1
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Schwierzeck V, Effner R, Abel F, Reiger M, Notheis G, Held J, Simon V, Dintner S, Hoffmann R, Hagl B, Huebner J, Mellmann A, Renner ED. Molecular Assessment of Staphylococcus Aureus Strains in STAT3 Hyper-IgE Syndrome Patients. J Clin Immunol 2022; 42:1301-1309. [PMID: 35655107 PMCID: PMC9537231 DOI: 10.1007/s10875-022-01293-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/17/2022] [Indexed: 10/27/2022]
Abstract
Hyper-IgE syndromes (HIES) are a group of inborn errors of immunity (IEI) caused by monogenic defects such as in the gene STAT3 (STAT3-HIES). Patients suffering from HIES show an increased susceptibility to Staphylococcus aureus (S. aureus) including skin abscesses and pulmonary infections. To assess if the underlying immune defect of STAT3-HIES patients influences the resistance patterns, pathogenicity factors or strain types of S. aureus. We characterized eleven S. aureus strains isolated from STAT3-HIES patients (n = 4) by whole genome sequencing (WGS) to determine presence of resistance and virulence genes. Additionally, we used multi-locus sequence typing (MLST) and protein A (spa) typing to classify these isolates. Bacterial isolates collected from this cohort of STAT3-HIES patients were identified as common spa types in Germany. Only one of the isolates was classified as methicillin-resistant S. aureus (MRSA). For one STAT3 patient WGS illustrated that infection and colonization occurred with different S. aureus isolates rather than one particular clone. The identified S. aureus carriage profile on a molecular level suggests that S. aureus strain type in STAT3-HIES patients is determined by local epidemiology rather than the underlying immune defect highlighting the importance of microbiological assessment prior to antibiotic treatment.
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Affiliation(s)
- Vera Schwierzeck
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany. .,Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany. .,Institute of Hygiene, University Hospital Münster, 48149, Münster, Germany.
| | - Renate Effner
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany
| | - Felicitas Abel
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany.,University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337, Munich, Germany
| | - Matthias Reiger
- Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany.,Department of Environmental Medicine, Medical Faculty of University Augsburg, 86156, Augsburg, Germany
| | - Gundula Notheis
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany.,University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337, Munich, Germany
| | - Jürgen Held
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen und Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Valeska Simon
- Institute for Laboratory Medicine and Microbiology, University Hospital Augsburg, 86156, Augsburg, Germany
| | - Sebastian Dintner
- Institute of Pathology, University Hospital Augsburg, 86156, Augsburg, Germany
| | - Reinhard Hoffmann
- Institute for Laboratory Medicine and Microbiology, University Hospital Augsburg, 86156, Augsburg, Germany
| | - Beate Hagl
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany.,University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337, Munich, Germany
| | - Johannes Huebner
- University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337, Munich, Germany
| | - Alexander Mellmann
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany
| | - Ellen D Renner
- Translational Immunology in Environmental Medicine, School of Medicine, Technical University of Munich, 81675, Munich, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany.,Department of Pediatrics, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, 80804, Munich, Germany
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2
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Redor A, Danion F, Parize P, Chandesris O, Dbjay J, Duréault A, Le Guenno G, Cazorla C, Vergnon-Miszczycha D, Bats AS, Bodemer C, Hoarau C, Charlier C, Mahlaoui N, Lecuit M, Lanternier F, Lortholary O. Devastating Gynecological Infections in Women with STAT3 Deficiency. Clin Infect Dis 2021; 71:e186-e190. [PMID: 31916572 DOI: 10.1093/cid/ciaa020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/08/2020] [Indexed: 11/12/2022] Open
Abstract
We provide the first description of a series of 9 severe gynecological infections (mastitis and pelvic cellulitis) occurring in the French national cohort of women with STAT3 deficiency. Each episode had unique features in terms of clinical presentation, microbial documentation, location, treatment duration, and related persistent esthetic damage.
