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Rosain J, Le Voyer T, Liu X, Gervais A, Polivka L, Cederholm A, Berteloot L, Parent AV, Pescatore A, Spinosa E, Minic S, Kiszewski AE, Tsumura M, Thibault C, Esnaola Azcoiti M, Martinovic J, Philippot Q, Khan T, Marchal A, Charmeteau-De Muylder B, Bizien L, Deswarte C, Hadjem L, Fauvarque MO, Dorgham K, Eriksson D, Falcone EL, Puel M, Ünal S, Geraldo A, Le Floc'h C, Li H, Rheault S, Muti C, Bobrie-Moyrand C, Welfringer-Morin A, Fuleihan RL, Lévy R, Roelens M, Gao L, Materna M, Pellegrini S, Piemonti L, Catherinot E, Goffard JC, Fekkar A, Sacko-Sow A, Soudée C, Boucherit S, Neehus AL, Has C, Hübner S, Blanchard-Rohner G, Amador-Borrero B, Utsumi T, Taniguchi M, Tani H, Izawa K, Yasumi T, Kanai S, Migaud M, Aubart M, Lambert N, Gorochov G, Picard C, Soudais C, L'Honneur AS, Rozenberg F, Milner JD, Zhang SY, Vabres P, Trpinac D, Marr N, Boddaert N, Desguerre I, Pasparakis M, Miller CN, Poziomczyk CS, Abel L, Okada S, Jouanguy E, Cheynier R, Zhang Q, Cobat A, Béziat V, Boisson B, Steffann J, Fusco F, Ursini MV, Hadj-Rabia S, Bodemer C, Bustamante J, Luche H, Puel A, Courtois G, Bastard P, Landegren N, Anderson MS, Casanova JL. Incontinentia pigmenti underlies thymic dysplasia, autoantibodies to type I IFNs, and viral diseases. J Exp Med 2024; 221:e20231152. [PMID: 39352576 PMCID: PMC11448874 DOI: 10.1084/jem.20231152] [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: 07/06/2023] [Revised: 07/17/2024] [Accepted: 08/27/2024] [Indexed: 10/05/2024] Open
Abstract
Human inborn errors of thymic T cell tolerance underlie the production of autoantibodies (auto-Abs) neutralizing type I IFNs, which predispose to severe viral diseases. We analyze 131 female patients with X-linked dominant incontinentia pigmenti (IP), heterozygous for loss-of-function (LOF) NEMO variants, from 99 kindreds in 10 countries. Forty-seven of these patients (36%) have auto-Abs neutralizing IFN-α and/or IFN-ω, a proportion 23 times higher than that for age-matched female controls. This proportion remains stable from the age of 6 years onward. On imaging, female patients with IP have a small, abnormally structured thymus. Auto-Abs against type I IFNs confer a predisposition to life-threatening viral diseases. By contrast, patients with IP lacking auto-Abs against type I IFNs are at no particular risk of viral disease. These results suggest that IP accelerates thymic involution, thereby underlying the production of auto-Abs neutralizing type I IFNs in at least a third of female patients with IP, predisposing them to life-threatening viral diseases.
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Affiliation(s)
- Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, France
| | - Tom Le Voyer
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Clinical Immunology Department, AP-HP, Saint-Louis Hospital, Paris, France
| | - Xian Liu
- Diabetes Center, University of California San Francisco , San Francisco, CA, USA
| | - Adrian Gervais
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Laura Polivka
- Department of Dermatology, Reference Center for Genodermatosis and Rare Skin Diseases (MAGEC), University of Paris Cité, Necker Hospital for Sick Children, AP-HP, Paris, France
- Reference Center for Mastocytosis (CEREMAST), Necker Hospital for Sick Children, AP-HP , Paris, France
| | - Axel Cederholm
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Laureline Berteloot
- Pediatric Radiology Department, Necker Hospital for Sick Children, Imagine Inserm Institute, U1163, AP-HP, Paris, France
| | - Audrey V Parent
- Diabetes Center, University of California San Francisco , San Francisco, CA, USA
| | - Alessandra Pescatore
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso," IGB-CNR , Naples, Italy
| | - Ezia Spinosa
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso," IGB-CNR , Naples, Italy
| | - Snezana Minic
- Clinics of Dermatovenerology, Clinical Center of Serbia , Belgrade, Serbia
- School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Ana Elisa Kiszewski
- Section of Dermatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
- Section of Pediatric Dermatology, Hospital da Criança Santo Antônio, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Miyuki Tsumura
- Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima, Japan
| | - Chloé Thibault
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Maria Esnaola Azcoiti
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Jelena Martinovic
- Unit of Fetal Pathology, Hospital Antoine Béclère, Paris Saclay University , Paris, France
| | - Quentin Philippot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Taushif Khan
- Department of Immunology, Sidra Medicine, Doha, Qatar
| | - Astrid Marchal
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | | | - Lucy Bizien
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Caroline Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Lillia Hadjem
- Immunophenomics Center (CIPHE), Aix Marseille University, Inserm, CNRS , Marseille, France
| | | | - Karim Dorgham
- Sorbonne University, Inserm, Centre for Immunology and Microbial Infections, CIMI-Paris , Paris, France
| | - Daniel Eriksson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Emilia Liana Falcone
- Center for Immunity, Inflammation and Infectious Diseases, Montréal Clinical Research Institute (IRCM) , Montréal, Canada
- Department of Medicine, Montréal University, Montréal, Canada
| | - Mathilde Puel
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, France
| | - Sinem Ünal
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Amyrath Geraldo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Corentin Le Floc'h
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Hailun Li
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Sylvie Rheault
- Department of Medicine, Montréal University, Montréal, Canada
- Center of Research of the Geriatric University Institute of Montréal, University of Montréal , Montréal, Canada
| | - Christine Muti
- Department of Genetics, André Mignot Hospital, Versailles, France
| | | | - Anne Welfringer-Morin
- Department of Dermatology, Reference Center for Genodermatosis and Rare Skin Diseases (MAGEC), University of Paris Cité, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Ramsay L Fuleihan
