combined immunodeficiency, resulting in recurrent infections (especially Epstein-Barr virus viremia), autoimmunity, and cardiac malformations. Here we report a patient with an atypically mild presentation of this disease, initially presenting with severe T cell lymphopenia (< 500 per mm3) and intermittent neutropenia, but now surviving well on immunoglobulins and prophylactic antibacterial treatment. She harbors a unique STK4 mutation that lies further downstream than all others reported to date. Unlike other published cases, her mRNA transcript is not vulnerable to nonsense mediated decay (NMD) and yields a truncated protein that is expected to lose only the C-terminal SARAH domain. This domain is critical for autodimerization and autophosphorylation. While exhibiting significant differences from controls, this patient's T cell proliferation defects and susceptibility to apoptosis are not as severe as reported elsewhere. Expression of PD-1 is in line with healthy controls. Similarly, the dysregulation seen in immunophenotyping is not as pronounced as in other published cases. The nature of this mutation, enabling its evasion from NMD, provides a rare glimpse into the clinical and cellular features associated with the absence of a "null" phenotype of this protein.
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Affiliation(s)
- Bandar Al-Saud
- Section of Pediatric Allergy/Immunology, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Huda Alajlan
- Translational Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hibah Alruwaili
- Translational Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Latifa Almoaibed
- Section of Pediatric Allergy/Immunology, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amer Al-Mazrou
- Cell Therapy and Immunobiology Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hazem Ghebeh
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Cell Therapy and Immunobiology Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Monther Al-Alwan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Cell Therapy and Immunobiology Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Anas M. Alazami
- Translational Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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7
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Gutierrez-Marin PA, Castano-Jaramillo LM, Velez-Tirado N, Villamil-Osorio M, Patiño E, Reina MF, Hernandez MT. STK4 deficiency and epidermodysplasia verruciformis-like lesions: A case report. Pediatr Dermatol 2024; 41:96-99. [PMID: 37515487 DOI: 10.1111/pde.15400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/02/2023] [Indexed: 07/31/2023]
Abstract
Serine/threonine kinase 4 deficiency (STK4 or MST1, OMIM:614868) is an autosomal recessive (AR) combined immunodeficiency that can present with skin lesions such as epidermodysplasia verruciformis-like lesions (EVLL). Herein, we describe a 17-year-old male patient born from consanguineous parents presenting with recurrent respiratory infections, verruciform plaques, poikiloderma, chronic benign lymphoproliferation, and Sjögren syndrome with suspected interstitial lymphocytic pneumonia.
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Affiliation(s)
| | - Lina M Castano-Jaramillo
- Department of Pediatric Clinical Immunology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Natalia Velez-Tirado
- Department of Pediatric Clinical Immunology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatric Pulmonology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Esteban Patiño
- Department of Pathology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Maria Fernanda Reina
- Department of Pediatric Rheumatology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Maribel Trujillo Hernandez
- Department of Pediatric Dermatology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
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8
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Tang D, Xu H, Du X. The role of non-canonical Hippo pathway in regulating immune homeostasis. Eur J Med Res 2023; 28:498. [PMID: 37941053 PMCID: PMC10631157 DOI: 10.1186/s40001-023-01484-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
The Hippo pathway is a crucial signaling pathway that is highly conserved throughout evolution for the regulation of organ size and maintenance of tissue homeostasis. Initial studies have primarily focused on the canonical Hippo pathway, which governs organ development, tissue regeneration, and tumorigenesis. In recent years, extensive research has revealed that the non-canonical Hippo pathway, centered around Mst1/2 as its core molecule, plays a pivotal role in immune response and function by synergistically interacting with other signal transduction pathways. Consequently, the non-canonical Hippo pathway assumes significant importance in maintaining immune system homeostasis. This review concentrates on the research progress of the non-canonical Hippo pathway in regulating innate immune cell anti-infection responses, maintaining redox homeostasis, responding to microenvironmental stiffness, and T-cell differentiation.