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Affiliation(s)
- Alexis Redor
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France
| | - François Danion
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France
| | - Perrine Parize
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France
| | - Olivia Chandesris
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France
| | - Jonathan Dbjay
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France
| | - Amélie Duréault
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France
| | - Guillaume Le Guenno
- Department of Internal Medicine, University Estaing Hospital, Clermont Ferrand, France
| | - Celine Cazorla
- Department of Infectious Diseases and Tropical Medicine, University Hospital, Saint Etienne, France
| | | | - Anne Sophie Bats
- Paris University, Department of Gynecologic Surgery, Georges Pompidou University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christine Bodemer
- Paris University, Department of Dermatology, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, IHU Imagine, Paris, France
| | - Cyrille Hoarau
- Department of Immunology, University Hospital, Tours, France
| | - Caroline Charlier
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France.,French National Reference Center for Primary Immune Deficiencies, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Institut Pasteur, National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, Paris, France
| | - Nizar Mahlaoui
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France.,French National Reference Center for Primary Immune Deficiencies, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Pediatric Immuno-Hematology and Rheumatology Unit, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marc Lecuit
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France.,French National Reference Center for Primary Immune Deficiencies, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Institut Pasteur, Biology of Infection Unit, Inserm, Paris, France
| | - Fanny Lanternier
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France.,French National Reference Center for Primary Immune Deficiencies, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Institut Pasteur, National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, Paris, France
| | - Olivier Lortholary
- Paris University, Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University Hospital Institute (IHU) Imagine, Paris, France.,French National Reference Center for Primary Immune Deficiencies, Necker Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Institut Pasteur, National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, Paris, France
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3
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Park B, Liu GY. Staphylococcus aureus and Hyper-IgE Syndrome. Int J Mol Sci 2020; 21:ijms21239152. [PMID: 33271763 PMCID: PMC7729741 DOI: 10.3390/ijms21239152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 12/30/2022] Open
Abstract
Hyper-immunoglobulin E syndrome (HIES) is a primary immunodeficiency disease characterized by recurrent Staphylococcus aureus (S. aureus) infections, eczema, skeletal abnormalities and high titers of serum immunoglobulin E. Although the genetic basis of HIES was not known for almost a half century, HIES most frequently exhibits autosomal dominant trait that is transmitted with variable expressivity. Careful genetic studies in recent years identified dominant-negative mutations in human signal transducer and activator of transcription 3 (STAT3) gene as the cause of sporadic and dominant forms of HIES. The STAT3 mutations were localized to DNA-binding, SRC homology 2 (SH2) and transactivating domains and disrupted T helper 17 (TH17) cell differentiation and downstream expression of TH17 cytokines IL-17 and IL-22. Deficiency of IL-17 and IL-22 in turn is responsible for suboptimal expression of anti-staphylococcal host factors, such as neutrophil-recruiting chemokines and antimicrobial peptides, by human keratinocytes and bronchial epithelial cells. TH17 cytokines deficiency thereby explains the recurrent staphylococcal lung and skin infections of HIES patients.