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Romain Lévy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Marie Roelens
- Imagine Institute, University of Paris Cité , Paris, France
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, France
| | - Liwei Gao
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Marie Materna
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Silvia Pellegrini
- Diabetes Research Institute, IRCCS Ospedale San Raffaele , Milan, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, IRCCS Ospedale San Raffaele , Milan, Italy
| | | | - Jean-Christophe Goffard
- Internal Medicine, Brussels University Hospital, Free University of Brussels, Anderlecht, Belgium
| | - Arnaud Fekkar
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- Department of Parasitology Mycology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Aissata Sacko-Sow
- Department of Pediatrics, Jean Verdier Hospital, AP-HP, Bondy, France
| | - Camille Soudée
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Soraya Boucherit
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Anna-Lena Neehus
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Cristina Has
- Department of Dermatology, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
- European Reference Network (ERN) for Rare and Undiagnosed Skin Disorders
| | - Stefanie Hübner
- Department of Dermatology, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Géraldine Blanchard-Rohner
- Unit of Immunology, Vaccinology, and Rheumatology, Division of General Pediatrics, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Blanca Amador-Borrero
- Internal Medicine Department, Lariboisière Hospital, AP-HP, University of Paris Cité, Paris, France
| | - Takanori Utsumi
- Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima, Japan
| | - Maki Taniguchi
- Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima, Japan
| | - Hiroo Tani
- Department of Pediatrics, Hiroshima University Hospital, Hiroshima, Japan
- Department of Pediatrics, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Kazushi Izawa
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahiro Yasumi
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Kanai
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Mélanie Migaud
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
| | - Mélodie Aubart
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- Departments of Pediatric Neurology, Necker Hospital for Sick Children, AP-HP, University of Paris Cité, Paris, France
| | - Nathalie Lambert
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, France
| | - Guy Gorochov
- Sorbonne University, Inserm, Centre for Immunology and Microbial Infections, CIMI-Paris , Paris, France
- Department of Immunology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Capucine Picard
- Imagine Institute, University of Paris Cité , Paris, France
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, France
- Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, Inserm U1163, Paris, France
| | - Claire Soudais
- Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, Inserm U1163, Paris, France
| | - Anne-Sophie L'Honneur
- Department of Virology, University of Paris Cité and Cochin Hospital, AP-HP, Paris, France
| | - Flore Rozenberg
- Department of Virology, University of Paris Cité and Cochin Hospital, AP-HP, Paris, France
| | - Joshua D Milner
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Shen-Ying Zhang
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Pierre Vabres
- MAGEC Reference Center for Rare Skin Diseases, Dijon Bourgogne University Hospital, Dijon, France
| | - Dusan Trpinac
- Institute of Histology and Embryology, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Nico Marr
- Department of Immunology, Sidra Medicine, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University , Doha, Qatar
| | - Nathalie Boddaert
- Pediatric Radiology Department, Necker Hospital for Sick Children, Imagine Inserm Institute, U1163, AP-HP, Paris, France
| | - Isabelle Desguerre
- Departments of Pediatric Neurology, Necker Hospital for Sick Children, AP-HP, University of Paris Cité, Paris, France
| | | | - Corey N Miller
- Diabetes Center, University of California San Francisco , San Francisco, CA, USA
| | | | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Satoshi Okada
- Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima, Japan
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Rémi Cheynier
- University of Paris Cité, CNRS, Inserm, Institut Cochin , Paris, France
| | - Qian Zhang
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Aurélie Cobat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Vivien Béziat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Bertrand Boisson
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Julie Steffann
- Department of Genomic Medicine, Necker Hospital for Sick Children, AP-HP, University of Paris Cité, Paris, France
| | - Francesca Fusco
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso," IGB-CNR , Naples, Italy
| | - Matilde Valeria Ursini
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso," IGB-CNR , Naples, Italy
| | - Smail Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatosis and Rare Skin Diseases (MAGEC), University of Paris Cité, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Christine Bodemer
- Department of Dermatology, Reference Center for Genodermatosis and Rare Skin Diseases (MAGEC), University of Paris Cité, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, France
| | - Hervé Luche
- Immunophenomics Center (CIPHE), Aix Marseille University, Inserm, CNRS , Marseille, France
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Gilles Courtois
- University Grenoble Alpes, CEA, Inserm , BGE UA13, Grenoble, France
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Nils Landegren
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden
| | - Mark S Anderson
- Diabetes Center, University of California San Francisco , San Francisco, CA, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris Cité , Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Department of Pediatrics, Necker Hospital for Sick Children, AP-HP, Paris, France
- Howard Hughes Medical Institute , New York, NY, USA
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