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Jauch AJ, Bignucolo O, Seki S, Ghraichy M, Delmonte OM, von Niederhäusern V, Higgins R, Ghosh A, Nishizawa M, Tanaka M, Baldrich A, Köppen J, Hirsiger JR, Hupfer R, Ehl S, Rensing-Ehl A, Hopfer H, Prince SS, Daley SR, Marquardsen FA, Meyer BJ, Tamm M, Daikeler TD, Diesch T, Kühne T, Helbling A, Berkemeier C, Heijnen I, Navarini AA, Trück J, de Villartay JP, Oxenius A, Berger CT, Hess C, Notarangelo LD, Yamamoto H, Recher M. Autoimmunity and immunodeficiency associated with monoallelic LIG4 mutations via haploinsufficiency. J Allergy Clin Immunol 2023; 152:500-516. [PMID: 37004747 PMCID: PMC10529397 DOI: 10.1016/j.jaci.2023.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Biallelic mutations in LIG4 encoding DNA-ligase 4 cause a rare immunodeficiency syndrome manifesting as infant-onset life-threatening and/or opportunistic infections, skeletal malformations, radiosensitivity and neoplasia. LIG4 is pivotal during DNA repair and during V(D)J recombination as it performs the final DNA-break sealing step. OBJECTIVES This study explored whether monoallelic LIG4 missense mutations may underlie immunodeficiency and autoimmunity with autosomal dominant inheritance. METHODS Extensive flow-cytometric immune-phenotyping was performed. Rare variants of immune system genes were analyzed by whole exome sequencing. DNA repair functionality and T-cell-intrinsic DNA damage tolerance was tested with an ensemble of in vitro and in silico tools. Antigen-receptor diversity and autoimmune features were characterized by high-throughput sequencing and autoantibody arrays. Reconstitution of wild-type versus mutant LIG4 were performed in LIG4 knockout Jurkat T cells, and DNA damage tolerance was subsequently assessed. RESULTS A novel heterozygous LIG4 loss-of-function mutation (p.R580Q), associated with a dominantly inherited familial immune-dysregulation consisting of autoimmune cytopenias, and in the index patient with lymphoproliferation, agammaglobulinemia, and adaptive immune cell infiltration into nonlymphoid organs. Immunophenotyping revealed reduced naive CD4+ T cells and low TCR-Vα7.2+ T cells, while T-/B-cell receptor repertoires showed only mild alterations. Cohort screening identified 2 other nonrelated patients with the monoallelic LIG4 mutation p.A842D recapitulating clinical and immune-phenotypic dysregulations observed in the index family and displaying T-cell-intrinsic DNA damage intolerance. Reconstitution experiments and molecular dynamics simulations categorize both missense mutations as loss-of-function and haploinsufficient. CONCLUSIONS This study provides evidence that certain monoallelic LIG4 mutations may cause human immune dysregulation via haploinsufficiency.
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Affiliation(s)
- Annaïse J Jauch
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | | | - Sayuri Seki
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Marie Ghraichy
- Division of Immunology and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ottavia M Delmonte
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Valentin von Niederhäusern
- Division of Immunology and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Rebecca Higgins
- Division of Dermatology and Dermatology Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Adhideb Ghosh
- Division of Dermatology and Dermatology Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland; Competence Center for Personalized Medicine, University of Zürich/Eidgenössische Technische Hochschule, Zurich, Switzerland
| | - Masako Nishizawa
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mariko Tanaka
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - Adrian Baldrich
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Julius Köppen
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Julia R Hirsiger
- Translational Immunology, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Robin Hupfer
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Stephan Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty for Medicine, University of Freiburg, Freiburg, Germany
| | - Anne Rensing-Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty for Medicine, University of Freiburg, Freiburg, Germany
| | - Helmut Hopfer
- Institute for Pathology, University Hospital Basel, Basel, Switzerland
| | | | - Stephen R Daley
- Centre for Immunology and Infection Control, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland
| | - Florian A Marquardsen
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Benedikt J Meyer
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Michael Tamm