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Affiliation(s)
- Bonggoo Park
- Division of Pediatric Infectious Diseases and the Immunobiology Research Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - George Y. Liu
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence:
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4
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Meixner I, Hagl B, Kröner CI, Spielberger BD, Paschos E, Dückers G, Niehues T, Hesse R, Renner ED. Retained primary teeth in STAT3 hyper-IgE syndrome: early intervention in childhood is essential. Orphanet J Rare Dis 2020; 15:244. [PMID: 32912316 PMCID: PMC7488068 DOI: 10.1186/s13023-020-01516-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND STAT3 hyper-IgE syndrome (STAT3-HIES) is a rare primary immunodeficiency that clinically overlaps with atopic dermatitis. In addition to eczema, elevated serum-IgE, and recurrent infections, STAT3-HIES patients suffer from characteristic facies, midline defects, and retained primary teeth. To optimize dental management we assessed the development of dentition and the long-term outcomes of dental treatment in 13 molecularly defined STAT3-HIES patients using questionnaires, radiographs, and dental investigations. RESULTS Primary tooth eruption was unremarkable in all STAT3-HIES patients evaluated. Primary tooth exfoliation and permanent tooth eruption was delayed in 83% of patients due to unresorbed tooth roots. A complex orthodontic treatment was needed for one patient receiving delayed extraction of primary molars and canines. Permanent teeth erupted spontaneously in all patients receiving primary teeth extraction of retained primary teeth during average physiologic exfoliation time. CONCLUSIONS The association of STAT3-HIES with retained primary teeth is important knowledge for dentists and physicians as timely extraction of retained primary teeth prevents dental complications. To enable spontaneous eruption of permanent teeth in children with STAT3-HIES, we recommend extracting retained primary incisors when the patient is not older than 9 years of age and retained primary canines and molars when the patient is not older than 13 years of age, after having confirmed the presence of the permanent successor teeth by radiograph.
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Affiliation(s)
- Iris Meixner
- University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, Munich, Germany
- Oral and maxillofacial surgery, Ludwig Maximilian University, Munich, Germany
| | - Beate Hagl
- University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, Munich, Germany
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and HelmholtzZentrum München, Munich/Augsburg, Germany
| | - Carolin I Kröner
- University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, Munich, Germany
| | - Benedikt D Spielberger
- University Children's Hospital, Dr. von Haunersches Kinderspital, Ludwig Maximilian University, Munich, Germany
| | - Ekaterini Paschos
- Department of orthodontics, Ludwig Maximilian University, Munich, Germany
| | | | - Tim Niehues
- HELIOS Children's Hospital, Krefeld, Germany
| | - Ronny Hesse
- Oral and maxillofacial surgery, Ludwig Maximilian University, Munich, Germany
| | - Ellen D Renner
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and HelmholtzZentrum München, Munich/Augsburg, Germany.
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5
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Hanitsch L, Baumann U, Boztug K, Burkhard-Meier U, Fasshauer M, Habermehl P, Hauck F, Klock G, Liese J, Meyer O, Müller R, Pachlopnik-Schmid J, Pfeiffer-Kascha D, Warnatz K, Wehr C, Wittke K, Niehues T, von Bernuth H. Treatment and management of primary antibody deficiency: German interdisciplinary evidence-based consensus guideline. Eur J Immunol 2020; 50:1432-1446. [PMID: 32845010 DOI: 10.1002/eji.202048713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/25/2020] [Accepted: 08/20/2020] [Indexed: 12/13/2022]
Abstract
This evidence-based clinical guideline provides consensus-recommendations for the treatment and care of patients with primary antibody deficiencies (PADs). The guideline group comprised 20 clinical and scientific expert associations of the German, Swiss, and Austrian healthcare system and representatives of patients. Recommendations were based on results of a systematic literature search, data extraction, and evaluation of methodology and study quality in combination with the clinical expertise of the respective representatives. Consensus-based recommendations were determined via nominal group technique. PADs are the largest clinically relevant group of primary immunodeficiencies. Most patients with PADs present with increased susceptibility to infections, however immune dysregulation, autoimmunity, and cancer affect a significant number of patients and may precede infections. This guideline therefore covers interdisciplinary clinical and therapeutic aspects of infectious (e.g., antibiotic prophylaxis, management of bronchiectasis) and non-infectious manifestations (e.g., management of granulomatous disease, immune cytopenia). PADs are grouped into disease entities with definitive, probable, possible, or unlikely benefit of IgG-replacement therapy. Summary and consensus-recommendations are provided for treatment indication, dosing, routes of administration, and adverse events of IgG-replacement therapy. Special aspects of concomitant impaired T-cell function are highlighted as well as clinical data on selected monogenetic inborn errors of immunity formerly classified into PADs (APDS, CTLA-4-, and LRBA-deficiency).