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Affiliation(s)
- Dagang Tang
- Department of Orthopedics, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Huan Xu
- Department of Ophtalmology, Daping Hospital, Army Medical University, Chongqing, 400012, China
| | - Xing Du
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No.1 YouYi Road, Yuanjiagang, Yu Zhong District, Chongqing, 400016, China.
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China.
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9
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Cagdas D, Ayasun R, Gulseren D, Sanal O, Tezcan I. Cutaneous Findings in Inborn Errors of Immunity: An Immunologist's Perspective. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3030-3039. [PMID: 37391021 DOI: 10.1016/j.jaip.2023.06.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/26/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023]
Abstract
Cutaneous manifestations are common in patients with inborn errors of immunity (IEI)/primary immunodeficiency and could be due to infections, immune dysregulation, or lymphoproliferative/malign diseases. Immunologists accept some as warning signs for underlying IEI. Herein, we include noninfectious/infectious cutaneous manifestations that we come across in rare IEI cases in our clinic and provide a comprehensive literature review. For several skin diseases, the diagnosis is challenging and differential diagnosis is necessary. Detailed disease history and examination play a vital role in reaching a diagnosis, especially if there is a potential underlying IEI. A skin biopsy is sometimes necessary, especially if we need to rule out inflammatory, infectious, lymphoproliferative, and malignant conditions. Specific and immunohistochemical stainings are particularly important when diagnosing granuloma, amyloidosis, malignancies, and infections like human herpes virus-6, human herpes virus-8, human papillomavirus, and orf. Elucidation of mechanisms of IEIs has improved our understanding of their relation to cutaneous findings. In challenging cases, the immunological evaluation may lead the approach when there is a specific primary immunodeficiency diagnosis or at least help to reduce the number of differential diagnoses. Conversely, the response to therapy may provide conclusive evidence for some conditions. This review raises awareness of concomitant lesions and expands the scope of the differential diagnosis of IEI and the spectrum of skin disease therapy by highlighting frequent forms of IEI-associated cutaneous manifestations. The manifestations given here will guide clinicians to plan for alternative use of diverse therapeutics in a multidisciplinary way for skin diseases.
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Affiliation(s)
- Deniz Cagdas
- Department of Pediatrics, Ihsan Dogramaci Children's Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Pediatric Immunology, Institute of Child Health, Hacettepe University, Ankara, Turkey; Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Ruveyda Ayasun
- Depatment of Medical Oncology, Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, NY
| | - Duygu Gulseren
- Department of Dermatology, Hacettepe University Medical School, Ankara, Turkey
| | - Ozden Sanal
- Department of Pediatrics, Ihsan Dogramaci Children's Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Pediatric Immunology, Institute of Child Health, Hacettepe University, Ankara, Turkey; Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilhan Tezcan
- Department of Pediatrics, Ihsan Dogramaci Children's Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Pediatric Immunology, Institute of Child Health, Hacettepe University, Ankara, Turkey; Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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10
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Guo ZF, Tongmuang N, Li C, Zhang C, Hu L, Capreri D, Zuo MX, Summer R, Sun J. Inhibiting endothelial cell Mst1 attenuates acute lung injury in mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.27.559864. [PMID: 37808846 PMCID: PMC10557750 DOI: 10.1101/2023.09.27.559864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Background Lung endothelium plays a pivotal role in the orchestration of inflammatory and injury responses to acute pulmonary insults. Mammalian sterile 20-like kinase 1 (Mst1), a mammalian homolog of Hippo, is a serine/threonine kinase that is ubiquitously expressed in many tissues and has been shown to play an important role in the regulation of apoptosis, inflammation, stress responses, and organ growth. While Mst1 exhibits high expression in the lung, its involvement in the endothelial response to pulmonary insults remains largely unexplored. Methods Mst1 activity was assessed in lung endothelium by western blot. Mst1 endothelial specific knockout mice and a pharmacological inhibitor were employed to assess the effects of Mst1 on homeostatic and lipopolysaccharide (LPS)-induced endothelial responses. Readouts for these studies included various assays, including NF-κB activation and levels of various inflammatory cytokines and adhesion molecules. The role of Mst1 in lung injury was evaluated in a LPS-induced murine model of acute lung injury (ALI). Results Mst1 phosphorylation was significantly increased in lung endothelial cells after exposure to tumor necrosis factor (TNF)-alpha (TNF-α) and mouse lung tissues after LPS exposure. Overexpression of full length Mst1 or its kinase domain promoted nuclear factor kappaB (NF-κB) activation through promoting JNK and p38 activation, whereas dominant negative forms of Mst1 (DN-Mst1) attenuated endothelial responses to TNF-α and interleukin-1β. Consistent with this, targeted deletion of Mst1 in lung endothelium reduced lung injury to LPS in mice. Similarly, wild-type mice were protected from LPS-induced lung injury following treatment with a pharmacological inhibitor of Mst1/2. Conclusions Our findings identified Mst1 kinase as a key regulator in the control of lung EC activation and suggest that therapeutic strategies aimed at inhibiting Mst1 activation might be effective in the prevention and treatment of lung injury to inflammatory insults.