- Department of Pneumology, University Hospital Basel, Basel, Switzerland
| | - Thomas D Daikeler
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland; University Center for Immunology, University Hospital Basel, Basel, Switzerland
| | - Tamara Diesch
- Division of Pediatric Oncology/Hematology, University Children's Hospital Basel, Basel, Switzerland
| | - Thomas Kühne
- Division of Pediatric Oncology/Hematology, University Children's Hospital Basel, Basel, Switzerland
| | - Arthur Helbling
- Division of Allergology and clinical Immunology, Department of Pneumology and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Caroline Berkemeier
- Division Medical Immunology, Laboratory Medicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Ingmar Heijnen
- Division Medical Immunology, Laboratory Medicine, University of Basel and University Hospital of Basel, Basel, Switzerland
| | - Alexander A Navarini
- Division of Dermatology and Dermatology Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland; University Center for Immunology, University Hospital Basel, Basel, Switzerland
| | - Johannes Trück
- Division of Immunology and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jean-Pierre de Villartay
- Laboratory of Genome Dynamics in the Immune System, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherché 1163, Université Paris Descartes Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Annette Oxenius
- Institute of Microbiology, Eidgenössische Technische Hochschule, Zurich, Switzerland
| | - Christoph T Berger
- Translational Immunology, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland; University Center for Immunology, University Hospital Basel, Basel, Switzerland
| | - Christoph Hess
- University Center for Immunology, University Hospital Basel, Basel, Switzerland; Immunobiology Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland; Cambridge Institute of Therapeutic Immunology and Infectious Disease, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Hiroyuki Yamamoto
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland; AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Mike Recher
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel and University Hospital of Basel, Basel, Switzerland; University Center for Immunology, University Hospital Basel, Basel, Switzerland.
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Kistner A, Bigler MB, Glatz K, Egli SB, Baldin FS, Marquardsen FA, Mehling M, Rentsch KM, Staub D, Aschwanden M, Recher M, Daikeler T, Berger CT. Characteristics of autoantibodies targeting 14-3-3 proteins and their association with clinical features in newly diagnosed giant cell arteritis. Rheumatology (Oxford) 2017; 56:829-834. [PMID: 28064210 DOI: 10.1093/rheumatology/kew469] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Indexed: 01/21/2023] Open
Abstract
Objectives Autoantibodies are useful biomarkers for diagnosing and monitoring treatment in some autoimmune diseases. Antibodies against isoforms of 14-3-3 protein have been proposed as biomarkers for the presence of aortic aneurysm in large-vessel vasculitis (LVV). Here, we aimed to evaluate the diagnostic role and potential immunopathological involvement of anti-14-3-3 antibodies in newly diagnosed LVV patients. Methods Antibodies against three isoforms of 14-3-3 (γ, ɛ and ζ) were measured in 90 subjects: 48 GCA and 3 Takayasu's arteritis (TA) patients, and 39 controls (non-inflammatory and inflammatory diseases), using a multiplexed bead-based immunoassay and immunoprecipitation studies. The positive cut-off value was defined based on young healthy controls. Anti-14-3-3 IgG antibodies in LVV patients were compared with those in controls in order to assess their diagnostic performance, and the relationship of anti-14-3-3 IgG antibodies to the immunohistopathology of artery explants was assessed. Results Antibodies against all three 14-3-3 isoforms were detected in LVV patients as well as in age-matched inflammatory and non-inflammatory controls. Among LVV patients, detection of antibodies targeting 14-3-3 ɛ and ζ was associated with more severe disease. Detection of antibodies against 14-3-3 γ was linked to latent Toxoplasma gondii infection, a parasite that secrets a 14-3-3 homologue, suggesting potential cross-reactivity. Conclusion Detection of antibodies against 14-3-3 proteins at the time of LVV diagnosis is not disease-specific. Their presence at high levels in LVV patients with stroke, aortitis and-in a previous study-aneurysm formation may indicate an association with extensive tissue destruction. The relevance of 14-3-3 antibodies in non-LVV patients needs to be investigated in larger cohorts.