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Affiliation(s)
- Leif Hanitsch
- Institute for Medical Immunology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Ulrich Baumann
- Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany
| | - Kaan Boztug
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Department of Pediatrics and Adolescent Medicine and St. Anna Kinderspital and Children's Cancer Research Institute, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Maria Fasshauer
- ImmunoDeficiencyCenter Leipzig (IDCL), Hospital St. Georg gGmbH Leipzig, Academic Teaching Hospital of the University of Leipzig, Leipzig, Germany
| | | | - Fabian Hauck
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Gerd Klock
- Technische Universität Darmstadt, Clemens-Schöpf-Institut für Organische Chemie & Biochemie, Darmstadt, Germany
| | - Johannes Liese
- Pediatric Immunology, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Oliver Meyer
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rainer Müller
- Klinik und Poliklinik für HNO-Heilkunde, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Jana Pachlopnik-Schmid
- Division of Immunology, University Children's Hospital Zurich and University of Zurich, Switzerland
| | | | - Klaus Warnatz
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Chronic Immunodeficiency, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claudia Wehr
- Center for Chronic Immunodeficiency, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kirsten Wittke
- Institute for Medical Immunology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Tim Niehues
- Department of Pediatrics, Helios Klinikum Krefeld, Krefeld, Germany
| | - Horst von Bernuth
- Department of Immunology, Labor Berlin Charité - Vivantes GmbH, Berlin, Germany.,Berlin Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
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6
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Veen W, Krätz CE, McKenzie CI, Aui PM, Neumann J, Noesel CJM, Wirz OF, Hagl B, Kröner C, Spielberger BD, Akdis CA, Zelm MC, Akdis M, Renner ED. Impaired memory B-cell development and antibody maturation with a skewing toward IgE in patients with STAT3 hyper-IgE syndrome. Allergy 2019; 74:2394-2405. [PMID: 31269238 DOI: 10.1111/all.13969] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 04/10/2019] [Accepted: 05/22/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Signal transducer and activator of transcription 3 hyper-IgE syndrome (STAT3-HIES) is caused by heterozygous mutations in the STAT3 gene and is associated with eczema, elevated serum IgE, and recurrent infections resembling severe atopic dermatitis, while clinically relevant specific IgE is almost absent. METHODS To investigate the impact of STAT3 signaling on B-cell responses, we assessed lymph node and bone marrow, blood B and plasma cell subsets, somatic hypermutations in Ig genes, and in vitro proliferation and antibody production in STAT3-HIES patients and healthy controls. RESULTS Lymph nodes of STAT3-HIES patients showed normal germinal center architecture and CD138+ plasma cells residing in the paracortex, which expressed IgE, IgG, and IgM but not IgA. IgE+ plasma cells were abundantly present in STAT3-HIES bone marrow. Proliferation of naive B cells upon stimulation with CD40L and IL-4 was similar in patients and controls, while patient cells showed reduced responses to IL-21. IgE, IgG1, IgG3 and IgA1 transcripts showed reduced somatic hypermutations. Peripheral blood IgE+ memory B-cell frequencies were increased in STAT3-HIES, while other memory B-cell frequencies except for IgG4+ cells were decreased. CONCLUSIONS Despite impaired STAT3 signaling, STAT3-HIES patients can mount in vivo T-cell-dependent B-cell responses, while circulating memory B cells, except for those expressing IgG4 and IgE, were reduced. Reduced molecular maturation demonstrated the critical need of STAT3 signaling for optimal affinity maturation and B-cell differentiation, supporting the need for immunoglobulin substitution therapy and explaining the high IgE serum level in the majority with absent allergic symptoms.