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11
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Tomei L, Céspedes JA. Stk4, a key regulator in regulatory T cells homeostasis activity? Allergy 2023; 78:2329-2330. [PMID: 37017139 DOI: 10.1111/all.15735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/30/2023] [Indexed: 04/06/2023]
Affiliation(s)
- Leonardo Tomei
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Jose Antonio Céspedes
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain
- Department of Medicine, University of Málaga, Málaga, Spain
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12
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Uygun V, Keleş S, Daloğlu H, Öztürkmen S, Yalçın K, Karasu G, Yeşilipek A. Hematopoietic stem cell transplantation in serine/threonine kinase 4 (STK4) deficiency: Report of two cases and literature review. Pediatr Transplant 2023; 27:e14439. [PMID: 36394186 DOI: 10.1111/petr.14439] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 07/06/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Serine/threonine kinase 4 (STK4) deficiency is a combined immunodeficiency (CID) characterized by early onset recurrent bacterial, viral, and fungal infections. Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapy for CID; however, little is known about the necessity and benefits of HSCT in patients with STK4 deficiency. METHODS We report two siblings with STK4 deficiency transplanted from two unrelated donors with the same conditioning regimen. RESULTS In the conditioning regimen, rituximab was given on Day -11 (375 mg/m2 ), and sirolimus was added on the same day. Busulfan was administered at a myeloablative dose (3.2 mg/kg; Days -7 to -4) with 150 mg/m2 of fludarabine (Days -7 to -3). They were transplanted with peripheral blood stem cells, and graft-versus-host disease (GVHD) prophylaxis was administered with 10 mg/m2 methotrexate on Days 1, 3, and 6. In addition, mycophenolate mofetil (MMF) was started on Day 1 with ongoing use of sirolimus. We did not encounter veno-occlusive disease (VOD), high-grade acute GVHD, or significant organ toxicity in either patient. Both patients were well at the end of the first year after HSCT with complete donor chimerism. CONCLUSIONS Serine/threonine kinase 4 deficiency is a disease with high mortality post-HSCT; therefore, the conditioning regimen and GVHD prophylaxis strategies are important considerations in these patients. In our opinion, the conditioning regimen, which includes rituximab and busulfan and fludarabine (BU-FLU), GVHD prophylaxis with sirolimus and MMF, and short-term methotrexate, offers favorable outcomes and is well tolerated in our STK4-deficient patients.
