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Lopez-Rivera DO, Castano-Jaramillo LM, Yamazaki-Nakashimada MA, Ramirez Uribe RMN, Corcuera Delgado CT, Ignorosa-Arellano KR, Medina-Torres EA, Berrón Ruiz L, Espinosa-Padilla SE, Scheffler-Mendoza SC, López-Velázquez G, Cruz-Munoz ME, Lugo Reyes SO. Not enough by half: NFAT5 haploinsufficiency in two patients with Epstein-Barr virus susceptibility. Front Immunol 2022; 13:959733. [PMID: 36238298 PMCID: PMC9552184 DOI: 10.3389/fimmu.2022.959733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction The transcription factor Nuclear factor of activated T cells 5 (NFAT5), pivotal in immune regulation and function, can be induced by osmotic stress and tonicity-independent signals. Objective We aimed to investigate and characterize two unrelated patients with Epstein-Barr virus susceptibility and no known genetic etiology. Methods After informed consent, we reviewed the electronic charts, extracted genomic DNA, performed whole-exome sequencing, filtered, and prioritized their variants, and confirmed through Sanger sequencing, family segregation analysis, and some functional assays, including lymphoproliferation, cytotoxicity, and characterization of natural killer cells. Results We describe two cases of pediatric Mexican patients with rare heterozygous missense variants in NFAT5 and EBV susceptibility, a school-age girl with chronic-active infection of the liver and bowel, and a teenage boy who died of hemophagocytic lymphohistiocytosis. Discussion NFAT5 is an important regulator of the immune response. NFAT5 haploinsufficiency has been described as an immunodeficiency syndrome affecting both innate and adaptive immunity. EBV susceptibility might be another manifestation in the spectrum of this disease.
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Affiliation(s)
- Daniela Olivia Lopez-Rivera
- Molecular Immunology laboratory at the Faculty of Medicine, Universidad Autonoma del Estado de Morelos, Cuernavaca, Mexico
| | - Lina Maria Castano-Jaramillo
- Pediatric Immunology Department, Fundación Hospital de la Misericordia (HOMI) Hospital de la Misericordia, Bogotá, Colombia
- Clinical Immunology Service, National Institute of Pediatrics, Health Secretariat, Mexico City, Mexico
| | | | | | | | | | | | - Laura Berrón Ruiz
- Immune Deficiencies Laboratory, National Institute of Pediatrics, Health Secretariat, Mexico City, Mexico
| | - Sara Elva Espinosa-Padilla
- Immune Deficiencies Laboratory, National Institute of Pediatrics, Health Secretariat, Mexico City, Mexico
| | | | - Gabriel López-Velázquez
- Immune Deficiencies Laboratory, National Institute of Pediatrics, Health Secretariat, Mexico City, Mexico
| | - Mario Ernesto Cruz-Munoz
- Molecular Immunology laboratory at the Faculty of Medicine, Universidad Autonoma del Estado de Morelos, Cuernavaca, Mexico
| | - Saul O. Lugo Reyes
- Immune Deficiencies Laboratory, National Institute of Pediatrics, Health Secretariat, Mexico City, Mexico
- *Correspondence: Saul O. Lugo Reyes,
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