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Affiliation(s)
- Willem Veen
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Carolin E. Krätz
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- University Children's Hospital at Dr. von Haunersches Kinderspital Ludwig Maximilian University Munich Germany
| | - Craig I. McKenzie
- Department of Immunology and Pathology Monash University Melbourne Victoria Australia
- The Jeffrey Modell Diagnostic and Research Centre for Primary Immunodeficiencies in Melbourne Melbourne Victoria Australia
| | - Pei M. Aui
- Department of Immunology and Pathology Monash University Melbourne Victoria Australia
- The Jeffrey Modell Diagnostic and Research Centre for Primary Immunodeficiencies in Melbourne Melbourne Victoria Australia
| | - Jens Neumann
- Pathology Department Ludwig Maximilian University Munich Germany
| | - Carel J. M. Noesel
- Department of Pathology Academic Medical Center Amsterdam The Netherlands
| | - Oliver F. Wirz
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Beate Hagl
- University Children's Hospital at Dr. von Haunersches Kinderspital Ludwig Maximilian University Munich Germany
- Environmental Medicine, UNIKA‐T Augsburg Technische Universität München and Helmholtz Zentrum München Germany
| | - Carolin Kröner
- University Children's Hospital at Dr. von Haunersches Kinderspital Ludwig Maximilian University Munich Germany
| | - Benedikt D. Spielberger
- University Children's Hospital at Dr. von Haunersches Kinderspital Ludwig Maximilian University Munich Germany
- Environmental Medicine, UNIKA‐T Augsburg Technische Universität München and Helmholtz Zentrum München Germany
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Menno C. Zelm
- Department of Immunology and Pathology Monash University Melbourne Victoria Australia
- The Jeffrey Modell Diagnostic and Research Centre for Primary Immunodeficiencies in Melbourne Melbourne Victoria Australia
- Department of Allergy, Immunology and Respiratory Medicine Alfred Hospital Melbourne Victoria Australia
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Ellen D. Renner
- Christine Kühne Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Environmental Medicine, UNIKA‐T Augsburg Technische Universität München and Helmholtz Zentrum München Germany
- Hochgebirgsklinik Davos Davos Switzerland
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7
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Ferraro A, Buonocore SM, Auquier P, Nicolas I, Wallemacq H, Boutriau D, van der Most RG. Role and plasticity of Th1 and Th17 responses in immunity to Staphylococcus aureus. Hum Vaccin Immunother 2019; 15:2980-2992. [PMID: 31149870 PMCID: PMC6930085 DOI: 10.1080/21645515.2019.1613126] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The human commensal Staphylococcus aureus (SA) is a leading cause of skin/soft tissue and surgical-site infections, and bacteremia. Functional antibodies and T-cell-mediated immunity, particularly Th1/Th17 responses, are thought to mediate protection. Vaccine development may be hindered by modulation of vaccine-induced T cells by pathogen-activated immunoregulatory responses, e.g., via IL-10.We screened SA proteins for CD4+ T-cell-activating and IL-10/IL-17-inducing capacities using healthy donor-derived PBMCs. Responses were characterized (Th1/Th17/Th22/immunosuppressive IL-10-producing cells) using intracellular cytokine staining and flow cytometry. Phenotypic plasticity of Th1/Th17 cells was evaluated under pro- or anti-inflammatory conditions using modulatory cytokines. The impact of vaccination on SA-specific memory responses was assessed using samples from a clinical trial evaluating AS03-adjuvanted and non-adjuvanted multicomponent (CPS5/CPS8/α-toxin/ClfA) vaccines (NCT01160172).The donors exhibited SA-specific memory T-cell responses, indicative of pre-existing immunity to SA. We identified effective activators of Th1 responses (EbhA/IsaA/SdrE/MntC/Aaa/α-toxin), and Th17 and Th1/Th17 responses (EbhA/IsaA/SdrE and, to a lesser extent, α-toxin), but not of Th22 responses or IL-10 production. MRPII, IsdA, and ClfA were inefficient CD4+ T-cell activators in our assays. IL-10, likely produced by innate immune cells, influenced mainly Th1 cells by suppressing IFN-γ production. The memory CD4+ T-cells observed after long-term stimulation with α-toxin and ClfA indicated that vaccination with these proteins had induced expansion of pre-existing Th1 but not Th17 responses, without apparent adjuvant effect, confirming the trial data. The Th1/Th17-driving proteins (EbhA/IsaA/SdrE) shared low IL-10-promoting abilities and restricted phenotypic plasticity under pro- and anti-inflammatory conditions.Given the complex immunopathology and multiple virulence factors, identification of Th1/Th17-driving antigens, adjuvants and administration routes, and delineation of the role of memory responses, may advance vaccine development.