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Affiliation(s)
- Anne Kistner
- Translational Immunology, Department of Biomedicine
| | | | | | - Simon B Egli
- Translational Immunology, Department of Biomedicine
| | | | | | | | | | | | | | - Mike Recher
- Department of Biomedicine, Immunodeficiency Laboratory
- Immunodeficiency Clinic
| | | | - Christoph T Berger
- Translational Immunology, Department of Biomedicine
- Medical Outpatient Clinic, Department of Internal Medicine, University Basel Hospital, Basel, Switzerland
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Marquardsen FA, Baldin F, Wunderer F, Al-Herz W, Mikhael R, Lefranc G, Baz Z, Rezaee F, Hanna R, Kfir-Erenfeld S, Stepensky P, Meyer B, Jauch A, Bigler MB, Burgener AV, Higgins R, Navarini AA, Church JA, Chou J, Geha R, Notarangelo LD, Hess C, Berger CT, Bloch DB, Recher M. Detection of Sp110 by Flow Cytometry and Application to Screening Patients for Veno-occlusive Disease with Immunodeficiency. J Clin Immunol 2017; 37:707-714. [PMID: 28825155 DOI: 10.1007/s10875-017-0431-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 08/03/2017] [Indexed: 01/01/2023]
Abstract
Mutations in Sp110 are the underlying cause of veno-occlusive disease with immunodeficiency (VODI), a combined immunodeficiency that is difficult to treat and often fatal. Because early treatment is critically important for patients with VODI, broadly usable diagnostic tools are needed to detect Sp110 protein deficiency. Several factors make establishing the diagnosis of VODI challenging: (1) Current screening strategies to identify severe combined immunodeficiency are based on measuring T cell receptor excision circles (TREC). This approach will fail to identify VODI patients because the disease is not associated with severe T cell lymphopenia at birth; (2) the SP110 gene contains 17 exons, making it a challenge for Sanger sequencing. The recently developed next-generation sequencing (NGS) platforms that can rapidly determine the sequence of all 17 exons are available in only a few laboratories; (3) there is no standard functional assay to test for the effects of novel mutations in Sp110; and (4) it has been difficult to use flow cytometry to identify patients who lack Sp110 because of the low level of Sp110 protein in peripheral blood lymphocytes. We report here a novel flow cytometric assay that is easily performed in diagnostic laboratories and might thus become a standard assay for the evaluation of patients who may have VODI. In addition, the assay will facilitate investigations directed at understanding the function of Sp110.
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Affiliation(s)
- Florian A Marquardsen
- Immunodeficiency Laboratory, Department of Biomedicine, Basel University Hospital, Basel, Switzerland
| | - Fabian Baldin
- Immunodeficiency Laboratory, Department of Biomedicine, Basel University Hospital, Basel, Switzerland
| | - Florian Wunderer
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School and Massachusetts General Hospital, Massachusetts, MA, 02114, USA
| | - Waleed Al-Herz
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Raymond Mikhael
- Pediatrics Department, Hotel-Dieu Hospital, St Joseph University, Beirut, Lebanon
| | - Gérard Lefranc
- Institute of Human Genetics, UMR 9002 CNRS-University of Montpellier, 34095, Montpellier Cedex 5, France
| | - Zeina Baz
- Saint George Hospital, University Medical Center, Beirut, Lebanon
| | - Fariba Rezaee
- Center for Pediatric Pulmonary Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rabi Hanna
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH, USA
| | | | - Polina Stepensky
- Bone Marrow Transplantation Department, Hadassah Hospital, Jerusalem, Israel
| | - Benedikt Meyer
- Immunodeficiency Laboratory, Department of Biomedicine, Basel University Hospital, Basel, Switzerland
| | - Annaise Jauch
- Immunodeficiency Laboratory, Department of Biomedicine, Basel University Hospital, Basel, Switzerland
| | - Marc B Bigler
- Immune Deficiency Genetics Section, Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Anne-Valérie Burgener
- Immunobiology Laboratory, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - Rebecca Higgins
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | | | - Joeseph A Church
- Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Keck School of Medicine of University Southern California, Los Angeles, CA, USA
| | - Janet Chou
- Division of Immunology, Children's Hospital Boston, Boston, MA, USA
| | - Raif Geha
- Division of Immunology, Children's Hospital Boston, Boston, MA, USA
| | - Luigi D Notarangelo
- Immune Deficiency Genetics Section, Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Christoph Hess
- Immunobiology Laboratory, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - Christoph T Berger
- Translational Immunology, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - Donald B Bloch
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School and Massachusetts General Hospital, Massachusetts, MA, 02114, USA.,Division of Rheumatology, Allergy and Immunology, Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Mike Recher
- Immunodeficiency Laboratory, Department of Biomedicine, Basel University Hospital, Basel, Switzerland.
