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Fan J, Hale VL, Lelieveld LT, Whitworth LJ, Busch-Nentwich EM, Troll M, Edelstein PH, Cox TM, Roca FJ, Aerts JMFG, Ramakrishnan L. Gaucher disease protects against tuberculosis. Proc Natl Acad Sci U S A 2023; 120:e2217673120. [PMID: 36745788 PMCID: PMC7614233 DOI: 10.1073/pnas.2217673120] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/31/2022] [Indexed: 02/08/2023] Open
Abstract
Biallelic mutations in the glucocerebrosidase (GBA1) gene cause Gaucher disease, characterized by lysosomal accumulation of glucosylceramide and glucosylsphingosine in macrophages. Gaucher and other lysosomal diseases occur with high frequency in Ashkenazi Jews. It has been proposed that the underlying mutations confer a selective advantage, in particular conferring protection against tuberculosis. Here, using a zebrafish Gaucher disease model, we find that the mutation GBA1 N370S, predominant among Ashkenazi Jews, increases resistance to tuberculosis through the microbicidal activity of glucosylsphingosine in macrophage lysosomes. Consistent with lysosomal accumulation occurring only in homozygotes, heterozygotes remain susceptible to tuberculosis. Thus, our findings reveal a mechanistic basis for protection against tuberculosis by GBA1 N370S and provide biological plausibility for its selection if the relatively mild deleterious effects in homozygotes were offset by significant protection against tuberculosis, a rampant killer of the young in Europe through the Middle Ages into the 19th century.
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Affiliation(s)
- Jingwen Fan
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- MRC Laboratory of Molecular Biology, CambridgeCB2 0QH, UK
| | | | - Lindsey T. Lelieveld
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University2333 CC, Leiden, The Netherlands
| | - Laura J. Whitworth
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- MRC Laboratory of Molecular Biology, CambridgeCB2 0QH, UK
| | - Elisabeth M. Busch-Nentwich
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- School of Biological and Behavioral Sciences, Queen Mary University of London, LondonE1 4NS, UK
| | - Mark Troll
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- MRC Laboratory of Molecular Biology, CambridgeCB2 0QH, UK
| | - Paul H. Edelstein
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PhiladelphiaPA19104
| | - Timothy M. Cox
- Department of Medicine, University of Cambridge, CambridgeCB2 0QQ, UK
| | - Francisco J. Roca
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia30120, Spain
- Biomedical Research Institute of Murcia Pascual Parrilla (IMIB-Arrixaca), Murcia30120, Spain
| | - Johannes M. F. G. Aerts
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University2333 CC, Leiden, The Netherlands
| | - Lalita Ramakrishnan
- Molecular Immunity Unit, Cambridge Institute of Therapeutic Immunology and Infectious Diseases, Department of Medicine, University of Cambridge, CambridgeCB2 0QH, UK
- MRC Laboratory of Molecular Biology, CambridgeCB2 0QH, UK
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