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8
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Kröner C, Neumann J, Ley‐Zaporozhan J, Hagl B, Meixner I, Spielberger BD, Dückers G, Belohradsky BH, Niehues T, Borte M, Rosenecker J, Kappler M, Nährig S, Reu S, Griese M, Renner ED. Lung disease in STAT3 hyper-IgE syndrome requires intense therapy. Allergy 2019; 74:1691-1702. [PMID: 30793327 DOI: 10.1111/all.13753] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/26/2018] [Accepted: 10/31/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Pulmonary complications are responsible for high morbidity and mortality rates in patients with the rare immunodeficiency disorder STAT3 hyper-IgE syndrome (STAT3-HIES). The aim of this study was to expand knowledge about lung disease in STAT3-HIES. METHODS The course of pulmonary disease, radiological and histopathological interrelations, therapeutic management, and the outcome of 14 STAT3-HIES patients were assessed. RESULTS The patients' quality of life was compromised most by pulmonary disease. All 14 patients showed first signs of lung disease at a median onset of 1.5 years of age. Lung function revealed a mixed obstructive-restrictive impairment with reduced FEV1 and FVC in 75% of the patients. The severity of lung function impairment was associated with Aspergillus fumigatus infection and prior lung surgery. Severe lung tissue damage, with reduced numbers of ATP-binding cassette sub-family A member 3 (ABCA3) positive type II pneumocytes, was observed in the histological assessment of two deceased patients. Imaging studies of all patients above 6 years of age showed severe airway and parenchyma destruction. Lung surgeries frequently led to complications, including fistula formation. Long-term antifungal and antibacterial treatment proved to be beneficial, as were inhalation therapy, chest physiotherapy, and exercise. Regular immunoglobulin replacement therapy tended to stabilize lung function. CONCLUSIONS Due to its severity, pulmonary disease in STAT3-HIES patients requires strict monitoring and intensive therapy.
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Affiliation(s)
- Carolin Kröner
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
- German Center for Lung research (DZL) Munich Germany
| | - Jens Neumann
- Institute of Pathology Faculty of Medicine Ludwig Maximilian University Munich Germany
| | | | - Beate Hagl
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
- Environmental Medicine UNIKA‐T Technical University of Munich and HelmholtzZentrum Munich Munich/Augsburg Germany
| | - Iris Meixner
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
| | - Benedikt D. Spielberger
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
- Environmental Medicine UNIKA‐T Technical University of Munich and HelmholtzZentrum Munich Munich/Augsburg Germany
| | | | - Bernd H. Belohradsky
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
| | | | - Michael Borte
- Children's Hospital St. Georg Klinikum Leipzig Germany
| | - Joseph Rosenecker
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
| | - Matthias Kappler
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
| | - Susanne Nährig
- Medizinische Klinik und Poliklinik Ludwig Maximilian University Munich Germany
| | - Simone Reu
- Institute of Pathology Faculty of Medicine Ludwig Maximilian University Munich Germany
| | - Matthias Griese
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
- German Center for Lung research (DZL) Munich Germany
| | - Ellen D. Renner
- Department of Pediatrics Dr. von Hauner Children's Hospital Ludwig Maximilian University Munich Germany
- Environmental Medicine UNIKA‐T Technical University of Munich and HelmholtzZentrum Munich Munich/Augsburg Germany
- Hochgebirgsklinik and Christine Kühne‐Center for Allergy Research and Education (CK‐Care) Davos Switzerland
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9