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Bigler MB, Egli SB, Hysek CM, Hoenger G, Schmied L, Baldin FS, Marquardsen FA, Recher M, Liechti ME, Hess C, Berger CT. Stress-Induced In Vivo Recruitment of Human Cytotoxic Natural Killer Cells Favors Subsets with Distinct Receptor Profiles and Associates with Increased Epinephrine Levels. PLoS One 2015; 10:e0145635. [PMID: 26700184 PMCID: PMC4689586 DOI: 10.1371/journal.pone.0145635] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 12/07/2015] [Indexed: 11/18/2022] Open
Abstract
Background Acute stress drives a ‘high-alert’ response in the immune system. Psychoactive drugs induce distinct stress hormone profiles, offering a sought-after opportunity to dissect the in vivo immunological effects of acute stress in humans. Methods 3,4-methylenedioxymethamphetamine (MDMA), methylphenidate (MPH), or both, were administered to healthy volunteers in a randomized, double-blind, placebo-controlled crossover-study. Lymphocyte subset frequencies, natural killer (NK) cell immune-phenotypes, and changes in effector function were assessed, and linked to stress hormone levels and expression of CD62L, CX3CR1, CD18, and stress hormone receptors on NK cells. Results MDMA/MPH > MDMA > MPH robustly induced an epinephrine-dominant stress response. Immunologically, rapid redistribution of peripheral blood lymphocyte-subsets towards phenotypically mature NK cells occurred. NK cytotoxicity was unaltered, but they expressed slightly reduced levels of the activating receptor NKG2D. Preferential circulation of mature NK cells was associated with high epinephrine receptor expression among this subset, as well as expression of integrin ligands previously linked to epinephrine-induced endothelial detachment. Conclusion The acute epinephrine-induced stress response was characterized by rapid accumulation of mature and functional NK cells in the peripheral circulation. This is in line with studies using other acute stressors and supports the role of the acute stress response in rapidly mobilizing the innate immune system to counteract incoming threats.
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MESH Headings
- Cells, Cultured
- Cross-Over Studies
- Double-Blind Method
- Epinephrine/blood
- Female
- Flow Cytometry
- Humans
- Immunophenotyping
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Lymphocyte Subsets/immunology
- Lymphocyte Subsets/metabolism
- Male
- RNA, Messenger/genetics
- Real-Time Polymerase Chain Reaction
- Receptors, Adrenergic, beta-2/genetics
- Receptors, Adrenergic, beta-2/metabolism
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Stress, Physiological/immunology
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Affiliation(s)
- Marc B. Bigler
- Translational Immunology, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Simon B. Egli
- Translational Immunology, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Cédric M. Hysek
- Clinical Pharmacology, Dep. of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Gideon Hoenger
- Immunobiology Lab, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Laurent Schmied
- Immunotherapy Laboratory, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Fabian S. Baldin
- Immunodeficiency Lab, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Florian A. Marquardsen
- Immunodeficiency Lab, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Mike Recher
- Immunodeficiency Lab, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
- Medical Outpatient Clinic, Dep. of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Matthias E. Liechti
- Clinical Pharmacology, Dep. of Internal Medicine, University Hospital Basel, Basel, Switzerland
- * E-mail: (CTB); (MEL)
| | - Christoph Hess
- Immunobiology Lab, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
- Medical Outpatient Clinic, Dep. of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Christoph T. Berger
- Translational Immunology, Dep. of Biomedicine, University Hospital Basel, Basel, Switzerland
- Medical Outpatient Clinic, Dep. of Internal Medicine, University Hospital Basel, Basel, Switzerland
- * E-mail: (CTB); (MEL)
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