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Affiliation(s)
- Vedat Uygun
- Faculty of Medicine, MedicalPark Antalya Hospital, Department Of Pediatric Bone Marrow Transplantation Unit, İstinye University, Antalya, Turkey
| | - Sevgi Keleş
- Meram Medical Faculty, Division of Pediatric Immunology and Allergy, Necmettin Erbakan University, Konya, Turkey
| | - Hayriye Daloğlu
- Faculty of Health Sciences, MedicalPark Antalya Hospital, Department Of Pediatric Bone Marrow Transplantation Unit, Antalya Bilim University, Antalya, Turkey
| | - Seda Öztürkmen
- Department Of Pediatric Bone Marrow Transplantation Unit, MedicalPark Antalya Hospital, Antalya, Turkey
| | - Koray Yalçın
- Faculty of Medicine, MedicalPark Göztepe Hospital, Department Of Pediatric Bone Marrow Transplantation Unit, Bahçeşehir University, İstanbul, Turkey
| | - Gülsün Karasu
- Department Of Pediatric Bone Marrow Transplantation Unit, MedicalPark Göztepe Hospital, İstanbul, Turkey
| | - Akif Yeşilipek
- Department Of Pediatric Bone Marrow Transplantation Unit, MedicalPark Antalya Hospital, Antalya, Turkey
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13
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Cui Y, Benamar M, Schmitz-Abe K, Poondi-Krishnan V, Chen Q, Jugder BE, Fatou B, Fong J, Zhong Y, Mehta S, Buyanbat A, Eklioglu BS, Karabiber E, Baris S, Kiykim A, Keles S, Stephen-Victor E, Angelini C, Charbonnier LM, Chatila TA. A Stk4-Foxp3-NF-κB p65 transcriptional complex promotes T reg cell activation and homeostasis. Sci Immunol 2022; 7:eabl8357. [PMID: 36149942 DOI: 10.1126/sciimmunol.abl8357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The molecular programs involved in regulatory T (Treg) cell activation and homeostasis remain incompletely understood. Here, we show that T cell receptor (TCR) signaling in Treg cells induces the nuclear translocation of serine/threonine kinase 4 (Stk4), leading to the formation of an Stk4-NF-κB p65-Foxp3 complex that regulates Foxp3- and p65-dependent transcriptional programs. This complex was stabilized by Stk4-dependent phosphorylation of Foxp3 on serine-418. Stk4 deficiency in Treg cells, either alone or in combination with its homolog Stk3, precipitated a fatal autoimmune lymphoproliferative disease in mice characterized by decreased Treg cell p65 expression and nuclear translocation, impaired NF-κB p65-Foxp3 complex formation, and defective Treg cell activation. In an adoptive immunotherapy model, overexpression of p65 or the phosphomimetic Foxp3S418E in Stk3/4-deficient Treg cells ameliorated their immune regulatory defects. Our studies identify Stk4 as an essential TCR-responsive regulator of p65-Foxp3-dependent transcription that promotes Treg cell-mediated immune tolerance.
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Affiliation(s)
- Ye Cui
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mehdi Benamar
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Klaus Schmitz-Abe
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Varsha Poondi-Krishnan
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", Consiglio Nazionale delle Ricerche, Naples, Italy
| | - Qian Chen
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Bat-Erdene Jugder
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Benoit Fatou
- Department of Pathology, Boston Children's Hospital-Harvard Medical School, Boston, MA, USA
| | - Jason Fong
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Yuelin Zhong
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Stuti Mehta
- Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | | | - Beray Selver Eklioglu
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Esra Karabiber
- Marmara University, Pendik Training And Research Hospital, Department of Chest Disease, Division of Adult Immunology and Allergy, Istanbul, Turkey
| | - Safa Baris
- Marmara University, Faculty of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey.,Marmara University, the Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Ayca Kiykim
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sevgi Keles
- Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Emmanuel Stephen-Victor
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Claudia Angelini
- Istituto per le Applicazioni del Calcolo "M. Picone", Consiglio Nazionale delle Ricerche, Naples, Italy
| | - Louis-Marie Charbonnier
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Talal A Chatila
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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14
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Liquidano-Pérez E, Maza-Ramos G, Yamazaki-Nakashimada MA, Barragán-Arévalo T, Lugo-Reyes SO, Scheffler-Mendoza S, Espinosa-Padilla SE, González-Serrano ME. [Combined immunodeficiency due to DOCK8 deficiency. State of the art]. REVISTA ALERGIA MÉXICO 2022; 69:31-47. [PMID: 36927749 DOI: 10.29262/ram.v69i1.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Combinedimmunodeficiency (CID) due to DOCK8 deficiency is an inborn error of immunity (IBD) characterized by dysfunctional T and B lymphocytes; The spectrum of manifestations includes allergy, autoimmunity, inflammation, predisposition to cancer, and recurrent infections. DOCK8 deficiency can be distinguished from other CIDs or within the spectrum of hyper-IgE syndromes by exhibiting profound susceptibility to viral skin infections, associated skin cancers, and severe food allergies. The 9p24.3 subtelomeric locus where DOCK8 is located includes numerous repetitive sequence elements that predispose to the generation of large germline deletions and recombination-mediated somatic DNA repair. Residual production DOCK8 protein contributes to the variable phenotype of the disease. Severe viral skin infections and varicella-zoster virus (VZV)-associated vasculopathy, reflect an essential role of the DOCK8 protein, which is required to maintain lymphocyte integrity as cells migrate through the tissues. Loss of DOCK8 causes immune deficiencies through other mechanisms, including a cell survival defect. In addition, there are alterations in the response of dendritic cells, which explains susceptibility to virus infection and regulatory T lymphocytes that could help explain autoimmunity in patients. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment; it improves eczema, allergies, and susceptibility to infections.