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Darisipudi MN, Nordengrün M, Bröker BM, Péton V. Messing with the Sentinels-The Interaction of Staphylococcus aureus with Dendritic Cells. Microorganisms 2018; 6:microorganisms6030087. [PMID: 30111706 PMCID: PMC6163568 DOI: 10.3390/microorganisms6030087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/12/2018] [Accepted: 08/14/2018] [Indexed: 12/14/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is a dangerous pathogen as well as a frequent colonizer, threatening human health worldwide. Protection against S. aureus infection is challenging, as the bacteria have sophisticated strategies to escape the host immune response. To maintain equilibrium with S. aureus, both innate and adaptive immune effector mechanisms are required. Dendritic cells (DCs) are critical players at the interface between the two arms of the immune system, indispensable for inducing specific T cell responses. In this review, we highlight the importance of DCs in mounting innate as well as adaptive immune responses against S. aureus with emphasis on their role in S. aureus-induced respiratory diseases. We also review what is known about mechanisms that S. aureus has adopted to evade DCs or manipulate these cells to its advantage.
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Affiliation(s)
- Murthy N Darisipudi
- Department of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße DZ7, D-17475 Greifswald, Germany.
| | - Maria Nordengrün
- Department of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße DZ7, D-17475 Greifswald, Germany.
| | - Barbara M Bröker
- Department of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße DZ7, D-17475 Greifswald, Germany.
| | - Vincent Péton
- Department of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße DZ7, D-17475 Greifswald, Germany.
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10
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Romero Pastrana F, Neef J, Koedijk DGAM, de Graaf D, Duipmans J, Jonkman MF, Engelmann S, van Dijl JM, Buist G. Human antibody responses against non-covalently cell wall-bound Staphylococcus aureus proteins. Sci Rep 2018; 8:3234. [PMID: 29459694 PMCID: PMC5818649 DOI: 10.1038/s41598-018-21724-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 02/06/2018] [Indexed: 12/28/2022] Open
Abstract
Human antibody responses to pathogens, like Staphylococcus aureus, are important indicators for in vivo expression and immunogenicity of particular bacterial components. Accordingly, comparing the antibody responses to S. aureus components may serve to predict their potential applicability as antigens for vaccination. The present study was aimed at assessing immunoglobulin G (IgG) responses elicited by non-covalently cell surface-bound proteins of S. aureus, which thus far received relatively little attention. To this end, we applied plasma samples from patients with the genetic blistering disease epidermolysis bullosa (EB) and healthy S. aureus carriers. Of note, wounds of EB patients are highly colonized with S. aureus and accordingly these patients are more seriously exposed to staphylococcal antigens than healthy individuals. Ten non-covalently cell surface-bound proteins of S. aureus, namely Atl, Eap, Efb, EMP, IsaA, LukG, LukH, SA0710, Sle1 and SsaA2, were selected by bioinformatics and biochemical approaches. These antigens were recombinantly expressed, purified and tested for specific IgG responses using human plasma. We show that high exposure of EB patients to S. aureus is mirrored by elevated IgG levels against all tested non-covalently cell wall-bound staphylococcal antigens. This implies that these S. aureus cell surface proteins are prime targets for the human immune system.
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Affiliation(s)
- Francisco Romero Pastrana
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - Jolanda Neef
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - Dennis G A M Koedijk
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - Douwe de Graaf
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - José Duipmans
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - Marcel F Jonkman
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - Susanne Engelmann
- Institute of Microbiology, Technical University Braunschweig, Inhoffenstrasse 7, D-38124, Braunschweig, Germany.,Helmholtz Institute for Infection Research, Microbial Proteomics, Inhoffenstrasse 7, D-38124, Braunschweig, Germany
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands.
| | - Girbe Buist
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
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