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Aba Ü, Maslak İC, İpşir C, Pehlivan D, Warnock NI, Tumes DJ, Cildir G, Erman B. A Novel Homozygous Germline Mutation in Transferrin Receptor 1 (TfR1) Leads to Combined Immunodeficiency and Provides New Insights into Iron-Immunity Axis. J Clin Immunol 2024; 44:55. [PMID: 38270687 PMCID: PMC10811203 DOI: 10.1007/s10875-024-01658-0] [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: 11/08/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
A homozygous missense mutation in the transferrin receptor 1 (TfR1), also known as CD71, leads to a rare inborn error of immunity (IEI) characterized by the impaired lymphocyte activation and proliferation due to defective iron uptake of cells. However, only one causative mutation (c.58T > C, p.Y20H) in the TFRC gene coding for TfR1 has been reported so far. We herein identified a new disease-causing homozygous germline mutation in the TFRC gene (c.64C > T, p.R22W) (referred to as TfR1R22W from now on) in a Turkish patient with combined immunodeficiency (CID). TfR1R22W results in impaired TfR1 internalization similar to previously defined TfR1Y20H mutation. We found that TfR1R22W is associated with severely restricted B and T lymphocyte clonal diversity and impaired T cell activation and cytokine production as well as defective mitochondrial oxidative phosphorylation in helper T cells. In addition, circulating NK, Treg, and MAIT cell populations were significantly decreased in the patient. Using whole transcriptome analysis, we found dysregulated immune homeostasis and novel biological processes associated with TfR1R22W. We also identified a considerable expansion of circulating low-density neutrophils (LDNs) in patient's PBMCs. Overall, TfR1R22W mutation expands the current understanding of the IEI associated with TfR1 dysfunction and provides new insights underlying impaired immune function, lymphocyte diversity, and granulocyte homeostasis.
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Affiliation(s)
- Ümran Aba
- Department of Pediatric Immunology, Institute of Child Health, Hacettepe University, Ankara, Türkiye
- Can Sucak Research Laboratory for Translational Immunology, Hacettepe University, Ankara, Türkiye
| | - İbrahim Cemal Maslak
- Division of Pediatric Allergy and Immunology, Süleyman Demirel University, Isparta, Türkiye
| | - Canberk İpşir
- Department of Pediatric Immunology, Institute of Child Health, Hacettepe University, Ankara, Türkiye
- Can Sucak Research Laboratory for Translational Immunology, Hacettepe University, Ankara, Türkiye
| | - Damla Pehlivan
- Can Sucak Research Laboratory for Translational Immunology, Hacettepe University, Ankara, Türkiye
| | - Nicholas I Warnock
- Centre for Cancer Biology, SA Pathology and the University of South Australia, Adelaide, SA, 5000, Australia
| | - Damon J Tumes
- Centre for Cancer Biology, SA Pathology and the University of South Australia, Adelaide, SA, 5000, Australia
| | - Gökhan Cildir
- Centre for Cancer Biology, SA Pathology and the University of South Australia, Adelaide, SA, 5000, Australia.
- UniSA Bradley Building, North Terrace, Adelaide, SA, 5000, Australia.
| | - Baran Erman
- Can Sucak Research Laboratory for Translational Immunology, Hacettepe University, Ankara, Türkiye.
- Institute of Child Health, Hacettepe University, Ankara, Türkiye.
- Beytepe Campus of Hacettepe University, HUNITEK Building, Floor 1, 06800, Ankara, Türkiye.
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