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Affiliation(s)
- Eduardo Liquidano-Pérez
- Instituto Nacional de Pediatría, Unidad de Investigación en Inmunodeficiencias, Ciudad de México, México
| | | | | | - Tania Barragán-Arévalo
- Fundación de Asistencia Privada, Instituto de Oftalmología Conde de Valenciana, Departamento de Genética, Ciudad de México, México
| | - Saúl Oswaldo Lugo-Reyes
- Instituto Nacional de Pediatría, Unidad de Investigación en Inmunodeficiencias, Ciudad de México, México
| | | | - Sara Elva Espinosa-Padilla
- Instituto Nacional de Pediatría, Unidad de Investigación en Inmunodeficiencias, Ciudad de México, México
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15
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The pediatric common variable immunodeficiency - from genetics to therapy: a review. Eur J Pediatr 2022; 181:1371-1383. [PMID: 34939152 PMCID: PMC8964589 DOI: 10.1007/s00431-021-04287-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/20/2021] [Accepted: 10/03/2021] [Indexed: 12/15/2022]
Abstract
UNLABELLED Common variable immunodeficiency (CVID) is the most prevalent antibody deficiency, characterized by remarkable genetic, immunological, and clinical heterogeneity. The diagnosis of pediatric CVID is challenging due to the immaturity of the immune response and sustained actively developing antibody affinity to antigens and immunological memory that may overlap with the inborn error of immunity. Significant progress has been recently done in the field of immunogenetics, yet a paucity of experimental and clinical studies on different systemic manifestations and immunological features of CVID in children may contribute to a delayed diagnosis and therapy. In this review, we aimed at defining the variable epidemiological, etiological, and clinical aspects of pediatric CVID with special emphasis on predominating infectious and non-infectious phenotypes in affected children. CONCLUSION While pediatric CVID is a multifaceted and notorious disease, increasing the pediatricians' awareness of this disease entity and preventing the diagnostic and therapeutic delay are needed, thereby improving the prognosis and survival of pediatric CVID patients. WHAT IS KNOWN • CVID is an umbrella diagnosis characterized by complex pathophysiology with an antibody deficiency as a common denominator. • It is a multifaceted disease characterized by marked genetic, immunological, and clinical heterogeneity.. WHAT IS NEW • The diagnosis of pediatric CVID is challenging due to the immaturity of innate and adaptive immune response. • Increasing the pediatricians' awareness of CVID for the early disease recognition, timely therapeutic intervention, and improving the prognosis is needed.
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16
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Latour S. Inherited immunodeficiencies associated with proximal and distal defects in T cell receptor signaling and co-signaling. Biomed J 2022; 45:321-333. [PMID: 35091087 PMCID: PMC9250091 DOI: 10.1016/j.bj.2022.01.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sylvain Latour
- Laboratory of Lymphocyte Activation and Susceptibility to EBV infection, Inserm UMR 1163, Université de Paris, Institut Imagine, Paris, France.
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